Brucellosis in humans: Symptoms, and Treatment diagnostka

Brucellosis - a zoonotic infectious disease, which is transmitted animals. Despite the fact that the carriers of infection is livestock, it is highly contagious to humans.

For the disease characterized by a long and severe course of infection affects the musculoskeletal system, heart, blood vessels, the central nervous system. It is important to promptly detect brucellosis symptoms experienced doctor can easily recognize them at the first examination.

What it is?

Brucellosis - a zoonotic infectious disease caused by pathogenic microorganisms from the family Brucella, and characterized subacute inflammatory process in all organs and tissue with a primary lesion of the lymphatic, osteoarticular and nervous systems.

exciter

The causative agents of brucellosis - immobile gram-negative bacteria that can parasitize intracellularly. 6 types of known pathogens brucellosis and 17 biovars.

The source of hazardous to human Brucella are mainly four types: goats, sheep (Br.melitensis), cow (Br.abortus bovis), pig (Br.abortus suis) and dogs (Br.canis), releasing the pathogen with milk, urine, amniotic fluid, moreover, is a carrier of brucellosis stable fly (Stomaxys calcitrans).

insta story viewer

Human infection occurs through direct contact with the animal-carriers or by eating contaminated products - raw milk, cheese made from raw milk.

symptoms of brucellosis

At an early stage of brucellosis in humans, the symptoms of which are very similar to the flu or other viral infections, it is very difficult to diagnose. For the initial manifestations of brucellosis are:

1. An increase in temperature with high "candles" in the afternoon and evening (the most common symptom of brucellosis);
2. Back pain, pain or a burning sensation in the extremities;
3. Poor appetite and weight loss;
4. Headache, night sweats, weakness.

After penetration into the body of the pathogen that causes brucellosis, symptoms in humans appear after 5 - 30 days (mean, 2-3 weeks), with carriers of latent can elongate up to 3 months. severity depends on the agent type:

1. B. abortus causes mild symptoms. The patient's condition is regarded as a mild or moderate, but the disease often takes chronic.
2. Symptoms of the disease caused by the B. canis may be transient in nature. For like infection caused by B. abortus, but more often observed vomiting and diarrhea.
3. B. suis may cause the formation of abscesses in various organs.
4. B. melitensis causes severe course with sudden onset. This disease can lead to disability of the patient.

Protracted (chronic) for brucellosis manifests constant, increasing weakness, apathy, pain in the joints. Such a character has a less favorable prognosis and may lead to an underestimation of the condition and later seeking medical help. According to statistics, a chronic course several times more often ends in patients disabled.

The acute form

The acute form of brucellosis is established in patients with clinical symptoms that occur within 3 months.

With the gradual onset of the disease (more commonly in older patients), fatigue, malaise, fatigue, poor sleep, muscle and joint pain, low-grade body temperatures - the main symptoms of brucellosis in the period. Peripheral lymph nodes are enlarged slightly (mikropoliadenopatiya). With an increase in the intoxication symptoms body temperature rises significantly. The patient observed heavy sweats and chills. Increased liver and spleen.

With the rapid development of the disease (acute brucellosis) rises to body temperature 39 - 40 ° C. Temperature curve has a wave-like shape, often the wrong type. The patient observed heavy sweats and chills, but the general state of health, however, remains satisfactory. Peripheral lymph nodes are enlarged, some of them painful on palpation. Under the skin palpable painful education - cellulites and fibrositis. By the end of the first week of increased liver and spleen. No focal lesions. ESR and white blood cells remain in the normal range or slightly elevated.

subacute form

Subacute form of brucellosis is established in patients with clinical symptoms that occur within 3 - 6 months. The disease is characterized by recurrent course. Body temperature is worried sick for several days. Muscle and touch-joint pain, paresthesia, poor sleep and appetite, muscle weakness - the main symptoms of brucellosis in this period. Marked on the skin of allergic reactions in the form of exanthema and dermatitis.

In some cases, in severe disease shows signs of infectious and allergic endocarditis, myocarditis and pericarditis, meningitis symptoms sluggish. In 10 - 15% develop clinical picture lesions of the musculoskeletal system, peripheral nervous system and the reproductive system.

The chronic form

For chronic brucellosis flow characteristic periods of exacerbation and remission followed. The main blow falls on the nervous system: a variety of marked hearing loss, vision, decrease in sensitivity, rash.

Also suffers musculoskeletal system. Can develop a variety of destruction and deformity of the spine, abscess, perichondrium, neuroses. Affected and urogenital system: in women is manifested as endometritis, dysmenorrhea, salpingitis, and men generally develop orchitis.

Brucellosis can become the cause of a number of other pathological changes: hormonal failure, arthrosis, contractures, ankylosis.

diagnosis of brucellosis

Considered mandatory laboratory diagnosis of disease, including crops cerebrospinal fluid, blood, and lymph nodes punctates. Such a diagnosis is carried out in special laboratories, because of the low vyseivaemosti identify the infectious agent is very difficult.

In recent years, widely used:

• agregatgemagglyutinatsii reaction that detects Brucella antigens in the blood;
• Coombs' test for detection of incomplete antibodies in chronic brucellosis;
• Wright reaction, most informative during acute brucellosis;
• Brucella lysis reaction;
• Sample Burne, with intradermal administration brucellin.

Diagnosis of the disease is the differentiation of other diseases involving prolonged fever, diseases. In acute brucellosis graph of temperature measurement is incorrect character with the appearance of chills, sweating. Also, the physician should exclude rheumatoid arthritis and rheumatic disease, tuberculosis focal lesions, syphilitic arthritis and gonococcal. For suspected brucellosis check the state of the lymph nodes, liver and spleen.

Treatment of brucellosis in humans

Causal treatment is carried out by use of antibiotics. It is important to follow some rules:

1. Simultaneous use of two drugs active against Brucella;
2. The optimal duration of not less than 5-6 weeks;
3. Continuity;
4. Use of antibiotics only in an exacerbation of the process. The use of antibiotics in the attack-free period will bring more harm than good;
5. The use of high doses.

Of specific regimens have proved bad combination:

1. Tetracycline with streptomycin;
2. Rifampicin and doxycycline;
3. Doxycycline with streptomycin or erythromycin;
4. Azithromycin or clarithromycin with Biseptolum;
5. Doxycycline with amikacin.

In connection with the intracellular parasitism of Brucella in the human body and a long course of the disease, treatment should also be prolonged. Its main components should be etiotropic (pathogen destruction), pathogenic (impact mechanisms for starting and maintaining the inflammatory process), symptomatic (elimination alarming symptoms).

complications

Brucellosis can cause almost any part of the patient's body, including the reproductive organs, liver, heart, and central nervous system.

Among the possible complications of note:

1. Brucellosis in pregnant women can cause miscarriage, fetal anomalies.
2. Arthritis. Infectious inflammation of the joints characterized by pain, stiffness and swelling in the affected area (usually - in the knees, ankles, hip, wrists and spine);
3. Endocarditis. This is one of the most serious conditions that can lead to disruption of the heart valves. Endocarditis - the main cause of death in patients with brucellosis;
4. Infections of the central nervous system: meningitis (inflammation of the membranes surrounding the brain) and encephalitis (inflammation of the brain itself);
5. Infectious inflammation of the liver and spleen. With the development of this complication in a patient there is an increase in the size of these bodies and there are pain in the epigastric;
6. Infectious inflammation of the testicles (orchitis, epididymitis,). Brucella can penetrate into the epididymis, the tube that connects the vas deferens and the testicles. From there, the infection may spread further in the testicles, causing swelling and pain.

forecast treatment

Brucellosis is rarely a cause of death. Even before the advent of antibiotics mortality when it did not exceed 2% and was mainly due to endocarditis. However, brucellosis often ends disabilities. The severity of the residual defects depends on the type of pathogen.

The most serious consequences of leaving brucellosis caused by Brucella melitensis. One of the causes of disability - neurological disorders, including spinal cord injury and paraplegia. Sensorineural hearing loss is described as a complication of treatment of meningoencephalitis and streptomycin.

prevention

If there are diseases of this disease risks, then the situation where there are some signs of brucellosis should immediately consult a specialist. All preventive measures are aimed at preventing contact with sick animals, unless it is possible, it is necessary to compulsorily carry out measures to prevent the disease animals.