婴儿沙眼衣原体肺炎-陶孝芬.ppt

* The bi-phasic chlamydial growth cycle involves transformation between two distinct forms: the elementary body (EB) and the reticulate body (RB). The metabolically inactive but highly infectious EB attaches to columnar epithelial cells and is internalized within a host cell membrane-bound phagosome?(A)?. During early stages of the life cycle, 1 to 10 hours post infection (hpi), the vesicle migrates to a perinuclear location near the Golgi apparatus(B)?. It is during this migration that the nascent phagocytic vesicle begins to be modified by Chlamydia-produced inclusion membrane proteins to form a parasitophorous vacuole termed an inclusion. It is also during this time period that the EB differentiates into the RB, which is the metabolically active and the replicative form. At 10 to 16 hpi, the RB begins to divide by binary fission?(C)?. Accumulating RBs are located on the periphery of the inclusion membrane (IM), allowing type III secretory system (T3SS) needle-like structures (injectisomes) to penetrate the IM to secrete effector proteins into the cytosol which manipulate host-cellular functions, including signal transduction pathways (16 to 24 hpi).?(D)?Division continues as the inclusion expands, and between 24 and 36 hpi, the RBs begin to asynchronously differentiate back into EBs?(E)?. At 36 to 48 hpi, most of the RBs have converted back to the infectious EB form preparing for release and reinfection?(F)?. During very late stages, the infectious EBs escape the cell by lysis through proteolytic processes or by a process of extrusion?(G)?. Reinfection then occurs, initiating new cycles of infection?(H)?. * 临床表现 陈理华，尚世强等.小婴儿沙眼衣原体肺炎26例临床分析.中国冶金工业医学杂志1999年第16卷第5期.280-281. 217例6月肺炎患儿，CT阳性26例（12.0%）[2] 咳嗽 24例 92.30% 气促 22例 84.60% 发热 13例 50% 肺部湿啰音 19例 73.10% 喘鸣音 9例 34.60% 紫绀 4例 15.40% 合并呼吸衰竭 2例 7.70% 合并结膜炎 3例 11.50% 全身皮疹 2例 7.70% 肝脾肿大 7例 26.90% 合并腹泻 16例 61.50% 实验室检查 白细胞升高 8例 肝功能异常 19例 X线表现 两肺纹理增粗及斑片影 25例 伴肺气肿 3例 半个月复查胸片未好转 2例 临床表现 翟倩，曹云等.沙眼衣原体肺炎24例临床分析.中国实用儿科杂志2012年1