Download Infectious Disease

THE SYLLABUS OF INFECTIOUS DISEASES
Applicable Students: Six-year system oversea students in the department of
clinical medicine.
Class Hours: It takes 36 hours to study this course. The study of theory consists of
24 hours and the laboratory practices take up 12 hours.
Course Introduction:
Infectious disease is the study of how pathogens transmit diseases and how to
prevent diseases. The emphasis lies on the pathogenesis, clinical manifestations,
diagnosis and treatment of these diseases.
The Basic Objectives:
And students are to master the epidemic features of infectious diseases, the
pathogenesis, the clinical manifestations, diagnosis and differentiated diagnosis,
principles of treatment and prevention. Through the practical classes students are to
master the skills of treatment and prevention of common infectious diseases.
Teaching Hours Distribution
Chapter
Contents
Lecture
Chapter 1
Introduction
2
Chapter 3. 1
Viral Hepatitis
4
Chapter 5.5
Shigellosis
2
Chapter 3.9
Hemorrhagic Fever with Renal Syndrome
4
Chapter 5.2
Meningcoccal Meningitides
2
Chapter 3.3
Epidemic Encephalitis B
1
Chapter 3.8
Measles
1
Chapter 7.1
Amebiasis
2
Chapter5.3
Typhoid fever and Paratyphoid fever
2
Chapter5.1
Scarlet Fever
1
Chapter4.1
Epidemic Typhus
1
Practice
Chapter5.6
Cholera
2
Pratical 1
Summary and Viral Hepatitis
4
Pratical 2
Differentiated about Rashes and other
Infectious Diseases
4
Pratical 3
Viral Hepatitis and other Diseases
4
Total
24
12
Theoretical part (24hours)
CHAPTER 1: INTRODUCTION
[Objectives]
1. Understand concept of infection, effect of pathogen, the nature of communicable
disease, immunology range, essential changes in pathogenesis and pathology.
2. Grasp three essential links of the epidemiology process, influencing factors for
epidemiologic process, essential features for infectious disease, clinical features.
3. Master contagious process manifestation, the essential features and clinical phases,
diagnosis and treatment for infectious disease, principles for prevention.
[Contents]
Theory
1. Infection concept; Contagious process manifestation; pathogen’s effect in the
contagious process;
2. Host defense mechanisms; microorganism- host interactions; pathology of
infection; major manifestation of infection; three essential links of the
epidemiologic process; communicable disease features;
3. Clinical features:
4. Llaboratory examination: general examination, pathogenic examination, immunity
test, and biopsy histopathology examination.
5. Principle management of infection: principle: colligation therapy; method: General
management: insulation, nursing care, psychiatric care, etc.
6. Therapy for pathogens: chemical therapy, antibiotic therapy, and blood serum
therapy.
7. Prevention: management of the source of infection; break route of transmission;
protection susceptibility.
Practice
The diagnosis and treatment principles of sepsis and other infectious syndromes
CHAPTER 3.1: VORAL HEPATITIS
[Objectives]
1. Understand epidemiology, pathogenesis;
2. Grasp treatment and prophylaxis;
3. Master the features of the hepatitis A/ B virus (HAV, HBV). Antigen-antibody
system of the hepatitis B and its isoforms, major clinical manifestations, diagnosis
and major differential diagnosis
[Contents]
1. Antigen-antibody system of the hepatitis B. Antigen-antibody system of hepatitis A,
C and E.
2. Epidemiology: the patient and virus carrier are a major source of infection.
3. Clinical manifestation: general feature; clinical course of hepatitis A, B, C, D and
E. clinical types. Clinical features in children, old people and pregnancy.
4. Laboratory examination: liver function test: enzyme, plasma-protein, pigment
metabolism and others; etiology test; imaging examination; liver biopsy.
5. Complication and sequel.
6. Diagnosis: epidemiologic evidence; clinical diagnosis; etiology
7. Diagnosis differential diagnosis: different with alcoholic hepatitis, drug related
hepatitis, hemolytic jaundice and obstructive jaundice outside the liver, etc;
8. Prognosis: prognosis in several of hepatitis. Hepatitis is related to cirrhosis of the
liver and hepatocarcinoma.
9. Treatment: to take rest and appropriate diet. Application and assessment for various
“care liver” drugs. Application for immunologic drugs. Antiviral therapy; hepatitis
gravis and therapy for complications.
10. Definitions and hazards; etiology: type A, B, C, D and E. Hepatitis A/ B virus
features.
11. Pathogenesis: HAV, HBV, HCV, HDV, HEV;
12. Prophylaxis: management of the source of infection. Break transmission.
Hepatitis A vaccine and normal human immunoglobulin; hepatitis B vaccine and
high valence immunoglobulin.
CHAPTER 5.5: SHIGELLOSIS
[Objectives]
1. Understand pathogenesis and prevention;
2. Grasp etiology and epidemiology;
3. Master clinical manifestations; clinical type; laboratory examination; diagnosis and
differential diagnosis; treatment
[Contents]
Theory
1. Etiology: Shigella;
2. Epidemiology: source of infection; routes of infection; susceptible population;
epidemiologic feature.
3. Pathogenesis;
4. Clinical manifestations: clinical type; complications;
5. Laboratory examination: stool culture;
6. Diagnosis and differential diagnosis;
7. Treatment.
Practice
Feces screen of the patients; the diagnosis and treatment of infectious diarrhea.
CHAPTER 3.9: HEMORRHAGIC FEVER WITH RENAL
SYNDROME
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations( five stages), clinical type; diagnosis and principle
of treatment
[Contents]
Theory
1. Definition and brief introduction;
2. Etiology: hantaviruses; genome and structural proteins; morphology; typing and
biology; physical and chemical properties;
3. Epidemiology: source of infection; routes of infection; susceptible population;
4. Epidemiologic feature: geographic distribution, epidemic type
5. Pathogenesis and pathology:
6. Clinical manifestations: five stages; different symptoms in five stages;
complications and clinical types;
7. Laboratory Examination: blood routine examination, urine routine examination,
blood chemistry, and serology experiments; virus detection;
8. Diagnosis and differential diagnosis:
9. Prophylaxis: killing the mice, preventing contact with mice, personal protection
and vaccination.
Practice
1. The representative symptom of HFRS
2. The diagnosis of HFRS
3. The treatment principle of HFRS
CHAPTER 5.2: MENINGOCOCCAL MENINGITIDES
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, clinical type; laboratory examination, diagnosis and
treatment
[Contents]
1. Definition and brief introduction;
2. Etiology: Neisseria menigitidis;
3. Epidemiology: source of infection; routes of infection (contact transmission,
airborne transmission, common vertical transmission, vector-borne transmission);
susceptible population; epidemiologic feature;
4. Pathogenesis and pathology;
5. Clinical manifestations: symptoms; physical signs, clinical type;
6. Laboratory examination: blood routine examination, cerebrospinal fluid, imaging
studies, electroencephalogram, blood culture or CSF culture;
7. Diagnosis
and
differential
Diagnosis:
epidemical
information,
clinical
manifestations and the result of bacteria culture. Differentiated from menigitis
caused by viruses or other bacteria;
8. Complications:
9. Treatment: medical care, surgical care;
10. Prophylaxis: immunoprophylaxis (vaccination), chemoprophylaxis (rifampin,
ciprofloxacin, ceftriaxone).
Practice
1. The manifestations, diagnosis, empirical antibiotic treatment of purulent meningitis
2. The indication for lumbar puncture
CHAPTER 3.3: EPIDEMIC ENCEPHALITIS B
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, clinical stages; diagnosis and principle of treatment
[Contents]
1. Etiology: encephalitis B virus;
2. Epidemiology: source of infection (pig); routes of infection (the main vectoros
mosquito); susceptible population; epidemiologic feature;
3. Pathogenesis and pathology;
4. Clinical manifestations: incubation stage, primary stage, proximity stage,
convalescense stage;
5. Laboratory examination:
6. Diagnosis
and
differential
diagnosis:
epidemical
information,
clinical
manifestations and laboratory examinations. Differentiated from menigitis caused
by bacteria and cerebral malaria; prognosis;
7. Treatment: basic principle; prophylaxis:control mosquito, eliminationg human
exposure to infected mosquito, immunization( vaccine).
CHAPTER 3.8: MEASLES
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, cinical stages; diagnosis and principle of treatment
[Contents]
1. Etiology: measles virus;
2. Epidemiology: source of infection (patients); routes of infection (aerosal
transmission); susceptible population; epidemiologic feature;
3. Pathogenesis and pathology: viremia, characterized changes in pathology
(infiltration of monomuclear cells and formation of multinucleate giant cells);
4. Clinical manifestations:
5. Laboratory examination:
6. Diagnosis
and
differential
diagnosis:
epidemical
information,
clinical
manifestations (Koplik spots, maculopapular rash) and laboratory examinations
(viral isolation and antibody detection). Differentiated from rubella, exanthem
subitum, drug induced skin rash; prognosis;
7. Treatment: general measure, symptomatic therapy, treatment of complications;
8. Prevention: isolation of the source of infection, cutting down the route of
transmission, protecting the susceptibles, passive immunization.
CHAPTER 7.1: AMEBIASIS
[Objectives]
1. Understand pathogenesis , pathology, prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, diagnosis and principle of treatment
[Contents]
1. Etiology: Entamoeba histolytica;
2. Epidemiology: source of infection; routes of infection; susceptible population;
epidemiologic feature;
3. Pathogenesis and pathology: route and process of amebiasis cysts invading the
human body; the position of pathological process and the character of ulceration;
relationship between pathological process and clinical symptoms, pathological
changes of complications;
4. Clinical manifestations;
5. Complications;
6. Laboratory examination: stool examination, serological test, endoscopy, image
techniques, other investigation;
7. Diagnosis
and
differential
diagnosis:
epidemical
information,
clinical
manifestations. Amebic colitis should be differentiated from bacillary dysentery,
schistosomiasis japonicum, carcinoma of colon, nonspecific ulcerative colitis;
amebic liver abscess should be differentiated from primary hepatocarcinoma and
bacteria liver abscess.
8. Prognosis;
9. Treatment: general measure, anti-amebic therapy, antibiotics, aspiration of liver
abscess, surgical treatment;
10. Prophylaxis: management of cases, breaking off transmission route, vaccine.
CHAPTER 5.3: TYPHOID FEVER AND PARATYPHOID
FEVER
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master the clinical manifestations of the three types
4. Master the significance of the different specimen culture, principle of treatment.
[Contents]
Typhoid fever
1. Definition and clinical features;
2. Etiology: introduce the trait, resistance and antigen city of the typhoid bacilli;
3. Epidemiology: source of infection, route of transmission, susceptible population,
epidemiologic feature;
4. Pathogenesis and path anatomy: the way which organisms enter the body,
pathologic change, and disease process. The relationship between the bacterium
and intestinal pathological changes with the clinical situation;
5. Clinical manifestation: incubation period, the key features of symptoms, signs and
clinical course of the typical cases. The clinical manifestations of the atypical
types.
6. Relapse and recrudescence. The character of typhoid fever in children and older
people; complication: ischemia of intestine, intestinal perforation, toxic
myocarditis, et al;
7. Laboratory examination
8. Diagnosis and differential diagnosis;
9. Prognosis.
10. Treatment;
11. Prophylaxis.
Paratyphoid fever
Master the three types of paratyphoid fever and character of epidemiology, clinical
manifestations, diagnosis, treatment, and prophylaxis. Compare the two diseases,
typhoid fever and paratyphoid fever.
CHAPTER 4.1: EPIDEMIC TYPHUS
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, clinical types; diagnosis and principle of treatment
[Contents]
1. Etiology: rickettsia prowazekii, antigens system, sensitivity;
2. Epidemiology: source of infection; routes of infection; susceptible population;
epidemiologic feature;
3. Pathogenesis and pathology: vasculitis;
4. Clinical manifestations: clinical type, fever, rash, symptoms of CNS, splenomegaly
and hepatomegaly, symptom of cardiovascular system;
5. Laboratory examination
6. Complications: bronchopneumonia, myocarditis, otitis media and parotitis;
7. Diagnosis
and
differential
diagnosis:
epidemical
information,
clinical
manifestations and laboratory examinations (Weil- felix reaction). Differentiated
from other rickettsia disease, typhoid fever, relapsing fever, epidemic hemorrhagic
fever;
8. Treatment: general measure, pathogen treatment, symptom treatment;
9. Prophylaxis: manage source of infection, cutting off route of transmission,
protecting susceptiblility.
CHAPTER 5.1: SCARLET FEVER
[Objectives]
1. Understand pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, clinical type; laboratory examination, diagnosis and
treatment
[Contents]
1. Definition and brief introduction;
2. Etiology: group A streptococci;
3. Epidemiology: source of infection; routes of infection (airborne transmission,
contact
through
objects);
susceptible
population;
epidemiologic
feature;
pathogenesis and pathology;
4. Clinical manifestations: symptoms(fever，headache, vomit, sore throat); physical
signs( exudative tonsillitis, raspberry tongue, rash, Pastia line, desquamation),
clinical type;
5. Laboratory examination: blood routine examination, throat culture;
6. Diagnosis
and
manifestations
differential
and
the
diagnosis:
result
of
epidemical
bacteria
culture.
information,
Differentiated
clinical
from
staphylococcus aureus infection, drug-induced symdromes, measles, rubella;
complications: early complications, late complications;
7. Treatment: medical care (penicillin G), general treatment;
8. Prophylaxis: isolation of patients.
CHAPTER 5.6: CHOLERA
[Objectives]
1. Understand epidemic history, pathogenesis and prevention
2. Grasp etiology and epidemiology
3. Master clinical manifestations, clinical type; laboratory examination, diagnosis and
treatment.
[Contents]
1. Definition and brief introduction;
2. Etiology: V. cholera, microbiology, classification and antigenic types;
3. Epidemiology: history of epidemic, source of infection; routes of infection (fecaloral route), susceptible population; epidemiologic feature;
4. Pathogenesis and pathology: enter toxin; clinical manifestations: clinical stage,
degree of dehydration, changes in special populations;
5. Laboratory
examination:
blood
routine
examination,
direct
microscopic
examination (motility test and immobilized test), culture, serotyping and biotyping;
6. Diagnosis: confirmatory diagnosis and suspect diagnosis;
7. Complications: hypovolemic shock, acute tubular necrosis; prognosis;
8. Treatment
9. Prophylaxis: isolation of patients, education on specific hygiene practices, vaccine
Practice Part (12hours)
PRACTICE 1: SUMMARY AND VIRAL HEPATITIS
[Objectives]
1. Understand the composition of infectious ward
2. Grasp the methods of disinfections and isolation.
3. Master symptoms and signs of viral hepatitis
[Contents]
The composition of infectious ward, the methods of disinfections and isolation, how
to make a report about infectious disease, prepare 1-2 viral hepatitis patients and ask
history and take physical examination, with a lecture of how to differentiated jaundice,
the 1st test.
PRACTICE 2: DIFFERENTIATED ABOUT RASHES AND
OTHER INFECTIOUS DISEASES
[Objectives]
1. Understand the different rashes of infectious disease
2. Grasp how to differentiated measles from scarlet fever
3. Master how to evaluate result and how to diagnosis in HFRS
[Contents]
Prepare 1-2 patients of HFRS and ask history and take physical examination and
discuss how to evaluate result and how to diagnosis in HFRS; differentiated diagnosis
about rashes with the use of film slides; the 2nd test
PRACTICE 3: VIRAL HEPATITIS AND OTHER DISEASE
[Objectives]
1. Understand the different diagnosis about diarrhea disease
2. Grasp how to evaluate result and how to diagnosis about typhoid fever and cholera
3. Master clinical feature and criteria about typhoid fever, cholera and epidemic
typhus
[Contents]
Prepare 1-2 patients of HFRS or viral hepatitis or other infectious diseases and ask
history and take physical examination and discuss how to evaluate result and how to
diagnosis, differentiated diagnosis about diarrhea disease, treatment and diagnosis of
chronic HBV infection by the use of VCD, the 3rd test.
REFERENCES
1. Mendell, Douglas, and Bennett’s Principles and Practice of Infectious Disease, 6th
Edition, Elsevier Inc., 2005
2. Song Shize, Infectious Diseases, Beijing Medical University Press, 2003