2004-7-23-15655-Ch17Parasitology╲╲病理学课件.ppt

Parasitosis and Deep fungal disease Tian Dong Ping 田东萍 Dept. of Pathology Shantou University Medical College Amoebic dysentery Ⅰ. Etiology: Amaebiasis is also an infectious disease of digestive tract——caused by entamoeba histolytica. Two forms- trophozoites and cysts: cysts are ingested- enter the lower part of ileum and upper part of the colon- transform to trophozoites Ⅱ. Pathogenesis: The trophozoites penetrate the mucosa and release membrane- bound cytolytic ezymes – damage of mucosa (liquefactive necrosis) , cytotoxin- enterotoxin- caused diarrhea and mucosa damage Ⅲ. Pathological changes: Location- cecum, ascending colon, sigmoid and rectum There are stages Grossly: Solitary or multiple, 80% right lobe, 10% left lobe, 10% both The abscess contains a brown-pasty material (liquefactive necrosis and old blood) it appears ragged due to incompletely liquefied necrosis 1. Acute lesion The initial lesion is located in the surface of intes-tinal mucosa- crypts of colonic glands Multiple elevated lesion with grayish- yellow color can be seen- necrotic- superficial ulceration . The trophozoites penetrate the muscularis mucosa into the submucosa- large undermined flask- shaped ulceration can be seen The trophozoites found between viable tissue and necrotic tissoe. Clinically: Abdominal pain diarrhea Stools contain mucus blood and necrotic tissue 2. Chronic stage: The pathological changes are very complicated – necrosis, ulceration, granulation tissue and scar formation may alternate polyp formation fibrosis Amoebic liver abscess The parasite reach the liver through the portal vein. Clinically Fever, abdominal pain at right upper part of the abdomen The liver is enlarged and tender. Deep fungal disease Disease caused by fungi are called mycosis two groups: 1. The superficial mycosis—dermatophytosis 2. The deep or systemic mycosis- candiasis, aspergillosis, cryptococcosis, mucormycosis. Pathogenesis of fungi may