传染病学教学课件1typhoid伤寒.pptx

Typhoid FeverDept. Infectious Disease2nd Affiliated HospitalCMU DefinitionTyphoid fever is an acute infectious disease of digestive tract caused by typhoid bacillus.Lesion lymphatics in the terminal ileumPathological feature proliferation of large mononuclear macrophage cells DefinitionClinical feature continued fever relative slow pulse toxic symptoms rose rash splenomegaly and hepatomegaly leukopenia Complication hemorrhage perforation EtiologyEtiology EtiologyPathogen: Typhoid bacillus genus salmonella group DPathogenicity: endotoxinResistance: Stable in environment, sensitive to heat, acid, common disinfectants EtiologyAntigenicity:O antigen: lipopolysaccharide group-specialH antigen: protein, strain-specialVi antigen: polysaccharide EtiologyEpidemiologySource of infection Patient, Carrier, shed bacteria in feces 1. The best known carrier was Typhoid Mary. Mary Mallon was a cook in Oyster Bay, New York in 1906 who is known to have infected 53 people, 5 of whom died. 2. Later returned with false name but detained and quarantined after another typhoid outbreak. 3. She died of pneumonia after 26 years in quarantine. EpidemiologySource of infection Patient, Carrier, shed bacteria in fecesRoute of transmission Fecal-oral route:contaminated food or watercontagious spread spread by insectSusceptibility Epidemic features sporadic cases high incidence in fall summer Pathogenesis Bacillus Stomach killed by gastric acid Small intestine penetrate mucosa Regional lymphatics incubation period Blood stream - first bacteremia MPS in liver, spleen, bone marrow Blood stream -second bacteremia endotoxin liver spleen regional lymphotics clinical symptoms swelling inflammation PathologyProliferation of large mononuclear cell 1st week 2nd 3rd week 4th weekproliferation necrosis heal edema ulceration no scarPathologyPathologyPathologyTyphoid cellPath