Typoid Fever伤寒.ppt

Typhoid Fever Dept. Infectious Disease 2nd Affiliated Hospital CMU Definition Typhoid fever is an acute infectious disease of digestive tract caused by typhoid bacillus. Place of lesson lymphatics in the terminal ileum Pathological feature proliferation of large mononuclear cells derived from MPS Definition Clinical feature sustained fever relative slow pulse toxic symptoms a rose-color rash splenomegaly and hepatomegaly leukopenia Complication hemorrhage perforation Etiology Causative organism: Typhoid bacillus genus salmonella group D Pathogenicity: endotoxin Resistance: Stable in environment, sensitive to heat, acid, common disinfectants Etiology Antigenicity: O antigen: lipopolysaccharide group-special H antigen: protein, strain-special Vi antigen: polysaccharide Pathogenesis Bacillus Stomach killed by gastric acid incubation Small intestine penetrate mucosa period Regional lymphatics Blood stream - first bacteremia initial MPS in liver, spleen, bone marrow Blood stream -second bacteremia endotoxin liver spleen regional lymphotics Clinical symptoms absces inflammation Pathology Proliferation of large mononuclear cell 1st week 2nd 3rd week 4th week proliferation necrosis heal edema ulceration no scar Clinical manifestation Incubation period: 7-23 day(average 10 to 14 days) Typical typhoid fever: Initial period Fastigium Defervescence Convalescence Clinical manifestation Initial period onset: insidious, gradual fever: T stepwise fashion rising non-special symptoms: Clinical manifestation Fastigium sustained