Prototheca disease
Introduction
Introduction to primary algae Protothecosis is the infection of human skin, subcutaneous tissue, mouth, nose, serosa, etc. caused by green algae. Occasionally, it can cause systemic infection and is currently classified as fungal disease. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Infection method: pathogen infection Complications: diarrhea
Cause
Cause of primordial disease
Environmental factors (50%):
Superficial planting is the most common type and is partly related to exposure to sewage. It usually occurs several weeks or more after exposure. There may be granulomatous lesions, which may be rash or papular lesions, and patients with immune damage may develop acanthosis and ulcers. Some cases have plaque lesions. Skin atrophy and pigmentation or loss. It can be itchy. Occurs in exposed parts such as limbs, forehead, and cheeks. Can be secondary to bacterial infections, like skin swelling. There are also reports of tenosynovitis and cellulitis after trauma. Only one disseminated report developed a nasopharyngeal mucosal infection into a hard palate, esophageal, and tongue ulcer. The patient had multiple predisposing factors, including endotracheal intubation, diabetes, and high-dose dexamethasone.
Trauma factors (40%):
Partly related to trauma. The bursa may be suitable for the growth of chlorella, which is induced by the combination of other inflammations or the application of corticosteroids. The extracted cyst fluid can be bloody and positive for fungal culture.
Dietary factors (10%):
Can cause diarrhea. It is related to the ingestion of contaminated food.
Prevention
Primary algae prevention
For patients with immunosuppressive therapy, diabetes and trauma, it is especially important to keep the skin and wounds clean and prevent the invasion of germs.
Complication
Primary algal disease complications Complications, diarrhea
Systemic chlorella-free disease can affect organs such as the liver, peritoneum and gallbladder.
Symptom
Symbiosis symptoms common symptoms bacterial infection papules diarrhea skin atrophy and pigmentation rash keratitis keratinocyte infiltration granuloma
1. Skin, subcutaneous and mucosal non-Phalaphyte superficial planting is the most common type, some of which are related to exposure to sewage, often occur several weeks or more after exposure, may have granulomatous lesions, may be rash or Papular lesions, patients with immune damage may have acanthosis and ulcers, plaque sputum lesions in some cases, skin atrophy and pigmentation or loss, may have an itching sensation, occur in the limbs, forehead, cheeks Such exposure sites may be secondary to bacterial infections, such as skin swelling, as well as reports of tenosynovitis and cellulitis after trauma. Only one case reported that nasopharyngeal mucosal infections develop into hard palate, esophageal and tongue ulcers. There are multiple predisposing factors, including endotracheal intubation, diabetes, and the use of high-dose dexamethasone.
2. Chlorella-free olecranon bursitis is partly related to trauma. The bursa may be suitable for the growth of chlorella. When combined with other inflammations or corticosteroids to induce the disease, the sac fluid can be bloody, fungal culture. Positive.
3. Intestinal non-problem algae can cause diarrhea, which is related to food intake.
4. Systemic non-Pythium is rare, involving the liver, peritoneum and gallbladder and other organs.
Examine
Inspection of algae disease
Pathogen examination: specimens can be used for skin damage, pus, exudate, living tissue, etc.
Histopathology: epidermal hyperkeratosis, mild edema of the acanthosis, superficial dermis, inflammatory cells infiltrated by epithelial cells and lymphocytes around the blood vessels and skin attachments. Spores were observed in the superficial dermis during PAS staining. It is about 4 to 10 m in diameter and has a wall thickness with a number of endospores.
Animal test In the mouse abdominal cavity or guinea pig, rabbit and mouse testicular injection of about 1 × 106 cfu / ml bacterial suspension, 0.5ml in the abdominal cavity, 0.03ml in the testis, can cause local damage, the pathogen test results are the same as above.
Diagnosis
Diagnosis and identification of primary algae
Diagnostic criteria
1. The pathogen specimen can be used for skin damage, pus, exudate, living tissue, and the like.
(1) Direct microscopic examination: visible round, nearly circular, thick wall, diameter of about 1730m, non-bud spores, (20 ~ 30m) × (17 ~ 24m) size, with a large number of endospores, sterile silk , ascospores and spores.
(2) Culture: On the sand castle agar, 25 to 35 ° C, 2 to 3 days, a smooth and moist white yeast-like colony grows, gradually changing to cream color, with a slight wrinkle on the surface, cycloheximide and >37 ° C It can inhibit the growth of the bacteria. The non-green algae isolation medium contains phthalate to inhibit bacteria. Flucycytosine can inhibit yeast, which is beneficial to isolate the bacteria from the contaminated conditions. The asexual reproduction of the bacteria can be seen under the microscope, and the spores pass. The nucleus and cytoplasm divide and re-divide, forming a large number of endospores. After maturity, the cysts rupture, the endospore overflows, expands, divides, and expands to form new sporangia.
The difference between R. aeruginosa and P. aeruginosa is that the former has a large sporangia, a diameter of about 1025 m, a larger endospores, and a diameter of 911 m, but the number is small and the arrangement is loose; the latter sporangia is about 611 m in diameter. The endospores are small, the diameter is about 45m, the number is larger, and the arrangement is tighter.
(3) Biochemical characteristics: A. chlorella does not utilize trehalose and uses n-propanol; W. chlorpyrifos uses trehalose but cannot use n-propanol.
2. Histopathological epidermal hyperkeratosis, mild edema of the acanthosis, superficial dermis, inflammatory cells infiltrated by epithelial cells and lymphocytes around the blood vessels and skin attachments, scattered spores in the superficial layer of dermis during PAS staining It is about 4 to 10 m in diameter and has a wall thickness with a number of endospores.
3. Animal test In the mouse abdominal cavity or guinea pig, rabbit and mouse testicular injection of about 1 × 106 cfu / ml bacterial suspension, 0.5ml in the abdominal cavity, 0.03ml in the testis, can cause local damage, the pathogen test results are the same as above.
