Miscellaneous

Iersinioz: causes, symptoms, treatment, prevention

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Iersinioz - a pathology of infectious nature, which is triggered by entering the susceptibility of specific pathogen, provoking the development of pathognomonic clinical picture, witnessing the defeat of a authority.

Infectious disease in numerous laboratory studies have identified seven species of Yersinia, however, not all of them are pathologically dangerous to humans. Pathogen iersinioza morphological characteristics similar to the causative agents of plague and pseudotuberculosis.

What it is?

Iersinioz - acute zoonotic intestinal infection accompanied by toxic-allergic reaction, characterized multiochagovostyu.

Pathogen iersinioza

Pathogen and pathogenicity factors (ability to cause disease):

  1. Gram negative bacilli (with Gram stain okarshivaetsya in pink color), the color of which indicates the presence of the capsule;
  2. Also have flagella that cause active movement after the introduction of the organism;
  3. As is adhesin that link the collagen, resulting in an arthritis;
  4. The ability to synthesize serine protease which provides destruction of mucosal secretory IgA and facilitates penetration through the barrier, because it is the line of first IgA protection at mucosal (and not only intestine).
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  5. Like pseudotuberculosis, intestinal pathogen in iersinioza have outer membrane proteins providing penetration through the bowel mucosa noninvasive way (ie without violating the integrity of the intestinal wall).

The last two factors explain unimpeded penetration through the mucosal barrier and into glublezhaschie tissue.

Epidemiology

The natural reservoir for Yersinia - the soil. Animals and birds is withdrawn as a secondary reservoir and the source of infection. The main of them - rodents, farm animals (such as pigs, cattle, rabbits), birds and pets (cats, dogs).

The main transport mechanism of the disease - the fecal-oral. Man becomes infected when consuming food and water contaminated with Yersinia (vegetables, milk and dairy products). In areas with hot climates, about 80% of all outbreaks associated with by drinking contaminated water. There are cases of yersiniosis after transfusion of infected blood. Susceptibility is high. The risk groups include people working in animal husbandry, poultry farming and nutrition units. SMPS in the population in different regions is 10-20%.

Postinfectious immunity intraspecific.

Iersinioz recorded everywhere. The most frequently - in Western and Northern Europe, UK, USA, Canada, Japan and Russia, at least - in Africa, Asia, South America and Eastern Europe. The actual incidence in Russia is much higher than officially recorded. The ascent begins in March and lasts 4-5 months, dramatically decreasing in August and again increasing at the end of the year.

Kinds

Based on the leading manifestations of infection, yersiniosis can be divided into several forms:

gastrointestinal which affects the development of stomach gastritis, colon and appendix.
generalized in which the entire body is affected with sepsis, liver disease, kidney, brain and lung membranes.
mixed with lesions of two or more organs, for example - the liver and kidneys.
Secondary focal the defeat of the joints, the heart muscle, intestine, skin, against the background of the previously flowed infection.

Severity can distinguish mild forms of yersiniosis, moderate and severe septic forms. Downstream the disease may be acute, chronic or relapsing (and decay periods of exacerbation).

Yersiniosis and pseudotuberculosis

Pseudotuberculosis called pathology that as yersiniosis, caused by micro-organisms of the same species. Clinical symptoms of these diseases is similar, especially when the patient is suffering from severe lesions of the gastrointestinal tract and joints. With the development of these abnormalities are equally observed a rash on the hands and feet. Doctors often very difficult to distinguish the appearance of yersiniosis pseudotuberculosis, so appointed by laboratory tests.

Pseudotuberculosis has an incubation period, which lasts about 1-2 weeks. First of all patients with this diagnosis starts tormenting symptoms of intoxication, expressed in the form of headaches, redness and swelling of the throat, pain in the joints and muscle tissues. The patient sees the language covering dirty gray. So the language is for people suffering from scarlet fever.

When the disease crosses the 2-4 week mark, a rash appears on the body, which is a small red dot. In most cases these rashes pass after 7 days and after his disappearance left traces in the form of flake flaking.

Therapy pseudotuberculosis is also receiving antibiotics, drugs that eliminate the symptoms of intoxication and hormonal agents. Thus, these infectious diseases have similarities, so the correct diagnosis is made only after all the necessary diagnostic measures.

symptoms of yersiniosis

The incubation period - the time from the beginning of the introduction of the pathogen into the body before the first clinical manifestations, with yersiniosis can last from 15 hours to 6 days, but usually 2-3 days. During this period, through the gastrointestinal tract pathogen penetrates into the intestine, where it is fixed and multiplies.

There he captured tissue makrovagami part of it dies, releasing endotoxin, and part is carried by the same macrophages (because of the unfinished phagocytosis) of lymphoid system, and then through the bloodstream - causing local spread that I S trigger for the emergence of clinical period manifestations. The duration of the incubation period, and for all other processes will depend on the following factors: the immunological reactivity of the organism from infective dose and strain of the pathogen, the route of penetration.

Symptoms of yersiniosis in adults much like gastroenteritis, gastroenterocolitis, enterocolitis, terminal ileitis.

For intestinal yersiniosis is characterized by abdominal pain, which may be permanent or cramping in nature, vomiting, nausea, foul-smelling diarrhea. Chair during the disease may be from 2 to 15 times per day, with an admixture of pus, mucus, and sometimes blood.

Symptoms of yersiniosis in addition to the defeat of the intestine, evidenced also about the general intoxication - increase or decrease in temperature, dehydration, toxemia. For the onset of the disease in some cases, characterized by the appearance melkopyatnistoy or rash on the spot limbs and trunk, as in this period iersinioza meningeal syndrome can be observed liver damage.

For the later period of the infection characterized by the development of diseases such as erythema nodosum, mono- or arthritis, iritis, conjunctivitis, myocarditis, Reiter's syndrome.

Intestinal yersiniosis can last from one week to several months.

Diagnostics

Yersiniosis may suspect physician or emergency physician, but the final diagnosis is infectious disease.

To confirm the diagnosis it is necessary to detect the microbe in the feces, blood, bile, urine, or cerebrospinal fluid. You can spend bakposev sputum or swabs from the oropharynx.

Abjection complex and requires up to 30 days. In order to apply rapid diagnosis determination pathogen antigens in biological secretions.

When iersinioza needed expert advice:

  • gastroenterologist,
  • cardiologist,
  • neurologist,
  • nephrologist.

Necessary to carry out ECG, ultrasound of the heart and abdominal organs.

complications

In this disease complications may be very diverse in nature. This may include various types of inflammatory organ disease (hepatitis, myocarditis, pancreatitis, cholecystitis), surgical pathology character (intestinal obstruction, adhesive disease, peritonitis, etc.).

Not excluded and CNS diseases (e.g., meningoencephalitis), musculoskeletal (osteomyelitis, arthritis, etc.), urinary system diseases (glomerulonephritis).

iersinioza treatment

In current clinical practice, yersiniosis treated permanently assigning prolonged etiotropic funds even in mild forms of the disease. This tactic is caused by the frequency of chronic infection and the development of recurrent nature of the flow. Causal treatment includes a course of antibiotics and fluoroquinolones for the entire duration of febrile period and 10-12 days.

Later prescriptions (after 3 days of clinical symptoms) does not guarantee the prevention of complications and chronic infections. Generalized form treated complex (prescribed drugs of different groups of antibacterial agents parenterally), to prevent a recurrence, change the antibiotics during the course.

Complex nonspecific therapeutic action is selected depending on the patient and the disease. By indications prescribed detoxification solutions (dextran colloid and crystalloid mixture), antihistamines, antiinflammatory group of non-steroidal agents, and if necessary - prednisolone (often used hormonal anti-inflammatory agents for local application). Patients can be displayed vitamin, digestive enzymes, probiotics to correct intestinal biocenosis and also means for increasing the immune defense (immune modulators, human immunoglobulin).

Prevention of yersiniosis

In every state, there are actively working bodies that are authorized to sanitary-epidemiological supervision over the observance of sanitary norms, which are aimed at disseminating yersiniosis. Constantly have to carry out preventive measures aimed at preventing Yersinia possible contamination on food products, which are subject to long-term storage, for example, vegetables.

Vegetables should be stored in special storages equipped in such a way that it is not allowed to enter them rodents, which are the main carriers of yersinia. All racks and shelves in storages are subject to mandatory regular disinfection with subsequent ventilation of the room. The effectiveness of disinfection measures is assessed only by a fence of laboratory samples Surface vegetable store, which must be completely absent even non-pathogenic Yersinia serotype. An important value has to maintain a certain microclimate storages (air temperature 4o ° C and relative humidity 70%).

Patients with a history of yersiniosis, are subject to discharge from hospital, not only after the elimination of clinical manifestations of the disease, but also the full normalization of laboratory iersinioza markers, especially intestinal forms. Bacillicarriers Yersinia are subject to out-patient treatment. In order to prevent the spread of infection, yersiniosis bacillicarriers and sick persons working on the easting suspended from work for the period of medical treatment.

Children who have suffered yersiniosis, after discharge from the hospital infection, be sure to be medical examination at the district pediatrician, because this pathology is likely to develop chronic process and occurrence of relapses. Persons belonging to the decreed groups of yersiniosis are required to undergo a full laboratory examination before discharge from the hospital, which includes not only biochemical indicators, but also the presence of faecal Yersinia.

Forecast

In most cases the disease ends in recovery. In people with low resistance developing septic conditions, some patients the disease takes a prolonged or chronic.

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