Myleioid pneumonia
Introduction
Introduction to Rhizoctonia pyogenes A snoring is a human and animal comorbidity, a contagious disease similar to horse snot. The disease is very similar to the clinical and pathological features of horse snot, but the epidemiology is different. basic knowledge The proportion of illness: the incidence rate is about 0.001%-0.0025 Susceptible people: no special people Mode of infection: respiratory transmission Complications: sepsis
Cause
Causes of Rhizoctonia pyogenes
(1) Causes of the disease
The genus sinus is caused by pseudomonas pseudomallei, which is 1 to 2 m long, 0.5 m wide, and can move, without spores, without capsules, negative for Gram stain, and the bacteria are aerobic bacteria. The growth on the substrate is good. After 48-72 hours of culture, the colonies are brownish yellow, the surface has honeycomb folds, and is concentric, the culture has a strong moldy smell, and the filtrate of the culture contains two kinds of toxins: one is Necrotic toxin (boiling inactivated for 4 min); the other is a lethal toxin (boiling for 15 min), which can cause lethal infection in guinea pigs and rabbits.
(two) pathogenesis
Most of the lesions occur in the lungs during acute infection, and there are abscesses in other organs. In the case of subacute infection, the lung abscess tends to spread throughout the skin, subcutaneous tissue, meninges, brain, eyes, heart, liver, kidney, spleen. Bone, prostate, synovium and lymph nodes, acute abscess is characterized by peripheral bleeding, a large amount of neutral multinucleated leukocyte infiltration in the middle, and a necrotic debris in the center, which contains a large number of 2 to 3 nuclear giant tissues. Cells, obvious nuclear rupture is an important feature of histology. In the case of chronic infection, the center of the lesion is seen in caseous necrosis, formed by monocytes, plasma cell infiltration and granulation tissue, and there is no calcification.
Prevention
Rhizoctonia pyogenes prevention
There is no specific preventive method, which mainly prevents the water and soil contaminated by the bacteria from being infected through the skin mucosa. Under the condition that there may be contaminated bacterial dust, the staff should wear protective masks, excrement and purulent infiltration of patients and sick animals. The food should be disinfected with bleaching powder. In the endemic areas, skin abrasion and tearing should be strictly cleaned. The source of the disease should be disinfected at the end of the period, and insecticide and rodent control measures should be taken. Medical treatment should be carried out for suspected infected people. After 15 days of observation, animals imported from the source of the disease should be strictly quarantined.
Complication
Rhinobacteria-like pneumonia complications Complications sepsis
Untreated acute pneumonia with sepsis, the mortality rate is as high as 90%.
Symptom
Symptoms of Pneumoniae pneumonia Common symptoms Weight loss, shortness of breath, shortness of breath, high heat, weakness, severe headache, abscess, bacterial infection, chest pain, chills
1. The incubation period is generally 4 to 5 days, but there are also several months after infection, several years, and even up to 20 years after the onset, the so-called "latent type of nasal discharge", such cases are often induced by trauma or other diseases.
2. Clinical types are clinically diverse and can be divided into the following types:
(1) Concealed infection: no symptoms, only high titer-specific antibodies were found during serological examination, and the positive rate in adult male healthy population in the endemic area was about 6% to 20%, which was reported in conventional X-ray photographs. Occasionally, there were asymptomatic infections during the examination.
(2) acute localized suppurative infection: often due to bacterial infection of damaged skin, local formation of nodules, complicated with lymphangitis and associated lymphadenitis, patients often have fever and general malaise, and then rapidly develop into acute sepsis.
(3) acute lung infection: is the most common form of this disease, manifested as primary or blood-borne disseminated pneumonia, sudden onset, chills or chills, followed by fever, body muscle pain, headache, cough, chest pain Shortness of breath, snoring can be heard in the lungs, X-ray examination of lung consolidation, and some thin-walled cavities can occur. When the body temperature drops, the cavity can persist. It resembles the X-ray manifestations of tuberculosis, and some patients can occur one after another. Progressive intrapulmonary dissemination or blood-borne dissemination develops into sepsis.
(4) acute septic infection: sudden onset, chills, high fever, small pustules on the skin of the head, trunk and limbs, such as pneumonia often accompanied by severe breathing difficulties, severe headache, cough and chest pain, wet phlegm in the lungs Tone and pleural friction sounds, X-ray examination often shows irregular nodular shadows throughout the lung, 4 to 10 mm in diameter, and then nodules expand and fuse to form a cavity, patients may be associated with arthritis or meningitis, liver and spleen, prognosis Poor, the disease develops rapidly and often falls short of treatment and dies.
(5) Chronic suppurative infection: some patients develop secondary suppurative lesions after acute phase, such as osteomyelitis, suppurative lymphadenitis, subcutaneous abscess, psoas abscess, lung abscess, empyema, liver abscess, spleen abscess And pyelonephritis, etc., these abscesses can form a fistula, long-term unhealed, become a chronic type, the patient gradually loses weight and weak.
Examine
Examination of Rhizoctonia pyogenes
1. Most patients with blood tumors have anemia, and the total number of white blood cells increases in the acute phase, mainly due to the increase of neutrophils.
2. Bacterial culture and animal inoculation of blood, sputum, cerebrospinal fluid, urine, feces, purulent exudate of local lesions for bacterial culture or animal inoculation, can be isolated from the genus Rhizopus, Strauss reaction positive.
3. Serological detection The indirect erythrocyte agglutination test titer is above 1:40, and the complement binding test titer is diagnostically significant at 1:8 or higher. It can be positive 1 week after the disease, and the positive rate can reach 90% or more in 4 to 5 weeks. The antibody titer can be maintained for about 1 year.
X-ray examination showed pneumonia, lung purulence and empyema.
Diagnosis
Diagnosis and identification of Rhizoctonia pyogenes
diagnosis
The disease is more strict regional, a patient who lives in a prevalent area or has a history of travel, when any unexplained purulent or hot disease occurs, or when tuberculosis is present on X-ray films and tuberculosis is not isolated All should consider the possibility of having a type of nasal sinus, and then combined with laboratory tests to make a diagnosis.
Differential diagnosis
In the acute phase, attention should be paid to the identification of typhoid fever, malaria, fungal infection, acute staphylococcal septicemia or staphylococcal pneumonia; in the chronic phase, attention should be paid to the identification of tuberculosis.
