pseudotuberculosis

Pseudotuberculosis - an acute infectious disease of eoonozov group, characterized by fever, general intoxication, lesion of the small intestine, liver, often Scarlatiniform rash. Infection occurs primarily through the alimentary.

Etiology, pathogenesis. Pathogen-Yersinia - Gram-negative rods with bipolar staining; without the capsule does not form spores. By antigenic properties it is similar to the plague pathogen, and intestinal yersiniosis. Good storage in the environment, particularly on products -up 3 months. Quickly killed by warming. Gate infection - the mucosa of the gastrointestinal tract, preferably the lower small intestine where the inflammatory changes occur (ileitis); also affected regional lymph nodes (mesenteric adenitis). The penetration of microbes in the blood and lead to their death, and metastatic drifts toxemia causative agent in various organs. When failure of the immune system may be acute and recurrent disease.

Symptoms within. The incubation period - from 3 to 21 days (usually 8-10 days). Disease begins acutely: there are chills, fever, symptoms of intoxication (weakness, pain in muscles and joints, headache, sleep disturbance). In the early days of the disease may be symptoms of catarrh of the upper respiratory tract. There is pain in the abdomen, and sometimes nausea, vomiting, diarrhea. There flushing of the face, neck, hands and plantar surface of the table. On the 2-4 th day of the disease in most patients rash appears (melkopyatnistaya, scarlatiniform, maculopapular, erythema nodosum appears occasionally in the later stages of the disease). In some patients the rash is accompanied by itching of the skin, with a 2-3-th week begins peeling skin (on the palms, feet lamellar, scaly on the trunk). Patients marked as "raspberry" tongue, which increases the similarity with scarlet fever (Scarlatiniform form).

When abdominal forms the fore symptoms of the gastrointestinal tract in the form of gastroenteritis, mezadenita, appendicitis. When icteric form (in 6-7% of patients) observed toxic hepatitis in violation of pigment metabolism, with artralgicheskoy shape against the backdrop of general intoxication symptoms of mono-or polyarthritis. When mixed form can display different clinical forms of the disease.

At diagnosis, clinical symptoms in addition, allow for epidemiological background. To confirm the diagnosis using abjection of feces or blood of patients, as well as serological methods (agglutination reaction and Phragmites).

Treatment. Assign chloramphenicol 0.5 g 4 times a day for 10-14 days. Symptomatic therapy. When abdominal form requires a surgeon's consultation to address the issue of prompt intervention.

Prediction: the ability to work is restored within 2-4 weeks.

Prevention. Rodent control, protection of products from rodents, the prohibition of the use of vegetables (cabbage, carrot) without heat treatment. Patients were discharged from the hospital after a full clinical recovery and double negative bacteriological examination of faeces.