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PathogenesisS.Typhi.stomachLower ileumpeyers patches&mesenteric lymph nodesthoracic duct 1st bacteremia(Incubation stage)10-14d()2nd bacteremialiver、spleen、gall、BM,ectearly stage&acme stage(1-3W)LN Proliferate,swell necrosis defervescence stage(3-4w)Bac.In gallBac.In fecesS.Typhi eliminatedconvalvescence stage(4-5w)Enterorrhagia,intestinal perforation 回肠:回肠:集合淋巴结集合淋巴结(PEYERSPATCHES)增生增生伤寒小结(TYPHOID NODULE)图图 典型伤寒自然病程示意图典型伤寒自然病程示意图 decreased in relapse图图 典型伤寒自然病程示意图典型伤寒自然病程示意图