symptoms, early symptoms and signs of protoalgae
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Typical symptoms: macula, diarrhea, abnormal pigmentation, ulcer and papule
Related symptoms: inflammatory cell infiltration, skin atrophy and pigmented macula granuloma
1. Skin, subcutaneous and mucosal types of chlorophyll-free superficial planting are the most common types, which are partly related to contact with sewage. It often occurs several weeks or more after exposure. There may be granulomatous damage, macula or papular damage, and patients with immune damage may have acanthosis and ulcer. Plaque verrucous lesions occurred in some cases. Skin atrophy and pigmentation or loss. Can have burning itch. It is more common in exposed parts such as limbs, forehead and cheeks. Bacterial infection and elephant skin swelling can be secondary. There are also reports of tenosynovitis and cellulitis after trauma. There is only one disseminated case of nasopharyngeal mucosal infection developing hard palate, esophageal and tongue ulcer. This patient has multiple inducing factors, including endotracheal intubation, diabetes and high-dose dexamethasone.
2. Chlorophyll-free olecranon bursitis is partly related to trauma. Synovial bursa may be suitable for growth without green algae, when complicated with other inflammation or induced by corticosteroid hormone. The extracted cyst fluid can be bloody and positive for fungal culture.
3. Intestinal chlorophylosis can cause diarrhea. It is related to eating contaminated food.
4. Systemic chlorophylosis is rare. Liver, peritoneum and gallbladder can be involved.
Mainly based on pathogenic bacteria examination and histopathological diagnosis.
1. Skin damage, pus, exudate, living tissue, etc. can be used for pathogenic bacteria examination.
(1) Direct microscopic examination showed round, nearly round, thick-walled spores with a diameter of about 1730 μ m and no bud, with a size of (20 ~ 30 μ m) × (17 ~ 24 μ m) and a large number of endophytic spores in them. There are no hyphae, ascoma and spores.
(2) Culture: Smooth and moist white yeast-like colonies grew on sandcastle agar at 25 ~ 35 ℃ for 2 ~ 3 days, which gradually changed into cream color with a little wrinkles on the surface. Cycloheximide and > 37 ℃ can inhibit the growth of this bacterium. Chlorophyll-free isolation medium containing phthalate can inhibit bacteria and fluorocytosine can inhibit yeast, which is beneficial to isolate this bacterium from contaminated conditions. Microscopically, the asexual reproduction of this bacterium can be seen. Spores form a large number of endophytic spores through the division and re-division of nucleus and cytoplasm. After maturity, cysts break, endophytic spores overflow, expand, divide and expand again, and form new sporangiae.
The difference between Rao's chlorophyllum and Wei's chlorophyllum is that the sporangium of the former is larger, with a diameter of about 1025 μ m, and the inner spores are larger, with a diameter of 911 μ m, but the number is small and the arrangement is loose; The sporangium of the latter is about 611 μ m in diameter, and the inner spores are smaller, about 45 μ m in diameter, with a large number and close arrangement.
(3) Biochemical characteristics: Rao's green algae uses n-propanol instead of trehalose; Chlorophyllum wickensis can use trehalose but not n-propanol.
2. Histopathologically, hyperkeratosis of epidermis, slight edema of spinous layer, infiltration of inflammatory cells, mainly dermoid cells and lymphocytes, around superficial dermis, blood vessels and skin appendages were observed. Spores were scattered in superficial dermis by PAS staining, with a diameter of about 4 ~ 10 μ m, wall thickness and endophytic spores in different numbers.
3. In animal test, about 1 × 106 CFU/ml bacterial suspension was injected into abdominal cavity of mice or testis of guinea pigs, rabbits and mice, 0.5 ml in abdominal cavity and 0.03 ml in testis, which could cause local damage. The results of pathogenic bacteria examination are the same as above.
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