系统病理学 (30)系统病理学.pdf

Overview of Infectious Diseases and Tuberculosis n Definition Ø Reservoir of infectious agents Ø Routes of infection Ø Susceptible host n Infectious agents n Techniques for identifying infectious agents n Routes of entry and dissemination of microbes n Pathogenesis Disease-producing properties of pathogen VS Defense capability of host n Host defenses Ø Skin: tough keratinized barrier, low pH, fatty acids, normal microbiota Ø Respiratory system: alveolar macrophages and mucociliary clearance by bronchial epithelium, IgA Ø Gastrointestinal system: acidic gastric pH, viscous mucus, pancreatic enzymes and bile, defensins, IgA, and normal flora Ø Urogenital tract: repeated flushing and acidic environment created by commensal vaginal flora n Microbial strategies against host immunity Ø Anti-genic variation Ø Inactivating antibodies or complement Ø Resisting phagocytosis Ø Escaping the phagosome Ø Viral latency Ø Suppressing the host adaptive immune response n Morphology Inflammation Ø Neutrophil-rich acute suppurative inflammation →“pyogenic” bacteria and some fungi Ø Mononuclear cell infiltrates →many chronic infections and some acute viral infections Ø Granulomatous inflammation →my cobacterium tuberculosis and certain fungi Ø Cytopathic and proliferative lesions →some viruses Ø Necrosis →microbes producing tissue-damaging toxins, such as C. p erf ringens Ø Chronic inflammation and scarring →final common pathway of many infections n The contents to study Ø Epidemiology Ø Chain of transmission Ø Pathogen Ø Pathogenesis Ø Patterns of inflammation Ø Clinical features Ø Diagnosis, especially pathogen identification Ø Prognosis and outcome n Epide