Samenvatting Mycologie, parasitologie en virologie
Inhoud
Deel 1: Parasitologie ..................................................................................................................... 5
Hoofdstuk 1: Inleiding ............................................................................................................... 5
1.1 Definities ........................................................................................................................ 5
Hoofdstuk 2: Laboratoriumdiagnostiek van parasitaire infecties.................................................. 8
2.1 Microscopenonderzoek .................................................................................................... 8
2.2 Sneltesten ..................................................................................................................... 12
2.3 Serologisch onderzoek → lezen ...................................................................................... 12
2.4 Moleculaire technieken → lezen ..................................................................................... 13
2.5 Kweekproeven → lezen .................................................................................................. 13
Hoofdstuk 3: sporozoa ............................................................................................................ 14
3.1 Taxonomische indeling ................................................................................................... 14
3.2 Plasmodium .................................................................................................................. 14
3.3 cryptosporidium............................................................................................................. 18
3.4 Toxoplasma gondii ......................................................................................................... 19
Hoofdstuk 4: Rhizopoda (Entamoeba, Acanthamoeba, Naegleria) ............................................. 21
4.1 Taxonomische indeling: Rhizopoda ................................................................................. 21
4.2 Entamoeba histolytica .................................................................................................... 21
4.3 Vrij levende amoeben (Naegleria & Acanthamoeba) ......................................................... 22
Hoofdstuk 5: Flagellata ........................................................................................................... 24
5.1 Taxonomische indeling ................................................................................................... 24
5.2 Leishmania donovani (viscerale leishmaniasis / Kala azar) ............................................... 24
5.3 Leishmania tropica (cutane leishmaniasis)...................................................................... 26
5.4 Trypanosoma cruzi (Ziekte van Chagas) ........................................................................... 26
5.5 Trypanosoma brucei (Afrikaanse slaapziekte) .................................................................. 28
5.6 Giardia lamblia .............................................................................................................. 29
5.7 Trichomonas vaginalis .................................................................................................... 31
Hoofdstuk 6: Trematoda .......................................................................................................... 32
6.1 Taxonomische indeling ................................................................................................... 32
6.2 Fasciola hepatica (leverbot)............................................................................................ 32
6.3 Schistosoma spp. (bloedbotten) ..................................................................................... 34
Hoofdstuk 7: Cestoda ............................................................................................................. 36
7.1 Taxonomische indeling ................................................................................................... 36
7.2 Taenia saginata .............................................................................................................. 36
7.2 Taenia solium (Varkenslintworm) .................................................................................... 38
1
, 7.3 Echinococcus granulosus .............................................................................................. 39
Hoofstuk 8: Nematoda ........................................................................................................... 41
8.1 Taxonomische indeling ................................................................................................... 41
8.2 Ascaris lumbricoides...................................................................................................... 41
8.3 Trichinella spiralis .......................................................................................................... 42
8.4 Enterobius vermicularis (aarsmade) ................................................................................ 43
8.5 Wuchereria bancrofti (lymfatische filariasis).................................................................... 44
8.6 Dracunculus medinensis (Guinea worm) ......................................................................... 45
Hoofdstuk 9: Arthropoda ......................................................................................................... 46
9.1 Indeling ......................................................................................................................... 46
9.2 Teken (Ixodidae) ............................................................................................................. 47
9.3 Mijten ............................................................................................................................ 48
9.4 Wantsen (Hemiptera – Heteroptera) ................................................................................ 49
9.5 Vlooien (Siphonaptera) → microscopisch herkennen ....................................................... 50
9.6 Luizen (Anoplura) → microscopisch herkennen ............................................................... 50
Deel 2: Mycologie ....................................................................................................................... 51
Hoofdstuk 10: Inleiding mycologie ........................................................................................... 51
10.1 Vermenigvuldiging bij fungi ........................................................................................... 51
10.2 Klinisch belang van mycosen ........................................................................................ 51
10.3 Diagnostiek .................................................................................................................. 51
10.4 Behandeling ................................................................................................................. 52
Hoofdstuk 11: Oppervlakkige mycosen .................................................................................... 53
11.1 Dermatofytosen (tinea, ringworm) ................................................................................. 53
11.2 Oppervlakkige mycosen ............................................................................................... 54
11.3 Oppervlakkige candidosen ........................................................................................... 55
Hoofdstuk 12: Onderhuidse mycosen ...................................................................................... 56
12.1 Sporotrichose .............................................................................................................. 56
Hoofdstuk 13: Diepe cosmopolitische mycosen ...................................................................... 57
13.1 Inleiding ....................................................................................................................... 57
13.2 Aspergillose ................................................................................................................. 57
13.3 Mucormycose / Zygomycose......................................................................................... 58
13.4 Diepe Candidose.......................................................................................................... 59
13.5 Cryptococcose ............................................................................................................ 60
13.6 Pneumocystose ........................................................................................................... 61
DEEL 3: Virologie ........................................................................................................................ 63
Hoofdstuk 1: Basisbeginselen van de virologie.......................................................................... 63
1.1 Algemene eigenschappen van virussen ........................................................................... 63
2
, 1.2 Morfologie van virussen .................................................................................................. 63
Hoofdstuk 2: Benaming en indeling van virussen ...................................................................... 65
2.1 Klasse I: DNA dubbelstrengs ........................................................................................... 66
2.2 Klasse II: ssDNA-virussen zonder enveloppe ................................................................... 68
2.3 Klasse III: dsRNA-virussen zonder enveloppe .................................................................. 68
2.4 Klasse IV (+sense) en klasse V (−sense): ssRNA-virussen ................................................. 68
2.5 VI en VII – Reverse transcriptase virussen met enveloppe ................................................. 74
2.6 Niet-geklassificeerde virussen ........................................................................................ 74
Hoofdstuk 3: Invloed van fysische en chemische agentia op virussen ........................................ 75
3.1 Inleiding......................................................................................................................... 75
3.2 Algemeen verloop van de inactivatie van virussen ............................................................ 75
3.3 Invloed van fysische en chemische agentia op virussen ................................................... 76
Hoofdstuk 4: Intracellulaire virusvermenigvuldiging .................................................................. 80
4.1 Bacteriofagen – lytische infectie...................................................................................... 80
4.2 Dierlijke virussen............................................................................................................ 81
Hoofdstuk 5: Gevolgen van een virale infectie van cellen ........................................................... 84
5.1 Cellulaire en virale factoren ............................................................................................ 84
5.2 Lytische infectie: gastheercel wordt afgedood ................................................................. 84
5.3 Inhibitie van cellulaire macromoleculen .......................................................................... 84
5.4 Abortieve infectie ........................................................................................................... 85
5.5 Persisterende infectie .................................................................................................... 85
5.6 Latente virusinfecties ..................................................................................................... 85
Hoofdstuk 6: Algemeen pathogeen verloop en virulentie van virale infecties .............................. 87
6.1 Binnendringen van het virus ............................................................................................ 87
6.2 Gelokaliseerde infecties ................................................................................................. 87
6.3 Veralgemeende virale infecties (systemic infections) ....................................................... 87
6.4 Uitscheiding van virus..................................................................................................... 88
6.5 Rol van de immuunreactie .............................................................................................. 88
6.6 Virale ziekten volgens symptomatologie .......................................................................... 89
Hoofdstuk 7: Laboratoriumtechnieken in de virologie ............................................................... 90
7.1 Inleiding......................................................................................................................... 90
7.2 Zuivering en aanconcentreren van virussen ..................................................................... 90
7.3 Bepaling van de afmeting van virussen ............................................................................ 91
7.4 Kweken van virussen ...................................................................................................... 91
7.5 Diagnose van een virale infectie ...................................................................................... 92
Hoofdstuk 8: Antivirale geneesmiddelen .................................................................................. 97
8.1 Inleiding......................................................................................................................... 97
3
, 8.2 Adsorptie en penetratie van virus verstoren ..................................................................... 97
8.3 Synthesereactie verstoren met nucleoside-analogen ....................................................... 98
8.4 Synthesereactie verstoren met polymerase-inhibitoren ................................................... 99
8.5 Maturatie en budding verstoren ...................................................................................... 99
8.6 Interferon en interferon-inductoren ................................................................................100
Hoofdstuk 9: Bespreking van enkele klinisch belangrijke virussen ............................................101
9.1 Virale hepatitis .............................................................................................................101
9.2 HIV-VIRUSSEN ..............................................................................................................106
4
Inhoud
Deel 1: Parasitologie ..................................................................................................................... 5
Hoofdstuk 1: Inleiding ............................................................................................................... 5
1.1 Definities ........................................................................................................................ 5
Hoofdstuk 2: Laboratoriumdiagnostiek van parasitaire infecties.................................................. 8
2.1 Microscopenonderzoek .................................................................................................... 8
2.2 Sneltesten ..................................................................................................................... 12
2.3 Serologisch onderzoek → lezen ...................................................................................... 12
2.4 Moleculaire technieken → lezen ..................................................................................... 13
2.5 Kweekproeven → lezen .................................................................................................. 13
Hoofdstuk 3: sporozoa ............................................................................................................ 14
3.1 Taxonomische indeling ................................................................................................... 14
3.2 Plasmodium .................................................................................................................. 14
3.3 cryptosporidium............................................................................................................. 18
3.4 Toxoplasma gondii ......................................................................................................... 19
Hoofdstuk 4: Rhizopoda (Entamoeba, Acanthamoeba, Naegleria) ............................................. 21
4.1 Taxonomische indeling: Rhizopoda ................................................................................. 21
4.2 Entamoeba histolytica .................................................................................................... 21
4.3 Vrij levende amoeben (Naegleria & Acanthamoeba) ......................................................... 22
Hoofdstuk 5: Flagellata ........................................................................................................... 24
5.1 Taxonomische indeling ................................................................................................... 24
5.2 Leishmania donovani (viscerale leishmaniasis / Kala azar) ............................................... 24
5.3 Leishmania tropica (cutane leishmaniasis)...................................................................... 26
5.4 Trypanosoma cruzi (Ziekte van Chagas) ........................................................................... 26
5.5 Trypanosoma brucei (Afrikaanse slaapziekte) .................................................................. 28
5.6 Giardia lamblia .............................................................................................................. 29
5.7 Trichomonas vaginalis .................................................................................................... 31
Hoofdstuk 6: Trematoda .......................................................................................................... 32
6.1 Taxonomische indeling ................................................................................................... 32
6.2 Fasciola hepatica (leverbot)............................................................................................ 32
6.3 Schistosoma spp. (bloedbotten) ..................................................................................... 34
Hoofdstuk 7: Cestoda ............................................................................................................. 36
7.1 Taxonomische indeling ................................................................................................... 36
7.2 Taenia saginata .............................................................................................................. 36
7.2 Taenia solium (Varkenslintworm) .................................................................................... 38
1
, 7.3 Echinococcus granulosus .............................................................................................. 39
Hoofstuk 8: Nematoda ........................................................................................................... 41
8.1 Taxonomische indeling ................................................................................................... 41
8.2 Ascaris lumbricoides...................................................................................................... 41
8.3 Trichinella spiralis .......................................................................................................... 42
8.4 Enterobius vermicularis (aarsmade) ................................................................................ 43
8.5 Wuchereria bancrofti (lymfatische filariasis).................................................................... 44
8.6 Dracunculus medinensis (Guinea worm) ......................................................................... 45
Hoofdstuk 9: Arthropoda ......................................................................................................... 46
9.1 Indeling ......................................................................................................................... 46
9.2 Teken (Ixodidae) ............................................................................................................. 47
9.3 Mijten ............................................................................................................................ 48
9.4 Wantsen (Hemiptera – Heteroptera) ................................................................................ 49
9.5 Vlooien (Siphonaptera) → microscopisch herkennen ....................................................... 50
9.6 Luizen (Anoplura) → microscopisch herkennen ............................................................... 50
Deel 2: Mycologie ....................................................................................................................... 51
Hoofdstuk 10: Inleiding mycologie ........................................................................................... 51
10.1 Vermenigvuldiging bij fungi ........................................................................................... 51
10.2 Klinisch belang van mycosen ........................................................................................ 51
10.3 Diagnostiek .................................................................................................................. 51
10.4 Behandeling ................................................................................................................. 52
Hoofdstuk 11: Oppervlakkige mycosen .................................................................................... 53
11.1 Dermatofytosen (tinea, ringworm) ................................................................................. 53
11.2 Oppervlakkige mycosen ............................................................................................... 54
11.3 Oppervlakkige candidosen ........................................................................................... 55
Hoofdstuk 12: Onderhuidse mycosen ...................................................................................... 56
12.1 Sporotrichose .............................................................................................................. 56
Hoofdstuk 13: Diepe cosmopolitische mycosen ...................................................................... 57
13.1 Inleiding ....................................................................................................................... 57
13.2 Aspergillose ................................................................................................................. 57
13.3 Mucormycose / Zygomycose......................................................................................... 58
13.4 Diepe Candidose.......................................................................................................... 59
13.5 Cryptococcose ............................................................................................................ 60
13.6 Pneumocystose ........................................................................................................... 61
DEEL 3: Virologie ........................................................................................................................ 63
Hoofdstuk 1: Basisbeginselen van de virologie.......................................................................... 63
1.1 Algemene eigenschappen van virussen ........................................................................... 63
2
, 1.2 Morfologie van virussen .................................................................................................. 63
Hoofdstuk 2: Benaming en indeling van virussen ...................................................................... 65
2.1 Klasse I: DNA dubbelstrengs ........................................................................................... 66
2.2 Klasse II: ssDNA-virussen zonder enveloppe ................................................................... 68
2.3 Klasse III: dsRNA-virussen zonder enveloppe .................................................................. 68
2.4 Klasse IV (+sense) en klasse V (−sense): ssRNA-virussen ................................................. 68
2.5 VI en VII – Reverse transcriptase virussen met enveloppe ................................................. 74
2.6 Niet-geklassificeerde virussen ........................................................................................ 74
Hoofdstuk 3: Invloed van fysische en chemische agentia op virussen ........................................ 75
3.1 Inleiding......................................................................................................................... 75
3.2 Algemeen verloop van de inactivatie van virussen ............................................................ 75
3.3 Invloed van fysische en chemische agentia op virussen ................................................... 76
Hoofdstuk 4: Intracellulaire virusvermenigvuldiging .................................................................. 80
4.1 Bacteriofagen – lytische infectie...................................................................................... 80
4.2 Dierlijke virussen............................................................................................................ 81
Hoofdstuk 5: Gevolgen van een virale infectie van cellen ........................................................... 84
5.1 Cellulaire en virale factoren ............................................................................................ 84
5.2 Lytische infectie: gastheercel wordt afgedood ................................................................. 84
5.3 Inhibitie van cellulaire macromoleculen .......................................................................... 84
5.4 Abortieve infectie ........................................................................................................... 85
5.5 Persisterende infectie .................................................................................................... 85
5.6 Latente virusinfecties ..................................................................................................... 85
Hoofdstuk 6: Algemeen pathogeen verloop en virulentie van virale infecties .............................. 87
6.1 Binnendringen van het virus ............................................................................................ 87
6.2 Gelokaliseerde infecties ................................................................................................. 87
6.3 Veralgemeende virale infecties (systemic infections) ....................................................... 87
6.4 Uitscheiding van virus..................................................................................................... 88
6.5 Rol van de immuunreactie .............................................................................................. 88
6.6 Virale ziekten volgens symptomatologie .......................................................................... 89
Hoofdstuk 7: Laboratoriumtechnieken in de virologie ............................................................... 90
7.1 Inleiding......................................................................................................................... 90
7.2 Zuivering en aanconcentreren van virussen ..................................................................... 90
7.3 Bepaling van de afmeting van virussen ............................................................................ 91
7.4 Kweken van virussen ...................................................................................................... 91
7.5 Diagnose van een virale infectie ...................................................................................... 92
Hoofdstuk 8: Antivirale geneesmiddelen .................................................................................. 97
8.1 Inleiding......................................................................................................................... 97
3
, 8.2 Adsorptie en penetratie van virus verstoren ..................................................................... 97
8.3 Synthesereactie verstoren met nucleoside-analogen ....................................................... 98
8.4 Synthesereactie verstoren met polymerase-inhibitoren ................................................... 99
8.5 Maturatie en budding verstoren ...................................................................................... 99
8.6 Interferon en interferon-inductoren ................................................................................100
Hoofdstuk 9: Bespreking van enkele klinisch belangrijke virussen ............................................101
9.1 Virale hepatitis .............................................................................................................101
9.2 HIV-VIRUSSEN ..............................................................................................................106
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