Leprosy - a chronic infection with the priority the defeat of the skin, nervous system, eyes and some internal organs. Currently there are about 2 million leprosy patients, mostly in developing countries Leprosy often record in men (2:1) Cases of leprosy disease in children under 1 year of extremely rare. Causative agent - acid-resistant bacterium mycobacterium leprosy (Hansen bacillus-Nayssera). Leprosy malozarazna, which makes it impossible to identify in each case the path of infection and the source of infection. The only reservoir - an ill man. Infection with leprosy occurs by direct contact, as well as airborne droplets through.
Prove the possibility of intrauterine infection, but children are isolated from sick parents after the birth, did not fall ill. Symptoms of leprosy Undifferentiated leprosy could transform into lepromatozny or tuberkuloidny type. Characterized by skin rash and the defeat of peripheral nerve trunks. Rash is clearly limited form of spots of different colors and sizes, and after a short period of heightened sensitivity become insensitive. Skin lesions often spontaneously heal. But perhaps progression to more severe forms. Tuberkuloidnaya leprosy. It starts with the appearance of slabopigmentirovannyh spots with clear edges and a reduced sensitivity. Characterized by the proliferation of Granulation tissue in the skin and mucous, often watching one pocket, which is sometimes the only manifestation of the disease.
Mature tuberkuloidnye lepromy asymmetrical, completely lacking sensitivity, edge up in the air above the surface of the skin. Around stricken sites reduced the number of sweat glands and hair follicles. Atrophy of muscles begins with a small hand muscles; latest possible contraction of upper and lower limbs. There may be cases of spontaneous healing. Lepromatoznaya leprosy. A disease affecting the skin, mucous membranes of nose and fauces, the front camera eyes, skin and peripheral nerves, adrenal and testicles. Lost located at the back and limbs to symmetric a continuous sealing of a reddish color buruyu.
Patients often loss of eyebrows and eyelashes, assemblies and seals are often attached to a peculiar expression, known as the «lion person». Observe mortgaged bow moves, nose bleeding, his nose is becoming saddle shape, and laringity ohriplost vote. Characterized by the eye, leading to a weakening of vision and blindness. Lymph nodes, especially bedrennye, inguinal and first segment, often enlarged and contain large quantities cause. Often an increase in liver and spleen. Left untreated, the disease progresses rapidly. Border (dimorfnaya) leprosy. Skin lesions even more diverse, cones and plaques can be combined with spots. The decline in sensitivity less pronounced than in tuberkuloidnoy leprosy. Note thinning of mochek ears, nose and increase superciliary arcs. Dermal more numerous, but not symmetrical, as if lepromatoznoy leprosy.
A survey on leprosy Leprosy in Detection of mycobacterium soskobah nasal mucosa of the wall, the affected area of skin and enlarged lymph nodes material When questionable results - biosamples at sea mumps (susceptible to mycobacterium tuberculosis and leprosy ustroychivy to mikoabkteriyam) Serodiagnostika: identification of antibodies to glikolipidu cell wall extracted phenol; sensitivity of the method - more than 90% at lepromatoznoy form and about 30% at tuberkuloidnoy form. Treatment of Leprosy Regular consultations orthopaedist, a surgeon, an ophthalmologist and general practitioner Wearing correctly selected footwear and the use of Plaster associations to prevent the appearance of lesions on the soles The formation of contractures upper limbs can be prevented through exercise and bandager .
When the eye is urgently conduct an appropriate correction Surgical treatment of leprosy. Shown reconstructive intervention - transplanting nerves and tendons, the removal of contractures and other operations, enhance functionality and social adaptation. Drug of choice. Dapson 100 mg / day and rifampicin 600 mg / day. When the border, border lepromatoznoy and lepromatoznoy leprosy further - Ethionamide 250-500 mg / day.
Duration of treatment: undifferentiated and tuberkuloidnaya leprosy - dapson 3 years, rifampicin - 6 months. Border tuberkuloidnaya leprosy - dapson 5 years, 6 months rifampicin. Border leprosy - dapson 10 years, rifampicin 2 years, Ethionamide 10 years. Border lepromatoznaya leprosy and leprosy lepromatoznaya - dapson life, rifampicin 2 years, Ethionamide life. The incubation period of illness lasts unusually long - an average of 4-6 years, often delayed by 10-15 years or more. Forecast with leprosy With timely diagnosis and treatment of favorable prognosis. The patient is not necessarily placed in the lazaretto.
Post a Comment