志贺氏细菌性痢疾教学讲义.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. * * * Etiology Agent: genus Shigella: non-motile, non-spore-forming, Gram negative bacillus 4 species: A S. dysenteriae :13 B S. flexneri:6 C S. boydii:18 D S. sonnei:1 Viability: strong,1-3weeks, sensitive to mercuric chloride, * Epidemiology Source of infection： Reservoir: Humans/primates Carriers, chronic patients, Atypical patients Mode of Transmission Fecal-oral, Person-to-person, oral-genital Ingestion of contaminated food and/or drink Contact with contaminated inanimate objects Houseflies 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, m