Anthrax

Anthrax is an acute infectious disease from a group of zoonoses. At the person proceeds in the form of dermal, pulmonary, intestinal and septic forms.

Etiology, pathogenesis. The causative agent is a relatively large anthrax scab; Forms a spore and capsule. The vegetative form of the pathogen dies without access to air, with heating, the effects of disinfectants. Disputes of the pathogen in the external environment are very stable.

Symptoms, course. The incubation period varies from 8 hours to 8 hours (usually 2-3 days). The most common anthrax in humans occurs as a cutaneous form (95-99% of cases) and only 1-5% of patients have pulmonary and intestinal. Typical manifestations of the skin form of anthrax occur in the area of ​​the infection gate. First, a red itchy speck appears, which quickly turns into a papule, and the latter into a vesicle with a clear or hemorrhagic content. The patient with a continuing itching tears the vial, in its place a sore with a dark bottom and abundant serous discharge is formed. On the periphery of the sore, an inflammatory cushion develops, in the zone of which daughter vesicles are formed. At the same time, edema develops around the jaundice (it can be very extensive) and regional lymphadenitis. Characteristic of the lack of sensitivity in the bottom of the sore, as well as the absence of pain in the area of ​​enlarged lymph nodes.

By the time of the formation of the sore, fever occurs, which lasts for 5-7 days, general weakness, weakness, headache, adynamia. Local changes in the lesion area increase approximately during the same periods as fever, and then reverse development begins: first, the body temperature decreases, serous fluid from the necrosis zone stops, the edema begins to decrease (until complete disappearance), and on the place of necrosis gradually Formed a scab. On the 10th-14th day, the scab is rejected, an ulcer with a granulating bottom and a moderate purulent discharge is formed, followed by scarring.

The pulmonary form of the anthrax begins acutely, it proceeds heavily. It manifests itself in chest pain, dyspnea, cyanosis, tachycardia (up to 120-140 per 1 min), cough with separation of frothy bloody sputum. Body temperature quickly reaches high figures (40 ° C and above), blood pressure decreases.

The intestinal form of anthrax is characterized by general intoxication, fever, epigastric pain, diarrhea and vomiting. The abdomen is swollen, sharply painful on palpation, there are often signs of irritation of the peritoneum. In vomit masses and secretions from the intestine appears an admixture of blood. With any of the described forms of anthrax, sepsis can develop with bacteremia and secondary foci (lesions of the liver, spleen, kidneys, meninges).

For diagnosis, epidemiological data (the patient's profession, contact with sick animals or contaminated raw materials of animal origin) and characteristic skin lesions are important. The laboratory confirmation of the diagnosis is the isolation of an agent of anthrax. An allergic test with anthraxin is of subsidiary importance.

Treatment. For mild forms of the disease, penicillin is prescribed in a dose of 200,000-300,000 units 6-8 times a day for 5-7 days. In extremely severe forms with a septic component, a single dose of penicillin is increased to 1 500 000-2 000 000 units 6-8 times a day. Levomycetin sodium succinate is effective at a dose of 3-4 g / day. The best results are given by treatment with antibiotics in combination with a specific antiulcer immunoglobulin at a dose of 20-75 ml IM. Antibiotics are canceled when the edema decreases significantly, the size of skin necrosis increases and the fluid separates from the affected area. In severe forms of anthrax, intensive pathogenetic therapy is required to remove a patient from an infectious-toxic shock.

Prognosis with cutaneous form and with timely treatment is favorable. With intestinal and pulmonary forms, the prognosis is questionable even with early and intensive treatment.

Prevention. An anthrax patient is hospitalized in a separate ward with the issuance of personal care items, linen, and utensils. Discharge of patients (excreta, urine, sputum), dressings are disinfected. Patients are discharged after complete clinical recovery with epithelialization of ulcers, and with intestinal and pulmonary forms - after a twofold negative bacteriological study of stool, urine and sputum on an anthrax stick.