志贺氏细菌性痢疾.pptVIP

Treatment---Chronic type General treatment: Symptomatic treatment: antispasmodic sedatives Etiological treatment: longer, repeat, multi-type retention enema  * Prevention * isolate after the symptoms disappeared, stool culture negative for twice observe Close contacts: observed medically for 7 days. Disrupt Sanitation control, avoid crowded and unclear environment Protect Protection of the susceptible population--vaccines * * * * * * *  * * 便秘constipation * *  * SHIGELLOSIS Definition Shigellosis is an intestinal infection caused by a genus of bacteria known as Shigella that causes diarrheal disease of the colon or large intestines. * Epidemiology Susceptible population: universe 2nd, 3rd year Epidemical features The peak incidence is in July to October * * cell invasion Intracellular multiply Intra and intercellular spread Host cell killing Pathogenesis colonic epithelial cells Enterotoxin, cytotoxin, cytokine-mediated inflammation, necrosis Pathogenesis * pathological features of the Sigmoid colon and rectum Acute period： Fibrin diffuse exudative inflammation Severe cases : pseudomembranes, Ulcerations polymorphonuclear and mononuclear cells infiltration, Mild cases: Diffuse edema of congestive, visible mucus exudation of blood. Chronic period: Mucosal edema, bowel wall thickening, scar formation, polypformation, intestinal stricture Pathogenesis of shigellosis in humans * * Pathological features of the Sigmoid colon and rectum * Clinical Manifestations Incubation Period Average: 1-3 (up to 4) days Range: 12 to 96 hours, up to 8 days Disease presentation, severity, and case fatality - dependent upon: Host Bacterial serotype and numbers  Clinical Manifestation Disease typical Presentation: Fever, nausea, vomiting, Dysentery (blood, mucus) ,frequent, small-volume, Tenesmus Abdominal pain (lower left abdominal quadrants) * Mild type : Low fever, Diarrhea 10 times/day, Mucoid but no bloody stools, No urgency and painful de