《Measles麻疹》.ppt

MEASLESFenHuaChen,.,,TheThirdAffiliatedHospitalSunYat-senUniversityMeaslesis…essivelyovertheneck,face,body,,human’,approximately90%:ursbydropletsprayduringtheprodromalperiod(catarrhalstage).Contagiousfrom5daysbeforesymptoms,5daysafteronsetofrashSeasons:inthespring,peakinFeb-MayPATHOGENESISANDPATHOLOGYPortalofentryRespiratorytractandregionallymphnodesEntersbloodstream(primaryviraemia)monocyte–phagocytesystemans(secondaryviraemia)ansTheskin;themucousmembranesofthenasopharynx,bronchi,andintestinaltract;andintheconjunctivae,ectResultingIn-----1)Koplikspotsandskinrash:serousexudationandproliferationofendothelialcellsofthecapillaries,vasculitis2)ConjunctivisPATHOGENESISANDPATHOLOGY3)Laryngitis,croup,bronchitis:generalinflammatoryreaction4)Hyperplasiaoflymphoidtissue:multinucleatedgiantcells(Warthin-Finkeldeyreticuloendothelialgiantcells)maybefound5)Interstitialpneumonitis:)Bronchopneumonia:duetosecondarybacterialinfections7)Encephalomyelitis:)Subacutesclerosingpanencephalitis(SSPE):degenerationofthecortexandwhitematterwithintranuclearandintracytoplasmicinclusionbodiesCLINICALMANIFESTATIONTypicalManifestation:patientshavn’thadmeaslesimmunization,inefailurewithnormalimmunityorthosehavn’(infectiontosymptoms):6-18days(average10days):3-4days Non-specificsymptoms:fever,malaise,anorexia,headacheClassicaltriad:cough,coryza,conjunctivitis(withphotophobia,lacrimation)CLINICALMANIFESTATIONEnanthem(Koplikspots):Pathognomonicformeasles24-48hrbeforerashappears1mm,grayishwhitedotswithsligh