Tularemia — disease of the lymph nodes. Characterized by intoxication, fever, defeat lymph nodes. The causative agent of the disease — small bacterium. When heated to 60 S dies after 5-10 minutes. Reservoirs of tularemia Bacillus — hares, rabbits, water rats, voles. In natural foci of epizootics periodically occur.
The infection is transmitted to humans or directly in contact with animals (hunting), or through contaminated food and water, less aspiration by (in the processing of grain and forage products, threshing bread), blood-sucking insects (horsefly, tick, mosquito, etc.).
Symptoms and course of tularemia. The incubation period of several hours to 3-7 days. Distinguish bubonic, pneumonic and generalized (circulated on organism) forms. The disease begins acutely with a sudden rise in temperature to 38,5-40C. There is a sharp headache, dizziness, pain in the muscles of the legs, back and lumbar region, loss of appetite. In severe cases may be vomiting, nosebleeds. Characterized by severe sweating, sleep disturbance in the form of insomnia or Vice versa drowsiness. Often there is euphoria and increasing activity against high temperature. Marked redness and swelling of the face and conjunctiva in the first days of the disease. Later on the mucous membrane of the oral cavity appear point hemorrhage. Tongue coated with a grayish bloom. A characteristic sign of the increase in various lymph nodes, the size of which may be from a pea to a walnut.
Cardio-vascular system observed bradycardia, hypotension. In the blood leukocytosis with a mild neutrophilic shift. Liver, spleen not increasing in all cases. Pain in the abdomen possible with a substantial increase in mesenteric lymph nodes. The fever lasts from 6 to 30 days.
Bubonic form of tularemia. Pathogen penetrates the skin without leaving a trace, after 2-3 days of illness develops regionarny lymphadenitis. Buboes little painful and have clear contours of up to 5 cm In the subsequent softening occurs or bubo (1-4 months), or his spontaneous dissection with separation of thick pus pus and the formation of tularemia fistula. More often 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 the eyes. Typically the appearance of follicular proliferations yellow size up to millet grain conjunctiva. Bubo develops in the parotid or submandibular areas for a long period of illness.
Anginal-bubonic form occurs in the primary lesion mucosa tonsils, usually one. It occurs when the food ways of infection.
There are forms of tularemia, mainly affecting the internal organs. Pneumonic form — often recorded in autumn-winter period. Generalized form proceeds on a common type of infection with the expressed toxicosis, loss consciousness, crazy, severe headache and muscle pain.
Complications of tularemia can be specific (secondary tularemia pneumonia, peritonitis, pericarditis, meningoencephalitis), and abscesses, gangrene due to secondary bacterial flora.
Diagnosis of tularemia is based on convallariaceae test and serological reactions.
Treatment of tularemia. Hospitalization of the patient. The leading role antibacterial drugs (tetracycline, aminoglycosides, streptomycin, levomitsetin), treatment conducted up to 5 days of normal temperature. When the protracted use of forms combined treatment with antibiotics with a vaccine that is injected intradermally, intramuscularly at a dose of 1-15 million microbial bodies on injection with intervals of 3-5 days, 6-10 treatment sessions. It is recommended that vitamin therapy, repeated transfusions of donor blood. When you see fluctuations bubo — surgery (wide incision and draining bubo). Patients discharged from hospital after complete clinical recovery.
Prevention of tularemia. Elimination of natural foci or reduction of their territories. Protection homes, wells, open reservoirs, products from rodents. The planned mass vaccination in hotbeds of tularemia.