《传染病学教学ppt课件》7流行性出血热.pptxVIP

Hemorrhagic Fever with Renal Syndrome ;Overview;;The viruses that cause hemorrhagic fever with renal syndrome include: Hantaan Dobrava-Belgrade Seoul Puumala Sin Nombre virus can cause hantavirus pulmonary syndrome (America) ;Epidemiology ;Striped field mouse Apodemus agrarius ;Norway rat Rattus norvegicus,;Bank voles Clethrionomys glareolus;Yellow-necked field mouse A. flavicollis;Epidemiology ;Epizootic Cycle;Epidemiology;Pathogenesis;Pathogenesis;Immune mediated vascular endothelial injury Increased capillary permeability Plasma extravasation Insufficient blood volume Primary shock occurs before oliguric stage ;Pathogenesis: hemorrhage tendency;Decreased blood flow Direct injury to the kidney; Histopathologic changes in kidney (cortex) Small arrow: interstitial edema with mild infiltration of mononuclear cells Large arrow : degeneration of renal tubules Arrow head: proteinaceous casts and exudate; Histopathologic changes in kidney (medulla) Most prominent change in the medulla is well–defined necrotic lesion (asterisk) ;Intracranial hemorrhage in HFRS patient;Clinical Manifestations: overview;Clinical Manifestations: Febrile stage;Clinical Manifestations: Febrile stage;Clinical Manifestations: Febrile stage;Drunken face;Clinical Manifestations: Febrile stage;Petechiae on axilla;Ecchymosis in severe case;Subconjunctival hemorrhage;Petechiae on the soft palate;Clinical Manifestations: Febrile stage;chemosis;Clinical Manifestations: Hypotensive stage;Clinical Manifestations: Oliguric stage;Clinical Manifestations: Diuretic stage;Clinical Manifestations: Convalescent stage;Clinical Manifestations;Laboratory findings;Laboratory findings;Massive protein and shedded epithelial cells in urine form Membrane-like substance;Laboratory findings;Laboratory findings;Summary of the clinical features;Complication;Treatment: overview;Treatment: Febrile stage;Treatment: Hypotensive stage;Treatment: Oliguric stage;Treatment of hyperkalemia;Trea