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(Francisella (致病 (Oculoglandular (眼腺）, Typhoidal (腸傷寒) ，易引發敗血病,…

- - - - H. influenzae
        
        virulence factor
        
        Antiphagocytic polysaccharide capsule：polyribitolphosphate(PRP）
        
        疾病
        
        meningitis嬰幼兒
        
        Epiglottitis (會厭炎): 2-4 yrs
        
        Cellulitis蜂窩性組織炎
        
        致病方式
        
        Encapsulated Hi type b (Hib, biotype I)
        
        H. parainfluenzae & Nonencapsulated Hi
        
        流病Hib
        
        在健康小孩很少分離出來
        
        疫苗：只有Polysaccharide則不適用嬰幼兒，要用Hib conjugate vaccine才有用
      - H. ducreyi
        
        性病
        
        soft chancre / chancroid (軟性下疳) in men
        
        tender papule丘疹膿皰
        
        與其他性病臨床症狀不同，可區分
      - 其他種
        
        耳朵，或鼻透言
      - H. aegyptius
        
        conjunctivitis埃及人眼睛大，熱帶地區盛行率較高
    - - needle aspiration
      - Cerebrospinal fluid腦脊髓液（for腦膜炎）
      - Oral swab
      - 培養：Chocolate agar or Levinthal agar
      - Satellite phenomeno
  - - - A. actinomycetemcomitan
        
        Mouth flora  blood：subacute endocarditis
      - A. aphrophilus
  - - - P. multocida
        
        Commensals in oropharynx
        
        貓狗咬傷
        
        培養blood and chocolate agar
        
        buttery (capsule) colonies with a 「musty」 odor
      - P. canis
- - - - Adenylate cyclase toxin / hemolysin
      - Dermonecrotic toxin (heat-labile)
      - Tracheal cytotoxin
      - LPS：Lipid A & Lipid X
      - S1 subunit of pertussis toxin
    - - Pertussis toxin（S1-S5）
      - Fimbria
      - Pertactin and Filamentous hemagglutinin
    - - Paroxysmal phase (發作期)
        
        whooping cough
        
        較不具感染力
      - Convalescent phase (恢復期)
      - Catarrhal phase (黏膜期)
        
        最具感染力
    - - Extremely sensitive to drying
      - synthetic fiber swabs not cotton swabs
      - PCR
      - ELISA
      - Regan-Lowe charcoal medium
        
        35°C, humidified, 7-12 days