Pathogenesis Pathology I Flea infected with Y. pestis- hungry bites ferociously. The inoculated organisms may be phagocytosed by polymorphonuclear cells and macrophages, they produce the antiphagocytic protein and subsequently are able to resist phagocytosis The pathogens rapidly reach the lymphatics and an intense hemorrhagic inflammation develops in the enlarged lymph nodes which may undergo necrosis and become fluctuant
Pathogenesis & Pathology I • Flea infected with Y. pestis hungry bites ferociously. The inoculated organisms may be phagocytosed by polymorphonuclear cells and macrophages, they produce the antiphagocytic protein and subsequently are able to resist phagocytosis. • The pathogens rapidly reach the lymphatics and an intense hemorrhagic inflammation develops in the enlarged lymph nodes, which may undergo necrosis and become fluctuant
Pathogenesis Pathology II Hemorrhagic and necrotic lesions may develop in all organS, meningitis, pneumonia, and serosanguineous pleuropericarditis are prominent features Primary pneumonic plague results from inhalation of infective droplets(usually from a coughing patient), with hemorrhagic consolidation sepsis and death
Pathogenesis & Pathology II • Hemorrhagic and necrotic lesions may develop in all organs; meningitis, pneumonia, and serosanguineous pleuropericarditis are prominent features. • Primary pneumonic plague results from inhalation of infective droplets (usually from a coughing patient), with hemorrhagic consolidation, sepsis, and death
腺鼠疫 肺鼠疫一黑死病
腺鼠疫 肺鼠疫—黑死病
Clinical findings High fever, painful lymphadenopathy, commonly with greatly enlarged, tender nodes in the groin or axillae Vomiting and diarrhea may develop with early sepsis Later disseminated intravascular coagulation leads to hypotension, altered mental status, and renal and cardiac allure Terminally, signs of pneumonia and meningitis can appear, and y pestis multiplies intravascularly and can be seen in blood smears
Clinical findings • High fever, painful lymphadenopathy, commonly with greatly enlarged, tender nodes in the groin or axillae. • Vomiting and diarrhea may develop with early sepsis. • Later, disseminated intravascular coagulation leads to hypotension, altered mental status, and renal and cardiac failure. • Terminally, signs of pneumonia and meningitis can appear, and Y pestis multiplies intravascularly and can be seen in blood smears
Diagnostic laboratory tests A Specimens Aspirates of lymph nodes Cerebrospinal fluid Blood putul B. Smears Giemsa's stain immunofluorescent stain C. Culture D. Serology
Diagnostic laboratory tests A. Specimens: – Aspirates of lymph nodes – Cerebrospinal fluid – Blood – Sputum B. Smears: -Giemsa’s stain -immunofluorescent stain C. Culture D. Serology