Pseudoerysipelas - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

pseudoerysipelas (swine erysipelas, erythema breaker, rubella naturalists, mouse septicemia, pseudoerysipelas Rosenbach) - zooantroponoznaya acute bacterial infection with the contact transmission mechanism, characterized by lesions of the skin and joints.

causative agent - Erysipelothrix rhusiopathiae - short, Gram-positive rods (with the Gram stain is painted in blue and bluish color).The dispute, capsules, no flagella.

pseudoerysipelas causative agent under the microscope

Despite the lack of protective structures (spores and capsules), the causative agent of quite stable in the environment:

• dies when cooked for 3 hours;
• in animal cadavers preserved for 4 months, in an open space - NA;
• salting and smoking do not kill the pathogen;
• destructive action of some disinfectants have 1% bleach solution and a 3% Lysol solution;
• The pathogen is sensitive to the antibiotics penicillin and tetracycline.

susceptibility and prevalence of pervasive, no sex and age restrictions, but at risk are:

butchers, cooks, people engaged in animal husbandry, fishermen, hunters, housewives, agricultural workers - is a group of people who may have direct contact with raw infected meator to care for sick animals.Record the summer-autumn season.

Causes infection pseudoerysipelas

source and reservoir (guardian) infections - livestock, pets, and some marine animals (pigs, sheep, cattle and small cattle, dogs, chickens and ducks, rodents, fish and crayfish).The mechanism of transmission - contact, and possibly contact-household, ie not only by direct contact, but also by contact with contaminated objects.Infection usually occurs through contact with infected animals or meat through the damaged skin.

Symptoms pseudoerysipelas

The incubation period - the time from penetration to the originator of the first symptoms last 1-7 days, but on average 2-3 days.Infection atriums are microtrauma of the skin, the passage of which is the causative agent of the inflammatory leaves a trace, since this point can be considered the beginning of the next period.

period will be characterized by clinical manifestations in addition to inflammatory changes in the skin, further spread through the blood and lymphatic vessels, causing local spread (dispersion) in other organs and tissues with the rise in their secondary foci.It is characterized by arthritis, carditis (endocarditis, myocarditis), central nervous system lesions and lung, as well as the anginal syndrome.

Depending on the predominance of a particular clinical picture, allocate appropriate clinical forms:

• Cutaneous pseudoerysipelas characterized by specific changes in the input gate of infection, namely, the first signs of the disease is the appearance of fast-growing red-violet plaques (increase in size at the 2-3 cm in diameter per day), with puffiness around the periphery but maintaining clear boundaries, accompanied by itching / burning / throbbing pain.At the same erythematous site may have several vesicles (bubbles) with a transparent or hemorrhagic content.From red-violet plaques depart painful inflamed lymph vessels - ie there is lymphangitis also increase regional lymph nodes - regional lymphadenitis.

• Anginal pseudoerysipelas form - occurs by eating infected meat and is manifested by pain in the throat (with hyperemia limfoglotochnogo ring) and feverish intoxication syndrome.

• articular form is manifested arthralgias and deforming arthritis later, with a possible polyarthritis (multiple lesions) and monoartrit (affecting only one joint).The duration of this period can occur clinical from 3 weeks to 12 months.

• Kardiomiopaticheskaya form pseudoerysipelas - manifest valvular lesion, followed by violation of hemodynamics in small or large circulation.This form can lead to complete destruction of the valve.The main clinical manifestations are determined Topeka lesions (ie what kind of valve is struck) and character (stenosis or delyatatsiya) - will be observed corresponding symptoms and ECG changes, but valvular lesions are often concomitant:

- When the mitral valve stenosis (clamshell,to the left) there is left ventricular failure and left ventricular hypertension, which appear inspiratory dyspnea (there is difficulty in breathing in and there is no feeling of satiety) and bluish pink blush on the cheeks due to hypertension in a small circle and hypertension violation + hemoptysis + cough + frequent vertigo +pain in the likeness of angina + passing hoarseness + possible thromboembolic complications (often with concomitant disorders coagulation system) + ECG changes (expansion of the P wave in the II standard lead and dextrogram) and echocardiography (a very informative method) + palpation determining apical impulse may bedetect a change of its borders + auscultation flapping first tone and diastolic murmur listens at the top position on the left side;

- When dilatation of the mitral valve (mitral regurgitation) - is the lack of closure of the valve, resulting in a return throw blood during systole.This lesion appears dyspnea.occurring either during physical activity or in a prone position, especially at night (until the development of cardiac asthma) + noise after I pitch after exertion and lying on his left side, at the top in the expiratory phase (duration and sound volume is directly proportional to the degree of severity)+ on the ECG and echocardiography are also seen changes.

- aortic stenosis - there are symptoms of angina + shortness of breath similar as in mitral valve stenosis + systolic murmur after I pitch, listens to the base of the heart, also along the carotid arteries and the apex of the heart + on the ECG (dextrogram increase in QRS amplitude, reduction of ST,negative T waves in leads V5-V6) + echocardiography to determine the degree of stenosis.

- Dilatation of the aorta - manifested by shortness of breath as orthopnea (dysfunction breathing when lying down) + auscultation auscultated "blowing" postdiastolichesky noise due to reverse casting of blood from the aorta into the left ventricle + visible pulsation of the carotid arteries ( "dance of carotid") atwhich the patient's head is often reeling from side to side with a certain frequency, the type of negative head movements + or symptom Musset (pokachivaenie Glowe and fro) + fumble capillary pulse Quincke determined with a small click on the nail bed + sign Hill (systolic blood pressure in the legabove 20 mm Hg than shoulder) + on the ECG is determined levocardiogram and negative T wave and ST segment in the left chest leads.

- stenosis of the tricuspid valve (tricuspid valve is located in the right heart) is often not manifest clinically, but decompensation possible hepatosplenomegaly (an increase in the spleen and liver).

- dilation of the tricuspid valve can also be asymptomatic, but can and hepatosplenomegaly, reduction of systolic blood pressure and diastolic blood may increase.

• Septic form suggests generalization of the process and, in this case in the forefront of clinical manifestations appears feverish intoxication syndrome with the rise in temperature to 40 ° C, disturbance of consciousness and general malaise.In this clinical form may join and other symptoms listed above is (in the form of cutaneous manifestations of erythema, anginal clinic, the articular manifestations, cardiomyopathy).

Diagnostics pseudoerysipelas

addition to epidemiological and clinical settings, and take into account the bacteriological method - by abjection of edematous fluid or a piece of skin biopsies.Serologic diagnostic techniques are not used.

Treatment pseudoerysipelas

Etiotropic treatment in the form of use of the drug - penicillin or erythromycin in the age dosages for a week.Pronounced toxicosis - corticosteroids for arthritis - the imposition of a plaster splint.

Complications pseudoerysipelas

From the heart - the deformation of the valve with their immediate replacement with artificial.From the joint - deforming arthritis.

Prevention pseudoerysipelas

Veterenarno-specific prevention is the vaccination of animals revealing + / insulation / treating sick animals + controls at meat processing plants.The health prevention is only in respect of personal prevention measures and conduct disinfection work;Specific prophylaxis has not been developed.

After suffering a disease formed unstable immune system and it is therefore possible reinfection.Sick people are not dangerous to others.

therapists Shabanova I.E