系统病理学 (32)系统解剖学.pdf

Typhoid fever and Bacillary Dysentery n Types by rod-shaped bacteria Ø Tuberculosis Ø Typhoid fever Ø Bacillary dysentry Ø Leprosy Ø Others n Brief overview Ø Systemic diseases: Enteric fever Ø Salmonella typ hi Children and adolescents in endemic areas Ø Salmonella p aratyp hi Travelers, developed countries n Brief overview ØTransmission route: Fecal-oral, from the patients and carriers (Gallbladder colonization →chronic carrier state) ØMorpholgy: Acute granulomatous inflammation, but lack of neutrophils infiltration n Chronic carrier state n Etiology Salmonella typ hi ØGram-negative bacilli, motile ØSomatic antigen (O antigen) Diagnosis ØFlagellar antigen (H antigen) ØSurface antigen (Vi antigen) Chronic carriers n Morphology Systemic disease Ø Lymphoid tissues l Intestine: ileum l Mesenteric lymph nodes l Spleen l Liver l Bone marrow Ø Gallbladder n Morphology Granulomatous inflammation Four stages Ø A: Hyperplasia Ø B: Necrosis Ø C: Ulceration Ø D: Healing N indicates healthy intestine N A B C D Typhoid nodule n Morphology Typhoid cell ：Large macrophages containing erythrocytes, lymphocytes, bacteria,necrotic cellular debris Typhoid nodule：Typhoid granuloma, aggregates of typh