measles麻疹ppt课件PPT文件格式下载.ppt

measles麻疹ppt课件PPT文件格式下载.ppt

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inthespring,peakinFeb-May,PATHOGENESISANDPATHOLOGY,PortalofentryRespiratorytractandregionallymphnodesEntersbloodstream（primaryviraemia）monocytephagocytesystemtargetorgans（secondaryviraemia）TargetorgansTheskin;

themucousmembranesofthenasopharynx,bronchi,andintestinaltract;

andintheconjunctivae,ectResultingIn-1）Koplikspotsandskinrash:

serousexudationandproliferationofendothelialcellsofthecapillaries,vasculitis2）Conjunctivis,PATHOGENESISANDPATHOLOGY,3）Laryngitis,croup,bronchitis:

generalinflammatoryreaction4）Hyperplasiaoflymphoidtissue:

multinucleatedgiantcells（Warthin-Finkeldeyreticuloendothelialgiantcells）maybefound5）Interstitialpneumonitis:

Hechtgiantcellpneumonia.6）Bronchopneumonia:

duetosecondarybacterialinfections7）Encephalomyelitis:

perivasculardemyelinizationoccursinareasofthebrainandspinalcord.8）Subacutesclerosingpanencephalitis（SSPE）:

degenerationofthecortexandwhitematterwithintranuclearandintracytoplasmicinclusionbodies,CLINICALMANIFESTATION,TypicalManifestation:

patientshavnthadmeaslesimmunization,orvaccinefailurewithnormalimmunityorthosehavntusedimmuneglobulin1.Incubationperiod（infectiontosymptoms）:

6-18days（average10days）2.Prodromalperiod:

3-4daysNon-specificsymptoms:

fever,malaise,anorexia,headacheClassicaltriad:

cough,coryza,conjunctivitis（withphotophobia,lacrimation）,CLINICALMANIFESTATION,Enanthem（Koplikspots）:

Pathognomonicformeasles24-48hrbeforerashappears1mm,grayishwhitedotswithslight,reddishareolaeBuccalmucosa,oppositethelower2ndmolarsfadesoonafterrashonset,CLINICALMANIFESTATION,Koplikspots,CLINICALMANIFESTATION,3.Rashperiod3-4daysExanthem:

Erythematous,non-pruritic,maculopapularUpperlateraloftheneck,behindears,hairline,facetrunkarmsandlegsTheseverityofthediseaseisdirectlyrelatedtotheextentandconfluenceoftherash,CLINICALMANIFESTATION,CLINICALMANIFESTATION,CLINICALMANIFESTATION,CLINICALMANIFESTATION,Temperature:

RisesabruptlyastherashappearsReaches40orhigherSettlesafter4-5daysifpersists,suspectsecondaryinfectionCoryza,fever,andcough:

IncreasinglysevereuptothetimetherashhascoveredthebodyLymphadenopathy（posteriorcervicalregion,mesenteric）splenomegaly,diarrhoea,vomitingChestXray:

Maybeabnormal,eveninuncomplicatedcases,CLINICALMANIFESTATION,4.Recoveryperiod3-4daysExanthem:

FadesinorderofappearanceBrannydesquamationandbrownishdiscolorationEntireillness10days,CLINICALMANIFESTATION,CLINICALMANIFESTATION,AtypicalManifestation:

1.MildmeaslesInpatients:

administeredimmuneglobulinproductsduringtheincubationperiodandimmunizedagainstmeasles;

ininfants8moLongincubationperiodandshortprodromalphaseMildsymptomNoKoplikspotTherashtendstobefaintNobrannydesquamationandbrownishdiscolorationoccurastherashfadesNocomplicationsandshortcourse,CLINICALMANIFESTATION,2.Severemeasles:

Incaseswithmalnutrition,hypoimmunityandsecondaryinfectionPersistenthyperpyrexia,sometimeswithconvulsionsandevencomaExanthem:

CompletelycoveredtheskinConfluent,petechiae,ecchymosesThehemorrhagictypeofmeasles（blackmeasles）,bleedingmayoccurfromthemouth,nose,orbowel.disseminatedintravascularcoagulation（DIC）,CLINICALMANIFESTATION,CLINICALMANIFESTATION,3.Atypicalmeaslessyndroma:

Recipientsofkilledmeaslesvirusvaccine,wholatercomeincontactwithwild-typemeaslesvirus.Distinguishedbyhighfever,severeheadache,severeabdominalpain,oftenwithvomiting,myalgias,respiratorysymptoms,pneumoniawithpleuraleffusionExanthem:

Firstappearsonthepalms,wrists,soles,andankles,andprogressesinacentripetaldirection.Maculopapularvesicularpurpuricorhemorrhagic.Koplikspotsrarelyappear,CLINICALMANIFESTATION,Atypicalmeaslessyndroma,CLINICALMANIFESTATION,4.MeaslesabsentofrushImmunodepressed,orpassiveimmunizedrecentlycasesandoccasionallyininfants9mowhohaveappreciablelevelsofmaternalantibodyNon-specificityDifficulttodiagnosis,COMPLICATIONS,1.RespiratoryTractLar