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Urogenital infection

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SYPHILISSyphilis is true human infection Syphilis is caused by spiral form bacteria belonging to genera Treponema sp. T.pallidum

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Слайд 1Urogenital infection
Professor Boichenko M.N.

Urogenital infectionProfessor Boichenko M.N.

Слайд 2SYPHILIS
Syphilis is true human infection Syphilis is caused by spiral form

bacteria belonging to genera Treponema
sp. T.pallidum

SYPHILISSyphilis is true human infection Syphilis is caused by spiral form bacteria belonging to genera Treponema sp.

Слайд 3Treponema
T.pallidum consists of 3 sub/species:
pallidum – syphilis
endemicum – bejel
pertenue –

yaws
T.carateum - pinta

TreponemaT.pallidum consists of 3 sub/species:pallidum – syphilisendemicum – bejelpertenue – yawsT.carateum - pinta

Слайд 4T.pallidum/pallidum
Microaerophilic bacteria
It cannot be cultivated in vitro
Drying kills microbe
In blood

stored at 4 C microbe remains viable for at least

24 h., which is a potential importance in blood transfusion
Microbe is sensitive to penicillin, is rapidly immobilized and killed by arsenical, mercury, bismuth

T.pallidum/pallidumMicroaerophilic bacteriaIt cannot be cultivated in vitroDrying kills microbeIn blood stored at 4 C microbe remains viable

Слайд 5T.pallidum/pallidum
Biochemical properties are investigated bad
Virulence: lipoproteins propously can take part

in immunopathological properties
Antigenic

structure
1. Specific termosensitive antigen
2. Non specific lipid’s antigen composition of which is similar to cardiolipin extracted from bovin’s heart
T.pallidum/pallidumBiochemical properties are investigated badVirulence: lipoproteins propously can take part in immunopathological properties

Слайд 6Syphilis is true human infection

Syphilis is true human infection

Слайд 7Syphilis
Treponema multiplies locally at the site of entry and spread

to nearly lymph nodes and then reach the blood stream
In

2-10 weeks after infection a papula develops at the site of infection and breaks down to form an ulcer with a clean hard base hard chancre
This is primery lesions
SyphilisTreponema multiplies locally at the site of entry and spread to nearly lymph nodes and then reach

Слайд 8Syphilis
In 2-10 weeks later the secondary lesions appears.
They consists

of mascular papular rash anywhere on the body which contains

microb
The untreated infection remains latent. The disease progresses to the terriary stage




SyphilisIn 2-10 weeks later the secondary lesions appears. They consists of mascular papular rash anywhere on the

Слайд 9Syphilis
Terriary stage is characterized by:
1/ development of granulomatous lesions

named Gummas, in skin, bones, liver;
2/ degenerative changes in central

nerves system or cardiovascular lessiones
In all terriary lessiones treponema be found very rary
SyphilisTerriary stage is characterized by: 1/ development of granulomatous lesions named Gummas, in skin, bones, liver;2/ degenerative

Слайд 12Immunity
PROTECTIVE IMMUNITY IS NOT FORMED !!!
Antibodies are evidence of infection
Antibodies

against non specific cardiolipin antigen appear first. They can persist

during presence of microbe in organism
Antibodies against specific antigen appear later and they can be found long time after disease
ImmunityPROTECTIVE IMMUNITY IS NOT FORMED !!!Antibodies are evidence of infectionAntibodies against non specific cardiolipin antigen appear first.

Слайд 13Diagnostic
Microscopy, serology and PCR
Microscopy is used during primery and secondary

syphilis
Serology: Nontreponemal antigen tests with cardiolipin are screening tests. They

are used to determine human to be infected with T.pallidum/pallidum
VDRL ( veneral disease research laboratory)
RPR ( rapid plasma reagins)
DiagnosticMicroscopy, serology and PCRMicroscopy is used during primery and secondary syphilisSerology: Nontreponemal antigen tests with cardiolipin are

Слайд 14Diagnostic
Positive VDRL and RPR develop after 2-3 weeks after

untreated syphilis and they are positive in high titer in

secondary syphilis
Nontreponemal tests may be false positive during some diseases: reumatism, malaria..
Treponemal antibodies test , containig specific antigen are used to confirm disease. IFA, indirect IF, IHA
Diagnostic Positive VDRL and RPR develop after 2-3 weeks after untreated syphilis and they are positive in

Слайд 16Congenital syphilis
A pregnant syphilitic woman can transmit T. pallidum/pallidum to

the fetus through placenta beginning in the 10th – 15th

week of gestation. Some of infected fetus die. Others are born with symptoms of congenital syphilis:
Keratitis, periostitis, central nerve system anomalies. Child shows IgM anti treponemal antibodies
Congenital syphilisA pregnant syphilitic woman can transmit T. pallidum/pallidum to the fetus through placenta beginning in the

Слайд 17Gonorrhoeae
Causative agent – Neisseria gonorrhoeae

GonorrhoeaeCausative agent – Neisseria gonorrhoeae

Слайд 23Urogenital chlamydia
Urogenital chlamydia is linked with Chlamydia trachomatis

Urogenital chlamydiaUrogenital chlamydia is linked with Chlamydia trachomatis

Слайд 24Chlamydia
Bacteria belonging to genus Chlamydia are:
1. obligate intracellular parasites,

because they lack mechanism for production metabolic energy and cannot

synthesize ATP
2. gramnegative bacteria which do not contain a typical peptidoglycan, because muramic acid appears to be absent from chlamydia cell wall
ChlamydiaBacteria belonging to genus Chlamydia are: 1. obligate intracellular parasites, because they lack mechanism for production metabolic

Слайд 25Chlamydia
All chlamydia posses a common reproductive cycle. They consist of

2 forms:
Extracellular infective particle, named ELEMENTRY BODIES (EB), which cannot

multiply
Intracellular forms with metabolic activity called RETICULATE BODIES (RB)
ChlamydiaAll chlamydia posses a common reproductive cycle. They consist of 2 forms:Extracellular infective particle, named ELEMENTRY BODIES

Слайд 26Chlamydia
In contras to RB, EB posses highly cross-linked membrane protein

given ability to EB to be resistance in enviroment.
The EB

have a high affinity for host epithelial cells and rapidly enter them. This process is linked with T3SS,(Thirdtype secretory system) effector proteins of which start up engulfing of chlamydia by epithelial cell, forming chlamydia conteining vacuole, named inclusion
ChlamydiaIn contras to RB, EB posses highly cross-linked membrane protein given ability to EB to be resistance

Слайд 27Chlamydia
Intra inclusion EB convert into RB.
RB devides by binary

fission and then convert into EB.
EB may liberated from the

host cell to inject to infect new cells.
ChlamydiaIntra inclusion EB convert into RB. RB devides by binary fission and then convert into EB.EB may

Слайд 32Chlamydia
Chlamydia posses shared group specific heat stable antigen, antibody to

which cav be detected by CFT and IF
Species-specific, serovar-specific protein

antigen
ChlamydiaChlamydia posses shared group specific heat stable antigen, antibody to which cav be detected by CFT and

Слайд 33Chlamydia trachomatis
Chlamydia trachomatis consists of 18 serovars
Serovars A,B,Ba,C –are linked

with trachoma -eye disease, beginning as kerato conjunctivitis progressing to

blindness.
Serovars D-K –nongonococcal urethritis
Serovars L1- L3 –lymphogranuloma venerum
Chlamydia trachomatisChlamydia trachomatis consists of 18 serovarsSerovars A,B,Ba,C –are linked with trachoma -eye disease, beginning as kerato

Слайд 35Chlamydia trachomatis
Chlamydia trachomatis D - K above nongonococcal urethritis can

cause cervicitis, pelvic inflammatory disease, which can led to sterility

and predispose ectopic pregnancy
The newborn acquires the infection during passage through an infected birth canal. This infection is appeared as conjunctivitis
Chlamydia trachomatisChlamydia trachomatis D - K above nongonococcal urethritis can cause cervicitis, pelvic inflammatory disease, which can

Слайд 37Chlamydia trachomatis Diagnosis
Specimen: swab or cytology brush are used to scrape

epithelial cells from 1-2 cm deep into endocervix, vagine, urethra

or conjunctive.
IF or Enzyme linked Immunoassay (EIA) are used to determine antigen, Such specimen may be used for PCR (urine) also may be used for PCR
Serology may be used for determination of the duration of infection and observation of effect of treatment

Chlamydia trachomatis Diagnosis Specimen: swab or cytology brush are used to scrape epithelial cells from 1-2 cm

Слайд 38Chlamydia trachomatis L1-L3
Lymphogranuloma venerum – sexually transmitted disease, is characterized

by suppuratic in guinal adenitis.
It is more common in

tropical climates
Chlamydia trachomatis L1-L3Lymphogranuloma venerum – sexually transmitted disease, is characterized by suppuratic in guinal adenitis. It is

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