Brucellosis - a disease defeat of the musculoskeletal system, nervous, sexual and other systems. Brutselly stable external environment. In the water they have saved more than 2 months, in milk - 40 days in bryndza - 2 months, in raw meat - 3 months, salted - up to 30 days in the wool - up to 4 months. Brutselly killed when heated and under the influence of many disinfectants. From a patient man healthy brutselly not passed. Reservoir and source of infection are domestic animals (sheep, goats, cows, pigs, dogs less).
Infection rights of the sick animal contact occurs, food and air routes. Infection through contact especially often in contact with skin amniotic fluid (assistance with hotels, yagnenii, in the care of newborn calves, yagnyatami). Most infected veterinary workers telyatnitsy, Csaba and others Infection can occur and in contact with the meat of infected animals, with the manure. Brutselly penetrate through the slightest damage to the skin.
Food contamination often occurs through raw milk, as well as the use of dairy products (bryndza, cheese, butter). Infection by air may occur when enters airways of dust containing brutselly (in the field grazing and pens to contain the sheep), as well as in laboratories with violating safety regulations. This path of infection occurs relatively rarely. More often ill persons of working age (18 ~ 50 years). In most cases this disease. The manifestations of brucellosis the disease occurs when you hit the body of 10 microbes.
Gate infections are mikrotravmy skin, mucous membranes of the digestive and respiratory tracts. On the ground the gates of infection of any change is growing. For lymphatic routes brutselly reach the lymph nodes. Reproduction and stockpiling of germs with brucellosis occurs primarily in the lymph nodes, of which brutselly periodically enter the blood. For brucellosis is expressed allergic restructuring of the body. Brucellosis is a tendency to chronic overflowing because of the long stay brutsell in the body. After the carry brucellosis formed immunity, but he was not very long and after 3-5 years may re-infection. Not every infection leads to disease. The response depends, perhaps, from a state of the immune system.
For some people the infection runs without any manifestations of other developing rapid infection process, or at the outset runs as chronic. Street with very weak immune even live brutselleznaya vaccine can cause reactions, reminding the disease brucellosis. The incubation period at the beginning of acute brucellosis can take up to 3 weeks, but incubation can take several months. Ostrosepticheskaya form is characterized by high fever (39-40 ° C and above). Despite high and very high body temperature, feeling sick to be good (at a temperature of 39 ° C and above the patient can read books, play chess, watch TV, etc.).
This form of brucellosis does not endanger the lives of patients, even without treatment, she ends recovery. The chronic form is characterized by general intoxication syndrome (weakness, headache). Common characteristics include a long low temperature, weakness, increased irritability, poor sleep, a violation of appetite, decrease efficiency. Almost all patients with an increase limfouzlov. Often detected an increase in liver and spleen. Against this background, identifies the defeat of joints, nervous and sexual systems. When brucellosis may be other lesions (pneumonia, miokardity, eye, etc.), but they occur less frequently. The defeat of the musculoskeletal system is the most frequent manifestation of chronic brucellosis. Patients complain of pain in muscles and joints, predominantly in the major.
More often affects the knee, elbow, shoulder, hip, rarely - small joints brush and feet. Opuhayut joints, limited mobility in the skin above them, usually a normal color. Violation of mobility and deformity of joints due to the growth of bone tissue. Porazhaetsya spine, often in the lumbar. The defeat of the nervous system in chronic brucellosis manifests itself most often neuritis, polinevritami, radiculitis. The defeat of the central nervous system (mielity, meningitis, encephalitis, meningoentsefality) are rare, but occur a long time and quite seriously. Change of sex in men seen in orchitis, epididimitah, declining sexual function. For women, there salpingity, metrity, endometritis. There amenorrhea, can develop infertility.
For pregnant women prone to abortion, stillbirth, premature birth, congenital brucellosis in children. Sometimes there are changes in the eye (irity, horioretinity, uveity, keratity, atrophy of the optic nerve, etc.). When aerogennom infection often develop low current brutselleznye pneumonia, which has unsuccessfully treated with antibiotics. There may be miokardity, Endocarditis, aortity and defeat the cardiovascular system. Diagnosis of Brucellosis Laboratory confirmation of brucellosis significantly limited because brutselly relate to dangerous pathogens, the allocation of which may take place only in special laboratories equipped in accordance with the requirements of prevention.
When aldergologicheskih and serological studies must be borne in mind that the vaccinated against brucellosis (instilled in risk groups, professional contact with animals) can be quite a long time, the positive results of serological reactions, and particularly allergic samples. Of the serological reactions of the most informative is the reaction agglutination test (reaction Wright). When ostrosepticheskoy form of brucellosis antibodies detected beginning at 2 nd week of illness, and further increases their title. Allergic test becomes positive at the end of the 1 st and 2 nd week. In chronic forms of rising titer antibodies often fail to detect.
Please note that the production of the allergic sample (sample Byurne) can lead to the emergence of antibodies or increasing titer. Other serological reactions (RSK, RPGA, ODF) less informative than the reaction of Wright and not essential. Negative test results Byurne allow the deletion of brucellosis (excluding HIV-infected people who have gone all the reaction GZT). Treatment of brucellosis The principles and methods of treatment depend on the kind of brucellosis. Antibiotikoterapiya can give effect only if ostrosepticheskoy (acute) form of brucellosis, with chronic forms of the appointment of antibiotics plays a subsidiary role, the significance is the vaccine. When ostrosepticheskoy (acute) form of brucellosis needed to appoint antibiotics in a fairly high doses. Insufficient intake and premature lifting of preparations make further development in the chronic form of brucellosis.
Antibiotics must be given continuously. Tetracycline - to 0.5 g over 6 hours for 3-6 weeks, during the first 2 weeks, moreover, used streptomycin (intramuscularly) in a dose of 1 g in 12 hours. Tetracycline is contraindicated for pregnant women and children under 8 years old. If you can not use the above chart, you can designate biseptol (co-trimoksazol) for 6 pills a day for 4 weeks. The combination biseptol rifampicin (900 mg / day) gives better results. With a full course of relapses are rare.
Appointed vitamins. Antibiotics for chronic forms proved ineffective. The main role in these forms is playing his drugs with nonspecific and specific desensibiliziruyuschim action. In chronic forms the most effective vaccine, which is not only desensibiliziruyuschim event, but also stimulates immunity. Patients designate complex vitamins, nonspecific stimulants blood (pentoksil, nukleinovokisly sodium, metatsil). In the winter time, it must necessarily hold a general ultraviolet irradiation. Antihistamines apply medications (pipolfen, suprastin etc.). When expressed by inflammatory changes (orchitis, neuritis, etc.) designate a corticosteroid medications (for 40-50 mg prednisolone within 2-3 weeks or other comparable doses of corticosteroids).
For specific desensitization and enhance immunity using vaccine therapy. When pronounced allergic restructuring brutsellin use, but the most special (dead) therapeutic vaccine. Live vaccine appoint only with prophylactic purposes. We propose different methods of vaccine delivery: intravenous, intramuscular, subcutaneous and intradermal. It must be remembered that the incorrect dosage of the vaccine could lead to a worsening of the disease (with overdose) or to express a lack of effect (when there is insufficient dose). In connection with the selection method of introducing and calculating individual dose plays a big role.
The largest widely subcutaneous and intradermal vaccination. Subcutaneous vaccine appoint deterioration in the current brucellosis and the expression of the process. An important principle VACCINOTHERAPY is a unique selection of dosage. To some extent, the determination expressed reaction judged by the intensity of the sample Byurne. SUBCUTANEOUS introduction of increasingly begun to 10-50 million microbial cells. If the local and general reactions are not available, the increased dose of the vaccine to enter the next day. To choose a treatment dose, which is reasonable reaction. A further injection of the vaccine do only after a clear response to the earlier introduction of the vaccine. Once entered the dose at the end of the course brings to 1-5 billion microbial cells. Intradermal vaccine is a more Sustainable.
This method is used in the process of compensation, as well as when moving the disease in latent form. In the words of skin reactions picked up a working culture vaccine (it should cause a local reaction of redness of skin in diameter from 5 to 10 mm). Vaccines introduce intradermal in the hand area of the forearm on the first day of 0.1 ml in 3 places, then every day added to 1 injections and bring an 8-day to 10 injections. If the reaction to the vaccine reduced, then take a more concentrated breeding. It should be noted that even with complete disappearance of all clinical manifestations, from 20-30% in the future may come a worsening of the disease. Forecast with brucellosis the forecast for the good life.
Prevention of brucellosis.
The fight against brucellosis farm animals. Compliance with preventive measures in caring for animals. Vaccination and revaccination live vaccine protivobrutselleznoy individuals at risk for brucellosis.
Post a Comment