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The diseases with the exanthemas syndromes презентация
Содержание
- 1. The diseases with the exanthemas syndromes
- 2. Measles (Morbilli) The pathogenic agent causing
- 3. Epidemiology The source of infection - a
- 4. The virus is expelled from the organism
- 5. Pathogenesis The portal of entry is the
- 6. The process in the bronchitis and bronchiolitis
- 7. Clinical manifestations The period of measles - incubation
- 8. Catarrhal period a rise in temperature,
- 9. Belsky-Filatov-Koplik's spots on the buccal mucosa
- 10. The eruptive period stage begins with
- 11. Elements of the rash look like
- 12. Period of pigmentation subsiding rash becomes
- 13. Blood at the end of the
- 14. Classification Typical form: – mild – moderately severe --
- 15. Mitigated form is in children who
- 16. Complications Laryngitis - of measles croup
- 17. Nervous complications are serous meningitis, encephalitis
- 18. Diagnosis Measles must be identified as early
- 19. Specific diagnosis The diagnosis is verified by
- 20. Treatment organized hygienic conditions, nursing care of
- 21. Treatment hospitalized when they are severe and
- 22. Prophylaxis Carantin is during 21 days after
- 23. Rubella The agent that causes rubella is
- 24. Epidemiology The source of infection is a
- 25. Clinical Manifestations incubation period lasts 15-21 days,
- 26. Rash the rash invades the face
- 27. Blood counts demonstrate leukopenia, lympho, and numerous
- 28. Clinical manifestations of congenital rubella: “Сongenital
- 29. Congenital rubella microcephalic hydrocephalus, deafness, cataract, retinopathy,
- 30. no treatment is required patient should be
- 31. Scarlet Fever Scarlet fever is an acute
- 32. pathogen of scarlet fever is a β-hemolytic
- 33. Epidemiology Scarlet fever is anthroponozic The source
- 34. Pathogenesis The principal portal of entry in
- 35. The toxic syndrome is the result of
- 36. The allergic syndrome is caused by
- 37. Clinical Manifestations The incubation period for scarlet
- 38. Tonsillitis Scarlatinal tonsillitis may be catarrhal, follicular
- 39. Tongue During the first 1 or
- 40. Exanthema It becomes generalized very rapidly. Patient
- 41. Rash is more intense in skin folds
- 42. Tiny petechiae occur in the creases of
- 43. initially on the face on the second
- 44. Cardiovascular changes In acute period of
- 45. Classification Typical: mild, moderate, severe Atypical (extrabuccal
- 46. Complications early one (first week) - septic
- 47. Treatment Hospitalization takes Severe course
- 48. Prophylaxis Specific prevention of scarlet fever has
Measles (Morbilli) The pathogenic agent causing measles is the paramyxoviruses. The measles virus is very unstable and is soon destroyed outside the human body.
Слайд 2Measles (Morbilli)
The pathogenic agent causing measles is the paramyxoviruses.
The
measles virus is very unstable and is soon destroyed outside the human body.
Слайд 3Epidemiology
The source of infection - a sick person
Infectivity is greatest in
the initial catarrhal stage and during the fourth days after the appearance of the rash
With complications pneumonia infectivity during the tenth days after the rash
The aerial-droplet route usually conveys infection
With complications pneumonia infectivity during the tenth days after the rash
The aerial-droplet route usually conveys infection
Слайд 4The virus is expelled from the organism in the secretion of
the mucous membranes
The susceptibility of humans to measles is very high (susceptibility index 0.96)
Infants under three months of age are immune to measles
The susceptibility of humans to measles is very high (susceptibility index 0.96)
Infants under three months of age are immune to measles
Epidemiology
Слайд 5Pathogenesis
The portal of entry is the mucous membrane of the respiratory
tract, and the conjunctiva
The principal pathological changes attending measles are inflammatory processes in the nasopharynx, respiratory organs, intestinal, and skin
The Belsky-Filatov-Koplik spots are the result of an inflammatory process with small foci of degeneration of the epithelium buccal and labial mucosa
The principal pathological changes attending measles are inflammatory processes in the nasopharynx, respiratory organs, intestinal, and skin
The Belsky-Filatov-Koplik spots are the result of an inflammatory process with small foci of degeneration of the epithelium buccal and labial mucosa
Слайд 6The process in the bronchitis and bronchiolitis has a tendency to
penetrate and format interstitial pneumonia
In the central nervous system format serous meningitis and encephalitis
The reactivity of the child's organism during measles is expressed in the condition known as measles anergy: positive tuberculin reaction disappears, the immune body’s falls, the complement decreases
In the central nervous system format serous meningitis and encephalitis
The reactivity of the child's organism during measles is expressed in the condition known as measles anergy: positive tuberculin reaction disappears, the immune body’s falls, the complement decreases
Pathogenesis
Слайд 7Clinical manifestations
The period of measles
- incubation period
– catarrhal period
– eruptive period
– period of pigmentation
The incubation
period of measles is usually from 9 to 17 days. In children who have been vaccinated, or were given blood or plasma transfusions, the incubation period may even he as long as 21 days
Слайд 8Catarrhal period
a rise in temperature, headache, rhinitis, and cough
general malaise,
adynamia, loss of appetite, and insomnia
conjunctivitis expresses itself in conjunctiva hyperemia and photophobia and blepharospasm
enanthema - red irregular spots varying in size can be seen on the mucosa of the soft, and in part of the hard, palate
conjunctivitis expresses itself in conjunctiva hyperemia and photophobia and blepharospasm
enanthema - red irregular spots varying in size can be seen on the mucosa of the soft, and in part of the hard, palate
Слайд 9Belsky-Filatov-Koplik's spots
on the buccal mucosa on the line of opposition
of the molar teeth, and less commonly on the lip inner surfaces and on the gums, occasionally on the conjunctiva
element looks tike a whitish papule, the size of a poppy-seed, surrounded by a narrow band of hyperemia, or areola
element looks tike a whitish papule, the size of a poppy-seed, surrounded by a narrow band of hyperemia, or areola
Слайд 10The eruptive period
stage begins with a new rise of temperature
first
elements of the rash are found behind the ears and in the centre of the face
it spreads rapidly over the whole face, neck, and upper part of the chest.
On the second day, the exanthema rapidly spreads over the trunk
and the proximal parts of the limbs, and on the third day covers the limbs
it spreads rapidly over the whole face, neck, and upper part of the chest.
On the second day, the exanthema rapidly spreads over the trunk
and the proximal parts of the limbs, and on the third day covers the limbs
Слайд 11Elements of the rash
look like pink papules of a soft
consistency, the size of a grain of millet
soon adjacent maculopapules become confluent, forming large blotches of irregular outline
maculopapular elements have a tendency to fuse further
rash exanthem persists for three days
soon adjacent maculopapules become confluent, forming large blotches of irregular outline
maculopapular elements have a tendency to fuse further
rash exanthem persists for three days
Слайд 12Period of pigmentation
subsiding rash becomes less prominent and assumes a
cyanotic tinge; its elements, gradually fading, leave spots of a light-brown pigmentation
persists for one or two weeks
persists for one or two weeks
the rash on the face fades on the third day when it appears on the extremities
Слайд 13Blood
at the end of the incubation period, the blood picture
shows mild leukocytosis and neutrophilosis
at the end of the catarrhal stage leukopenia and neutropenia,
and at the eruptive stage leukopenia, often with a relative neutropenia, eosinopenia and thrombopenia
at the end of the catarrhal stage leukopenia and neutropenia,
and at the eruptive stage leukopenia, often with a relative neutropenia, eosinopenia and thrombopenia
Слайд 14Classification
Typical form:
– mild
– moderately severe
-- severe.
Atypical forms:
– measles with a toxic
– abortive
– rudimentary course
-- mitigated
Слайд 15Mitigated form
is in children who underwent serum prophylactic immunization
the incubation
period is protracted to a maximum of 21 days
the initial and eruptive periods are shortened
catarrhal symptoms in the mucous membrane are usually mild or absent
the enanthema and Belsky-Filatov-Koplik's spots may not appear
rash is usually sparse and sometimes is represented by few macularpupular elements
no complications issues
the initial and eruptive periods are shortened
catarrhal symptoms in the mucous membrane are usually mild or absent
the enanthema and Belsky-Filatov-Koplik's spots may not appear
rash is usually sparse and sometimes is represented by few macularpupular elements
no complications issues
Слайд 16Complications
Laryngitis - of measles croup
Pneumonia is one of the most
common complications in measles: early pneumonia (in the catarrhal stage), secondary infection (pneumococcal, staphylococcal and streptococcal)
Complications of the alimentary tract are stomatitis (gangrenous stomatitis or noma), dyspepsia is common, colitis
Catarrhal otitis, purulent otitis, blepharitis and keratitis
Complications of the alimentary tract are stomatitis (gangrenous stomatitis or noma), dyspepsia is common, colitis
Catarrhal otitis, purulent otitis, blepharitis and keratitis
Слайд 18Diagnosis
Measles must be identified as early as possible.
The diagnosis is
based on clinical symptoms, taking into account the epidemiological anamnesis
In the catarrhal stage can resemble influenza and other respiratory viral infections
During the eruptive stage – Rubella; Scarlet fever, Serum rash, Drug rash
In the catarrhal stage can resemble influenza and other respiratory viral infections
During the eruptive stage – Rubella; Scarlet fever, Serum rash, Drug rash
Слайд 19Specific diagnosis
The diagnosis is verified by a serological test - hemagglutina-don-inhibition
test, neutralization and the complement-fixation test. The increasing titer (4 times and over), as determined during a repeated test in 7-10 days, is a more reliable diagnostic sign
Слайд 20Treatment
organized hygienic conditions, nursing care of the patient and protection from
secondary infections
hospitalized when they are severe and complicated; home conditions are unsatisfactory, or it is impossible to arrange due nursing care; when epidemiological signs are present
fresh and clean air is very important for the patient
diet should be nourishing, easily digestible, and have a minimum of solid particles; liquids and soups should be preferre
hospitalized when they are severe and complicated; home conditions are unsatisfactory, or it is impossible to arrange due nursing care; when epidemiological signs are present
fresh and clean air is very important for the patient
diet should be nourishing, easily digestible, and have a minimum of solid particles; liquids and soups should be preferre
Слайд 21Treatment
hospitalized when they are severe and complicated;
home conditions are unsatisfactory,
or it is impossible to arrange due nursing care;
when epidemiological signs are present
antibiotics are given in case of complications, which are usually of bacterial nature
when epidemiological signs are present
antibiotics are given in case of complications, which are usually of bacterial nature
Слайд 22Prophylaxis
Carantin is during 21 days after contact
Gamma-globulin is only used for
prophylactic purposes in a small number of children who were in contact with the measles patients and are 3-months to one year of age dose of 1.5 ml
Patient should be isolated until the 5th day from the outbreak of eruption
Vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine
Patient should be isolated until the 5th day from the outbreak of eruption
Vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine
Слайд 23Rubella
The agent that causes rubella is a microvirus, it contains a
single-stranded RNA, and is sensitive to chemical agents and heat
Слайд 24Epidemiology
The source of infection is a sick person, who probably becomes
infective a few days before the disease becomes manifest
Contagiousness does not probably disappear two weeks (and over) after the rash resolves
The aerial-droplet route transmits the infection
Pregnant women with manifest or symptomless rubella may become the source of intrauterine infection of the fetus
Susceptibility to rubella is high
Life-long stable immunity develops as a rule
Contagiousness does not probably disappear two weeks (and over) after the rash resolves
The aerial-droplet route transmits the infection
Pregnant women with manifest or symptomless rubella may become the source of intrauterine infection of the fetus
Susceptibility to rubella is high
Life-long stable immunity develops as a rule
Слайд 25Clinical Manifestations
incubation period lasts 15-21 days, sometimes up to 24 days
slight
rise in temperature is noted
occasionally slight malaise, cough, and reddening of the conjunctiva (conjunctivitis)
the typical symptom is swelling of the post-auricular cervical, sub-occipital, and other lymph nodes, which develops 1-3 days before the eruption and disappears several days after it subsides
occasionally slight malaise, cough, and reddening of the conjunctiva (conjunctivitis)
the typical symptom is swelling of the post-auricular cervical, sub-occipital, and other lymph nodes, which develops 1-3 days before the eruption and disappears several days after it subsides
Слайд 26Rash
the rash invades the face and neck, and covers the
whole body within a few hours
localized mainly on the extensor surface of the limbs
elements are pale red, round or oval spots, with no tendency to coalesce
rash lasts 2 or 3 days and disappears rapidly without leaving any pigmentation and desquamation
localized mainly on the extensor surface of the limbs
elements are pale red, round or oval spots, with no tendency to coalesce
rash lasts 2 or 3 days and disappears rapidly without leaving any pigmentation and desquamation
Слайд 27Blood counts demonstrate leukopenia, lympho, and numerous plasma cells (10-15 %)
Complications
are exceptionally rare :
arthropathy,
otitis,
pneumonia,
nephritis, polyneuritis
encephalitis and encephalomyelitis cases have been reported
arthropathy,
otitis,
pneumonia,
nephritis, polyneuritis
encephalitis and encephalomyelitis cases have been reported
Слайд 28Clinical manifestations of congenital rubella:
“Сongenital rubella syndrome" are :
cataract,
cardiac defects,
deafness
Слайд 29Congenital rubella
microcephalic hydrocephalus, deafness, cataract, retinopathy, microphthalmia, glaucoma, cardiac defects
A risk
of various embryopathies arises in women with rubella:
cataracts in the 5th-6th week,
deafness in the 9th week,
and cardiopathy in the 5th-10th week
cataracts in the 5th-6th week,
deafness in the 9th week,
and cardiopathy in the 5th-10th week
Слайд 30no treatment is required
patient should be isolated until the 5th day
from the outbreak of eruption
current vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine and to administer a second dose of MMR during childhood
current vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine and to administer a second dose of MMR during childhood
Treatment
Prophylaxis
Слайд 31Scarlet Fever
Scarlet fever is an acute infectious disease, characterized by lesions
of oropharynx with submaxillary lymphadenitis, fever toxemia, rash and then desquamation
Слайд 32pathogen of scarlet fever is a β-hemolytic
Streptococcus group
A
have considerable stability to the influence of physical factors
streptococcus produces exotoxins (Erythrogenous exotoxin )
stable antitoxic immunity is acquired against erythrogenous toxin
bacterial antigens of streptococcus and antibodies against them are typospecific and antibacterial immunity is not stable
have considerable stability to the influence of physical factors
streptococcus produces exotoxins (Erythrogenous exotoxin )
stable antitoxic immunity is acquired against erythrogenous toxin
bacterial antigens of streptococcus and antibodies against them are typospecific and antibacterial immunity is not stable
Etiology
Слайд 33Epidemiology
Scarlet fever is anthroponozic
The source of infection is a child with
scarlet fever or with other forms of streptococcal infection (tonsillitis, nasopharyngitis).
Duration of infectious period may fluctuate from some days to several weeks or sometimes months
The principal route of scarlet fever infection is an air-droplet one. Alimentary route plays insignificant
The contagious index is about 40 %.
Duration of infectious period may fluctuate from some days to several weeks or sometimes months
The principal route of scarlet fever infection is an air-droplet one. Alimentary route plays insignificant
The contagious index is about 40 %.
Слайд 34Pathogenesis
The principal portal of entry in scarlet fever is mucous membrane
of oropharynx
The infection may penetrate through damaged skin (in bums or injuries) or mucous membranes of the genitals (extrabuccal scarlet fever)
complex pathologic process, which may be presented in the form of three lines of pathogenesis: toxic, septic and allergic ones
The infection may penetrate through damaged skin (in bums or injuries) or mucous membranes of the genitals (extrabuccal scarlet fever)
complex pathologic process, which may be presented in the form of three lines of pathogenesis: toxic, septic and allergic ones
Слайд 35The toxic syndrome is the result of influence of the toxic
substances produced by the hemolytic streptococcus
the signs of toxemia in the form of fever,
rash,
headache, and vomiting,
lesions of the vegetative nervous system
the signs of toxemia in the form of fever,
rash,
headache, and vomiting,
lesions of the vegetative nervous system
The septic syndrome includes primary inflammation in the portal of entry and microbial streptococcal complications
purulent one and spreading of hemolytic streptococcus from the primary focus to the surrounding tissue and through lymphatic and blood vessels
Слайд 36The allergic syndrome
is caused by the sensitizing substances of hemolytic
streptococcus, which are proteins
reaches its peak on the 2nd -3rd week of illness
allergic syndrome is manifested by various eruptions on the skin, myocarditis, glomerulonephritis, synovitis and "Allergic waves”
reaches its peak on the 2nd -3rd week of illness
allergic syndrome is manifested by various eruptions on the skin, myocarditis, glomerulonephritis, synovitis and "Allergic waves”
Слайд 37Clinical Manifestations
The incubation period for scarlet fever is 2 to 7
days
The disease is started in fever, vomiting, sore throat and toxic symptoms such as headache and malaise
The disease is started in fever, vomiting, sore throat and toxic symptoms such as headache and malaise
Слайд 38Tonsillitis
Scarlatinal tonsillitis may be catarrhal, follicular or necrotic
Tonsillitis is accompanied by
regional lymphadenitis
The upper border of hyperemia is on the anterior palatal arches and on the base of the uvula (delimited hyperemia)
The upper border of hyperemia is on the anterior palatal arches and on the base of the uvula (delimited hyperemia)
is a typical sign of scarlet fever
Слайд 39Tongue
During the first 1 or 2
days the dorsum has
a
white "fur coat",
and the tip and edges
are reddened
By the fourth or fifth
day the white coat has peeled off
The red, glistening tongue, studded with prominent papillae, presents the appearance of raspberry ("raspberry tongue')
white "fur coat",
and the tip and edges
are reddened
By the fourth or fifth
day the white coat has peeled off
The red, glistening tongue, studded with prominent papillae, presents the appearance of raspberry ("raspberry tongue')
Слайд 40Exanthema
It becomes generalized very rapidly.
Patient face is
typical in scarlet
fever
- cheeks are
red, smooth and
flushed, and the
area around the
mouth is pale,
lips are crimson.
red, smooth and
flushed, and the
area around the
mouth is pale,
lips are crimson.
Слайд 41Rash is more intense in skin folds such as the axillae,
cubital, inguinal, popliteal, and also on skin of the neck, breast, abdomen, buttocks.
Слайд 42Tiny petechiae occur in the creases of the folds of the
joints and form transverse lines (Pastia's sign) that persist after the rash has faded.
Rash usually remains for 4-5 days
Rash usually remains for 4-5 days
Слайд 43initially on the face on the second week as fine branny
flakes
desquamation skin of the trunk comes off in larger, thicker flakes
sometimes a retrospective diagnosis
desquamation skin of the trunk comes off in larger, thicker flakes
sometimes a retrospective diagnosis
Desquamation
Слайд 44Cardiovascular changes
In acute period of scarlet fever tachycardia, increased blood
pressure
Bradycardia, arrhythmia, decreasing of blood pressure, dull heart sounds, systolic murmur occur the 4th-5th day of illness
N. F. Filatov has described the so-called “scarlatinal heart”
The bases of these changes are extracardiac disorders of vegetative nervous system
There is leukocytosis, neutrophilia, increased ESR in the acute period of scarlet fever
Bradycardia, arrhythmia, decreasing of blood pressure, dull heart sounds, systolic murmur occur the 4th-5th day of illness
N. F. Filatov has described the so-called “scarlatinal heart”
The bases of these changes are extracardiac disorders of vegetative nervous system
There is leukocytosis, neutrophilia, increased ESR in the acute period of scarlet fever
Слайд 45Classification
Typical: mild, moderate, severe
Atypical (extrabuccal forms) - they are characterized by
a short-term incubation period, absence of mild tonsillitis, rash appears near the portal of entry, it is more intensive there: burn, injury, puerperal
The forms with aggravated signs are atypical too; they are hypertoxic and septic ones
The forms with aggravated signs are atypical too; they are hypertoxic and septic ones
Слайд 46Complications
early one (first week) - septic complications are tonsillitis, lymphadenitis, otitis
media
allergic ones the late one (2nd-3rd week) - allergic complications include lesions of kidneys (nephritis), heart (myocarditis) and joints (synovitis)
allergic ones the late one (2nd-3rd week) - allergic complications include lesions of kidneys (nephritis), heart (myocarditis) and joints (synovitis)
Слайд 47Treatment
Hospitalization takes
Severe course of scarlet fever with various complications.
Children
from boarding schools and other institutions
Antibiotics should be administered
Penicillin should be given in the dosage of 100 000/kg/ day for 7-10 days
Слайд 48Prophylaxis
Specific prevention of scarlet fever has not been devised.
The patients
with scarlet fever are isolated for 22 days.
The children who had contacts with the patient should be observed for 7 days
The children who had contacts with the patient should be observed for 7 days
