tularemia

Zoonotic infections having natural foci. It is characterized by intoxication, fever, lymph node. The causative agent of the disease - small bacterium. When heated to 60 C ± dies in 5-10 minutes. Reservoirs sticks tularemia - hares, rabbits, water rats, voles. In natural foci arise periodically epizootic.
Infection is transmitted to humans either directly in contact with animals (hunting), or through contaminated food and water, sometimes by aspiration (in the processing of grain and forage products, threshing grain), blood-sucking insects (horsefly, ticks, mosquitoes, etc..).
The incubation period of several hours to 3-7 days. There are bubonic, pulmonary and generalized (spread throughout the body) form. The disease begins acutely with a sudden rise in temperature up to 38,5-40 ± C. There is a sharp headache, dizziness, pain in the muscles of the legs, back and lumbar region, loss of appetite. In severe cases, it may be vomiting, nosebleeds. Characterized by severe sweating, sleep disturbance in the form of insomnia, sleepiness, or vice versa. Often there is euphoria and increased activity against high temperature. Marked redness and swelling of the face and conjunctiva in the first days of illness. Later on the oral mucosa appears petechial hemorrhages. Language overlaid with a grayish bloom. A characteristic feature - the increase in the various lymph nodes, the size of which can be from a pea to a walnut.
Cardio-vascular system marked bradycardia, hypotension. In blood moderate leukocytosis with neutrophilic shift. Liver, spleen did not increase in all cases. Abdominal pain may be a considerable increase in the mesenteric lymph nodes. Fever lasts for up to 30 days b.
Bubonic form of tularemia. Pathogen penetrates the skin without leaving a trace, after 2-3 days of illness develops regional lymphadenitis. Buboes little disease and have clear contours of up to 5 cm. Subsequently, there is a softening of the bubo (1-4 mo.) Or its spontaneous opening with the release of a thick creamy pus and fistula formation tularemia. Most affected axillary, inguinal and femoral lymph nodes.
Ulceroglandular form is characterized by a primary lesion at the site entrance gate of infection.
Eye-bubonic form develops in contact with the pathogen on the mucous membranes of eyes. Typically, the emergence of follicular growths yellow millet grain size up to the conjunctiva.
Bubonic develops in the parotid or submandibular areas, long-term course of the disease.
Anginal-bubonic form occurs when the primary lesion of the mucous membrane of the tonsils, usually one. It occurs when the food ways of infection.
There are forms of tularemia with a primary lesion of the internal organs. Pulmonary form - often registered in the autumn-winter period. Generalized form of flows by type of general infections with severe toxicity, loss of consciousness, delirium, severe headache and muscle pains.
Complications can be specific (tularemia secondary pneumonia, peritonitis, pericarditis, meningoencephalitis), and abscesses, gangrene due to secondary bacterial flora.
Diagnosis is based on a sample kozhioallergicheskoy and serological tests.
patient hospitalization. The leading role is given antibiotics (tetracycline, aminoglycosides, streptomycin, chloramphenicol), treatment is carried out to 5 days of normal temperature. When protracted forms using a combination of antibiotics with the vaccine, which is administered intradermally, intramuscularly at a dose of 1-15 million microbial bodies per injection at intervals of 3-5 days, the treatment course of 6-10 sessions. Recommended vitamin therapy, repeated transfusions of donated blood. When fluctuations bubo - surgery (wide incision to emptying bubo). Patients discharged from hospital after full clinical recovery.
Elimination or reduction of natural foci of their territories. Protection of dwellings, wells, open reservoirs, products from rodents. Conducting mass routine vaccination in outbreaks of tularemia.