《獸醫(yī)臨床檢查技術》課件-14實訓任務八 伍氏燈檢查

《伍氏燈檢查》Wood’sLampExamination授課專業(yè)：動物醫(yī)學Outline2024/5/19《寵物臨床檢查技術》課件2PURPOSEToevaluatepatientswithlesionssuggestiveofdermatophyte(ringworm)infection評估患病寵物感染類似皮膚真菌（錢癬）的病灶。2024/5/19《寵物臨床檢查技術》課件3INDICATIONSThisexamisusedfortheevaluationofdogsandcatswithdermatologiclesionsthatcouldberingworm.Theclassicallesionwouldbewelldemarcated,crusted,andpruritic.Dermatophyteinfectioncan,however,haveavariedappearance,soWood’slampexaminationshouldbeconsideredinanycasewithregionalorpatchyalopecia,scaling,crusting,seborrhea,pruritus,orregionalfolliculitis.評估犬與貓可能是錢癬的皮膚病灶。典型的病灶為明顯的界限，痂皮以及搔癢。然而皮膚真菌感染會出現(xiàn)各式不同的外觀，國此胡任何病例有區(qū)域性或片狀脫毛、痂皮、皮脂漏、搔癢或者區(qū)域性的毛囊炎，應考慮以伍氏燈檢查。2024/5/19《寵物臨床檢查技術》課件42024/5/19《寵物臨床檢查技術》課件5CONTRAINDICATIONSANDCONCERNS1.Wearglovesbecausethedermatophytesinfectingdogsandcatscancauselesionsinhumans.需戴手套，因為感染犬與貓的皮膚真菌也可感染人

2.TheWood’slampmustbeturnedonfor5to10minutesbeforeusebecausethestabilityofthelight’swavelengthandintensityistemperaturedependent.伍氏燈使用前要暖機5—10分鐘因為光波長穩(wěn)定性以及強度取決于溫度。2024/5/19《寵物臨床檢查技術》課件63.Itisimportanttodistinguishnonspecificfluorescencethatoccursoncrustsandscalesfromthefluorescenceassociatedwithdermatophyteinfection.Scalesandcruststendtohaveadiffuse(notconfinedtothehairshaft)glowthatisolive-greentoyellowishgreen.Microsporumcanisfluorescenceisconfinedtotheindividualhairs(whichareoftenbrokenoff)andistypicallyapple-green(averybrightgreen,likeaflashlightshiningthroughalimelollipop).2024/5/19《寵物臨床檢查技術》課件7重要的是要區(qū)分出痂皮以及鱗屑上的發(fā)出的非特異性螢光，以及皮膚真菌感染所發(fā)出的螢光。鱗屑與痂皮往往呈擴散分布（并不局限在毛干上），發(fā)出的光線為橄欖綠到黃綠色。犬小孢子菌的螢光則限定在個別的毛發(fā)上（常為脫落的毛發(fā)），且典型為蘋果綠（非常亮的綠色，如同燈光透過萊姆棒棒糖所發(fā)出的光）2024/5/19《寵物臨床檢查技術》課件84.ThefluorescenceofM.caniswillremainevenafterthefungushasbeenkilledbytreatment.Overtime,asthehairsgrow,thedeadfunguswillbelocatedneartheendsofthehairsinsteadofnearthebaseasexpectedwithanactiveinfection.犬小孢子菌的熒光會持續(xù)到真菌被治療之后。過一段時間后，當毛發(fā)長出，死亡的真菌會位于接近毛發(fā)的發(fā)尾，而非如感染活躍期時出現(xiàn)在發(fā)根。2024/5/19《寵物臨床檢查技術》課件9POSITIONINGANDRESTRAINTAdequaterestrainttokeeptheanimalstill適當?shù)谋６ㄒ跃S持動物不動。2024/5/19《寵物臨床檢查技術》課件10EQUIPMENTTheWood’slampisanultravioletlightwithalightwavefilteredthroughacobaltornickelfilter.Greenfluorescenceoccurswithsomedermatophytesbecauseofthetryptophanthatisproducedbythefungus.伍氏燈是一種紫外線光，會透過鈷或鎳的過濾器過濾光波。有些皮皮膚真菌會出現(xiàn)綠色螢光，因為此真菌會制造色胺酸。2024/5/19《寵物臨床檢查技術》課件112024/5/19《寵物臨床檢查技術》課件12TECHNIQUE1.TurnontheWood’slampatleast5minutesbeforeusingittoexaminethepatient.檢查病患前，伍氏燈需暖機至少5分鐘。2.Weargloves,andexaminethepatientusingtheWood’slampinadarkenedroom.戴手套，并在暗房間內(nèi)以伍氏燈檢查病患。2024/5/19《寵物臨床檢查技術》課件132024/5/19《寵物臨床檢查技術》課件143.Lookforbrightgreenfluorescenceassociatedwiththehairsinthelesion.在病灶處找尋毛發(fā)上的亮綠色熒光。2024/5/19《寵物臨床檢查技術》課件15RESULTSOnlyM.canisshowspositiveresults,andonlyapproximately50%ofM.canisinfectionsarepositive.Suspiciouslesions(andallWood’slamp-positivelesions)shouldhavehairs,crusts,andswabsculturedtoconfirmthepresenceofadermatophyte.M.canisisresponsibleformostdermatophyteinfectionsincats(>98%)anddogs(50%to70%).LesscommonlydiagnosedpathogenicdermatophytesincludethenonfluorescingTrichophytonmentagrophytesandMicrosporumgypseum.2024/5/19《寵物臨床檢查技術》課件16只有犬小孢子菌感染會呈現(xiàn)陽性，且只有大約50%的犬小孢子菌感染會呈現(xiàn)陽性。因此對懷疑的病灶（及所有伍氏燈呈陽性的病灶），應做毛發(fā)、痂皮及及拭子進行真菌培養(yǎng)，確診皮膚