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Chapter Spirochete [Requirement] Master the characteristics of spirochete [Class hour: 1 hours ] [Outline] I. General properties 1. Thin-long ,flexible helical rods (0.1 x 10-20 um) Fontana silver stain (brown) possess an axial filament (actively motile) 2. Sensitive to antibiotics (penicillin etc) 3. Classification: Three genera: Treponema---- causes syphilis Borrelia ---- causes relapsing fever Leptospira ---- causes leptospirosis II. Leptospira 1. Can be cultured under aerobic conditions ( Korthof media ) 2. Can survive for months in water 3. Classification. 4. Pathogenicity Pathogenic substance: Haemolysis, Cytoxicity factor, LPS Disease : Leptospirosis (zoonosis) 5. Laboratory diagnosis Examination of spirochete: silver stain, dark-field microscopy Serology: agglutination- lysis test III.T. pallidum (TP ) 1. Has not been successfully cultured on artificial media 2.Weak resistance, sensitive to penicillin 3. Pathogenicity and Immunity pathogenesis: ---- immunosuppression ---- adherence ---- immunopathological reaction Disease: Syphilissexually transmitted disease (STD) Acquired syphilis : sexual contact Congenital syphilis : vertical infection Immumity: infectious immunity ---- CMI: important ---- Anti-TP Ab : protective ----Anti-lipid Ab: diagnosis ( reagin ) 4. Laboratory diagnosis (1) Examination of TP (2) Non-specific serologic test: Known Ag( beef heart cardiolipin) unknown Ab (reagin) (3) TP Ag serologic test Chapter Actinomyces [Requirement] Understand the general properties and pathogenicity of actinomyces [Class hour: 1 hours ] [Outline] I.General properties 1. Filamentous prokaryotic microbes, form hyphae 2. Cell structure is similar to bacteria 3. sensitive to antibiotics II. Pathogenicity Pathogenic organism: Actinomyces---- A. israelii Nocardia----- N. Asteroides A. israelii N. asteroides G+ , non-acid fast G+ , acid fast anaerobic aerobic normal flora of oral in the soil endogenous infection exogenous infection chronic pyogenic inflammation cervicofacial actinomycosis pyogenic infection pneumonia abdominal actinomycosis thoracic actinomycosis III.Laboratory diagnosis Specimens (pus, tissues) -------- Sulfur granules IV.Treatment penicillin—12-18 months; sulfadiazine; surgical excision Chapter Mycoplasma [Requirement] Master the characters of mycoplasma Master the pathogenic mycoplasma [Class hour: 1 hours ] [Outline] I. Introduction 1. mycoplasma is the smallest prokaryotic organisms that can grow in artificial media. 2. distributed extensive Human;,animals, plants, insects and sewage. 3. non-cell wall; pleomorphic; pass through filters. 4. pleuro-pneumonia-like organisms --------PPLO II. Biological properties 1. Morphology 1) size: 0.2~0.3μm 2) pleomorphic: coccoid, coccobacillary, ring,dumb-bell forms, short and long branching 3) Giemsa stain: purple 4) Structure : three layer of membrane: two protein membrane one lipid membrane terminal structure: some mycoplasma have speciaallized structures at one or both ends by which they to respiratory or gential tract mucosal surfaces 2. Culture 1) anaerobic/facultatively anaerobic 2) high nutrient: serum, yolk, cholesterol 3) slowly growth:2~3 days; fried-egg colony: mycoplasma-----600μm ureaplasma----10~30μm 4) optimum temperature:36~38℃ 3. classification mycoplasma Mycoplaaasmaataceae Ureaplasma Acholeplaasmataceae Spiroplasmataceae 4. Resistant Week; 45℃ 15~30 min killed resistant to penicillin, polymyxin sensitive to tetracycline, III.Pathogenic mycoplasma 1. M. pneumoniae[MP] 1) Terminal structure→adherence→damage CM →release products(H2O2, toxic enzyme) →injur cell(RBC, tracheal epithelia cell) 2) Primary atypical pneumonia [PAP] (1) PAP often in school children and adulte (2) Spread by respiratory; incubation 2~3 weeks; (3) Headache, chills, fever; malaise; dismiss after 3~10 days (4) Rarely fetal (5) Tetracyclines----adults; Erythromycin---children, pregnant women 2. Ureaplasma urealyticum [UU] 1) genitourinary tract infection 2) nongonococcal urethritis(NGU) 3) vaginitis,cervicitis→premature birth, abortion, sterility 4) arthritis 5) Doxycycline Chapter Chlamydiae [Requirement] Master the characteristics of chlamydiae [Class hour: 1 hours ] [Outline] I. General properties 1. Obligately intracellular parasite 2. G-, similar to G- bacillus 3. Filtrable (0.2-0.4 um) 4. Unique life-cycle: elementary body---infectious form initial body----replicative form 5. Classification II. Pathogenicity 1.Pathogenic factor: suface struture: LPS endotoxin: like substance 2.Disease (1). C. trachomatis: ①. Trachoma (A. B. Ba. C seroytpes) ②. Genital-tract infection ----NGU (D-K serotypes) ③. Inclusion conjunctivitis: (D-K serotypes) ④. infantile pneumonia (2) C. Pneumonia: pneumonia III. Laboratory Diagnosis: 1. Inclusion body 2.Immunofluorescence technique IV. Treatment Chapter Medical Mycology [Requirement] Master the characteristics and pathogenicity of main pathogenic fungi. Understand the morphology and culture properties of fungi [Class hour: 1 hours ] [Outline] The fungi--being eucaryotic organisms, lack chlorphyll, nonmotile,grow as single cell or as long dranched, filamentous strcture I. morphology monocellular fungi: yeast form; yeast-like form multicellular fungi: hypha— hyphae septum/ hyphae nonseptum spore— asexual/sexual reproductive mycelium hypha aerial mycelium vegetative mycelium spore blastospore chlamydospore asexual spore arthrospore spore conidiaspore sporangiospore II. culture properties 1. sabouraud medium 2. Dextrose,peptone, agar, pH 5.6 zygospore sexual oospore spore basidiospore ascospore 3. monocellular fungi---37℃; 4. grow slowly: multicellular fungi---28℃ 4 days-3 weeks yeast-form colony 5. colonal types yeast-like colony hyphomycete-form colony III. resistance *more resistant to dry, sunlithg, disinfectants, alkline, acid *sensitive to heat(60℃ 30min) *sensitive antibiotic:amphotericin B; nystatin; griseofulvin IV. Pathogenisis and immunity 1. Pathogenisis *pathogenic fungi infection----exogenous infection superficial mycoses (Dermatophytes) -----nfect skin, nail and hair --- cause tinea deep mycoses----chromic granulama, tissue ulcer , necrosis *opportunity fungi infection----endogenous infection flora disquilibrium --Candida albicans : mucocutaneous infection ---- thrush Organ infection ----meningitis *hypersensitive disease penicillium; fuarium; aspergillus ---asthma; urticaria; allergic rhinitis; allergic dermatitis *fungal poisoning Fusarium; Arthrinium; Patulin; Flavus *fungal toxin----cancer aflatoxin---10g/d/personcancer 2. immunity non-specific immunity specific immunity-----CMI V. Laboratory diagnosis sample--- direct observation (hypha , spore) --- culture (mycelial colony) VI.prevention & treatment 1. personal, public hygiene 2. chemothearopatic agents amphotericin B; nystatin; griseofulvin 1.Introduction 1). Eukaryotic organism 2). Morphology (1) monocellular fungi: (2) multicellular fungi: hypha (mycelium) spore reproductive organs 3). Culture 4). Resistance 5). Pathogenisis and immunity Pathogenicity : Pathogenic fungi infection Opportunity fungi infection Fungal poisoning Hypersensitive disease Immunity : Non-specific immune CMI 2.Main Pathogenic Fungi 1).Shallow fungi (Dermatophytes) ---- pathogenic fungi infect skin, nail and hair --- cause tinea Laboratory diagnosis: sample--- direct observation (hypha , spore) --- culture (mycelial colony) Treatment: fungicidal agents 2).Deep fungi --- opportunity fungi (1). Candida albicans: ① Constitute part of the normal flore of the body Usually secondary infection: Superinfection host defenses Disease: mucocutaneous infection ---- thrush Organ infection --- lung kidney etc Meningitis ②Laboratory diagnosis: G+,monocellular fungi, blastospore with pseudohyphae Culture :Yeast-like colony (2). Cryptococcus neoformans: Monocellular fungi, possesses a think capsule Cause cryptococcal meningitis Serological test : ELISA (3) Mycotoxicosis: Aspergillus flavus --- aflatoxin --- contaminate food ----- liver cancer