主要致病性真菌精品.ppt

* * * * * * * * * * * * * * * * * * * 培养特性：沙保或血琼脂培养基，25℃和37℃ 生化特性：分解尿素 荚膜多糖抗原：A～D 和AD 5个血清型，我国约70%属A型 * 芽管形成试验：接种于0.5~1.0ml正常人或羊血清，37℃孵育1.5~4h，镜检可见芽生孢子及芽管形成 厚膜孢子形成试验：接种于1％吐温80玉米粉培养基，25℃孵育24~48h，镜检可见厚膜孢子 * 肺孢子菌又称肺孢子虫，因其具有原虫的生活史及形态，近年发现其超微结构及DNA、蛋白质均与真菌相似， 故归属于真菌。 * 正常成人的CD４细胞在每立方毫米500个到1600个,艾滋病病毒感染者的CD４细胞出现进行性或不规则性下降,标志着免疫系统受到严重损害,当CD４细胞小于每立方毫米200个时,可能发生多种机会性感染或肿瘤. 足细胞→分生孢子梗→顶囊→杆状小梗→串状分生孢子（分生孢子头） Species The genus Aspergillus includes over 185 species. Around 20 species have so far been reported as causative agents of opportunistic infections in man. Among these, Aspergillus fumigatus is the most commonly isolated species, followed by Aspergillus flavus and Aspergillus niger.  Pathogenicity and Clinical Significance 局限性肺曲霉病 基础疾病致肺空洞存在 曲霉在此生长，不侵犯组织不播散 曲霉肺炎（免疫功能低下） 过敏性支气管肺曲霉病（过敏体质） Pathogenicity and Clinical Significance 全身性曲霉病 多发生在某些重症疾病晚期 原发病灶主要在肺 常由败血症引起全身性感染 生前很难得到确诊 Pathogenicity and Clinical Significance 黄曲霉毒素与恶性肿瘤，尤其是肝癌的发生密切相关 Laboratory diagnosis The specimen like sputum biopsy, bronchalveolar lavage or transbronchial biopsy depending in the site involved. Direct examination of septate hyphae by 10% KOH preparation. 血清学诊断或血清学试验检出曲霉细胞壁半乳糖甘露乳糖抗原. Culture : In SDA with antibiotics at 25 and 37c 有隔菌丝和分生孢子头. Pneumocystis carinii Pneumonia PCP: Historical Features 1909 - First recognized in lungs of Guinea pigs by Chagas. Similar to Trypanosoma cruzi, yet different. These observations were confirmed by Carini soon after. 1912 - Delanoes named it after its discoverer and to reflect its tendency to infect the lungs. PCP: Historical Features Not initially believed to affect humans. 1951 - Vanek described an interstitial pneumonia with Pneumocystis carinii organisms in a human. 1955 - First reported in immunodeficiency. 1957 - First associated with chemotherapy. 1982 - AIDS and Pneumocystis carinii association. PCP: ClassificationFungus or Protozoan? Shares both fungal and protozoan nucleic acids and structural features of each. Does not grow in fungal