Infectious diseases



Leptospirosis photo Leptospirosis (canine fever, infectious jaundice, Fiedler's disease, water fever, Japanese seven-day fever, etc.) - An acute infectious disease that is caused by different serotypes of Leptospira and characterized by symptoms common intoxication, fever, damage to the nervous system, liver and kidneys.In severe cases meningitis, jaundice and hemorrhagic syndrome.The agents of leptospirosis are Leptospira, which are adapted to life in water spiral microorganisms.Since Leptospira are aerobic, they die quickly under the influence of direct sunlight during boiling and drying.In addition, these microorganisms are very sensitive to tetracycline, penicillin, streptomycin and acids, and on the contrary, can sufficiently long period of time to maintain its viability during freezing and in moist soil or water.On food viability can range from a few hours to several days

Ways of infection leptospirosis

source of leptospirosis are different animals, both wild and domestic (mice, rats, vo

les, hedgehogs, shrews, pigs, dogs,cattle and so forth.).Sick people with leptospirosis, the source of the infection is not.

animals Transmission occurs through food and water.The man most often infected by contact of skin and mucous membranes with water that has been contaminated by animal secretions.Also, infection is possible when in contact with moist soil, at slaughter and butchering meat of infected animals due to consumption of contaminated secretions of infected rodents, certain foods (milk, etc.).Often, leptospirosis is professional in nature, as they often get sick shepherds, milkmaids, livestock specialists, veterinarians, employees of livestock farms, slaughterhouses and so forth. To leptospirosis characterized by a pronounced seasonality, with a peak incidence in August.

Most often, the infection is the gateway to the human skin, and leptospira able to penetrate with minimal damage.Therefore, the infection occurs even at very short contact with water, which contains Leptospira, at the same time, the site of infection no inflammatory symptoms arise.In addition, the agent can enter the human body through the conjunctiva of the eyes or mucous membranes of the digestive system.Subsequently, Leptospira promoted by lymphatic vessels, also without causing any inflammatory changes in the regional lymph nodes and lymph vessels.Leptospires easily overcome the barrier role of the lymph nodes and spread to different tissues and organs (most often in the kidneys, lungs, spleen, liver and central nervous system), in which the accumulation and further reproduction of Leptospira

Symptoms of leptospirosis

IncubationLeptospirosis is a period from four days to two weeks.The disease almost always begins acutely, with fever up to 39 - 41 C. At the same time there is a severe headache, abdominal pain, nausea and vomiting.For this disease are quite typical muscle pain, often in the abdominal muscles, back, neck, neck and calf muscles.The face becomes puffy and bloodshot, and sclera vessels injected.Often there is a polymorphic rash (hemorrhagic, morbilliform, scarlatiniform and urticaria), with localization on the extremities and trunk.Lymph nodes are dense, enlarged and painful, muffled heart sounds, blood pressure is lowered.From the second day of the disease the liver increases in size, becomes painful and dense.Tongue dry, with clear brown patina, usually swollen abdomen.Against the backdrop of severe intoxication at high temperature, the probability of infectious - toxic shock syndrome, which can cause death.

In the acute phase of leptospirosis is often a kidney disease: the amount of urine is markedly reduced (it contains red blood cells, granular and hyaline cylinders, in a lot of protein), a symptom Pasternatskogo positive, there is a pain in the lumbar region.Perhaps the development of acute renal failure, against which can develop severe liver, leading subsequently to acute liver failure, hepatic encephalopathy and coma.In severe cases of leptospirosis, from the third - the fifth day of the disease, there ikterichnost sclera, and in consequence, and icteric staining of the skin.There tachycardia, hypotension, voiceless heart tones.Above the lungs - non-permanent dry wheezing and breathing hard.People suffering from chronic alcoholism often develop pneumonia.

For most patients with leptospirosis outlook is quite favorable.After a prolonged fever (from five to twelve days), the temperature is gradually reduced to normal (rare in a long low-grade fever).People who were not receiving antibiotic treatment, three - nine days apyrexia comes the second wave of fever, with a minor clinical manifestations and less in duration.The course of leptospirosis in some cases may include two - three similar recurrence.

In most cases, the end of the second week, the general condition of the patient improves, regress the symptoms of intoxication, recovered diuresis goes jaundice.Duration of the disease is usually from three to four weeks.

There are also erased form of the disease, which flow easily without liver and kidney failure, having in their clinical manifestations similar to the flu.These forms of leptospirosis can be found only in the case of specific laboratory examination and seems to occur more often than recorded.

Possible complications of leptospirosis: inflammation of the meninges (meningitis), inflammation of the heart muscle (myocarditis), inflammation of the brain (encephalitis), polyneuritis, inflammation of the iris (iritis).In the case of additional bacterial infection occur: mumps, pielity, otitis, inflammation of the lungs (pneumonia)

diagnosis of leptospirosis

diagnosis of leptospirosis is set based on the results of serological and bacteriological research.With correct diagnosis in patients with leptospirosis often is suspected hepatitis, toxic shock syndrome, meningitis, fever of unknown origin, jade, Kawasaki syndrome, influenza and legionnaires' disease.For recognition it must be considered leptospirosis epidemiological conditions (contact with rodents, seasonality, profession and so on.), And the characteristic symptoms.When the flow of the milder forms of the disease, diagnosis is quite difficult, resulting in erroneous diagnosis can be established "SARS" or "flu".It should be laboratory confirmation, when the cerebrospinal fluid, urine and blood detected pathogen

Treatment of leptospirosis

The first patient to be hospitalized in the infectious hospital, and if necessary in the ICU ward.Particular attention in the care of patients should be given to identify early signs of infectious - toxic shock and renal failure.

Early administration of antibiotics is the main method of treatment of this disease.In addition, the introduction of specific immunoglobulin used.For the treatment of people with severe forms of leptospirosis, which in addition complicated by renal failure, apply pathogenetic therapy.The most well-established drugs are antibiotics penicillin, but when they are hypersensitive used antibiotics tetracycline group.Treatment is most effective if it was started not later than three - four days after onset.In contrast, the later the specific treatment started, the worse the prognosis for the patient.

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