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The cycle of leptospiral infection. Mammalian species excrete leptospiral pathogens in their urine and serve as reservoirs for their transmission. The pathogens are maintained in sylvatic and domestic environments by transmission among rodent species. In these reservoirs, infection produces chronic, asymptomatic carriage. Leptospires can then infect livestock and domestic and wild animals and cause a range of disease manifestations and carrier states. Maintenance of leptospirosis in these populations is due to their continued exposure to rodent reservoirs or to transmission within animal herds. Leptospirosis is transmitted to humans by direct contact with reservoir animals or by exposure to environmental surface water or soil that is contaminated with their urine. Leptospires penetrate abraded skin or mucous membranes, enter the bloodstream and disseminate throughout the body tissue. Infection causes an acute febrile illness during the early ‘leptospiraemic’ phase and progresses during the late ‘immune’ phase to cause severe multisystem manifestations such as hepatic dysfunction and jaundice, acute renal failure, pulmonary haemorrhage syndrome, myocarditis and meningoencephalitis. Although the immune response eventually eliminates the pathogens, leptospires may persist for prolonged periods in immunoprivileged sites, such as the renal tubules and the anterior chamber and vitreous humor of the eye, where they can produce, respectively, urinary shedding weeks after resolution of the illness and uveitis months after exposure. Humans are an accidental host and do not shed sufficient numbers of leptospires to serve as reservoirs for transmission. [ Last edited by conanthird on 2010-12-3 at 10:18 ] |
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鉤端螺旋體感染的周期 哺乳類動(dòng)物通過(guò)尿液排泄鉤端螺旋體致病原,并作為傳送該病原的宿主。該致病菌通過(guò)在嚙齒動(dòng)物中傳播一直存在于森林和家養(yǎng)環(huán)境中。在這些宿主里,感染是慢性無(wú)癥狀性的。然后鉤端螺旋體感染家畜和野生動(dòng)物,并引發(fā)一系列的疾病臨床表現(xiàn)和帶菌狀態(tài)。鉤端螺旋體在這些種群中的維持是由于它們持續(xù)接觸嚙齒類動(dòng)物或者是在動(dòng)物牧群傳播。人類通過(guò)與帶菌動(dòng)物接觸或者是接觸到周圍被帶菌動(dòng)物的尿液污染的地表水或表面土壤,也可被傳播至身上。鉤端螺旋體滲透損傷的皮膚或者粘膜通過(guò)身體組織進(jìn)入血液循環(huán),在早期的鉤端螺旋病里感染可以引起患者急性發(fā)熱 并且在后來(lái)的免疫反應(yīng)里發(fā)展為嚴(yán)重的多系統(tǒng)臨床表現(xiàn)如肝功能缺陷,黃疸,急性腎衰竭,肺出血并發(fā)癥,心肌炎以及腦膜腦炎等。雖然免疫反應(yīng)最終會(huì)消除該致病原,鉤端螺旋體還是可能會(huì)在缺乏免疫的部位持續(xù)很長(zhǎng)一段時(shí)間,比如說(shuō)腎小管,眼前房和玻璃體,這些部位,在機(jī)體感染該病數(shù)周后,可以各自的分泌類尿的液體。人類是偶然宿主,并不具有足夠數(shù)量的鉤端螺旋體來(lái)傳播 |
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