Leishmaniasis - the general name of infections caused by intracellular parasitic flagellate protozoa of the genus Leishmania.
Carriers - the female mosquitoes.
The symptoms of leishmaniasis
Manifestations of the disease are formed within 3-12 months after infection. In the Asian region in 75% of cases, there is the appearance of symptoms in the first month after infection.
visceral leishmaniasis
Leishman's disease - Donovan, leishmaniasis inner cachectic fever, splenomegaly tropical.
The main reservoirs of visceral leishmaniasis in Eurasia and Latin America - rodents, foxes, jackals, porcupines and dogs. In eastern India and Bangladesh, where natural reservoir - man, leishmaniasis epidemic was recorded every 20 years.
Visceral Leishmaniasis East Africa - a kind of visceral leishmaniasis. It is widespread in East Africa (the Sahara in the north to the Equator). Visceral Leishmaniasis East Africa recorded more frequently in men aged 10-25 years; characterized by skin lesions in the form of nodes, often ulcerate, followed visceral.
Visceral leishmaniasis India (kala azar, Assamese fever, kala-azar) - a kind of visceral leishmaniasis.
Distributed in eastern India and Bangladesh; characterized by dark skin color due to the lesion of the adrenal cortex.
Visceral leishmaniasis Mediterranean-Central Asian (kala azar Mediterranean children) - a kind of visceral leishmaniasis.
Common in Southern Europe, North Africa. Central Asia, the Middle East and north-western China. Observed mainly at children; characterized by an acute onset of a high fever and swollen lymph nodes.
Manifestations of visceral leishmaniasis
Fever. Febrile seizures continue, gradually fading away, for 2-8 weeks. Then the attacks occur at irregular intervals. added diarrhea; increasing liver and spleen; observed swelling. Individuals with a weak pigmentation of the skin may be grayish spots on the face and head. Often anemia.
juccuya
Leishmaniasis cutaneous New World (mucocutaneous leishmaniasis, mucosal leishmaniasis, leishmaniasis American). The disease is typical of humid forests of Central and South America; tank - large forest rodents. Typically recorded in workers employed in forestry and road works, among the population of forest villages. Symptoms of cutaneous leishmaniasis occur 1-4 weeks after being bitten by a carrier.
Mucocutaneous leishmaniasis Brazilian (espundia) - a kind of cutaneous leishmaniasis of the New World.
Widespread in the forests of South America east of the Andes, runs with extensive skin lesions, later mucous membranes, upper respiratory tract typically, sometimes with deep soft tissue destruction and cartilage.
Leishmaniasis Uta - a kind of cutaneous leishmaniasis of the New World.
It is widespread in the highlands of South America. It proceeds with the formation of individual ulcers, scarring throughout the year.
Diffuse cutaneous leishmaniasis - a kind of cutaneous leishmaniasis of the New World.
Manifestations do not differ from African and Asian types of cutaneous leishmaniasis. However, cases of spontaneous recovery is less common. Vectors - mosquitoes. Characterized by the formation of chronic painless (there are a few years old) ulcers, usually localized on the neck and ears. Typically, the observed gross deformation ears (ear chiklero).
Leishmaniasis cutaneous of the Old World (leishmaniasis).
Infection with the highest incidence in the autumn months. Natural reservoir - small rodents (mice, rats, Q) carriers - mosquitoes. Distributed in the areas bordering deserts, with low-lying groundwater. Borowski disease manifestations: incubation period lasts from two weeks to five months; characterized by lesions in the open areas of the body prone to ulceration and centrifugal distribution; ulcer edge inflamed; after 3-12 months, observe self-healing with the formation of a coarse pigmented scar.
Leishmaniasis anthroponotic skin (cutaneous leishmaniasis urban cutaneous leishmaniasis pozdnoizyazvlyayuschiysya) - a kind of cutaneous leishmaniasis of the Old World.
Distributed in the Mediterranean cities of the Middle East, the western part of the Indian subcontinent; characterized by a long incubation period.
Leishmaniasis is a zoonotic skin (cutaneous leishmaniasis ostronekrotiziruyuschiysya, cutaneous leishmaniasis rural) - a kind of cutaneous leishmaniasis of the Old World.
It is widespread in the oases of the deserts and semi-deserts of the Middle East, Central Asia, India and Africa. Characterized by a short incubation period.
Recurrent (lupus) Leishmaniasis - a kind of cutaneous leishmaniasis of the Old World.
It characterized by partial healing of the lesions, frequent development of associated lesions, with no signs of healing, sometimes for many years.
Manifestations of cutaneous leishmaniasis
Characterized by painless, deforming lesions of the mouth and the nose, spread to other areas with the advent of mushroom and erosive ulcers on the tongue, inside the cheeks and nose. Relapses in a few years after the self-extinction of the primary foci. Watch the destruction of the nasal septum, palate and throat lesions. The disease is accompanied by fever, weight loss.
Leishmaniasis lupoid skin (cutaneous leishmaniasis tuberculoid, metaleyshmanioz, paraleyshmanioz) - relapsed cutaneous leishmaniasis, characterized by the formation of dense confluent brownish red bumps around healed Leishmania.
Diagnostics
- Detection of pathogens in smears material lymph nodes, bone marrow, spleen;
- Skin tests with leyshmaninom (Montegoro test): the cutaneous form positive 6-8 weeks after recovery, but not in diffuse leishmaniasis. In visceral leishmaniasis the results are negative;
- For species identification using monoclonal antibodies or DNA hybridization method;
- IFA - a highly sensitive and specific method for the diagnosis of visceral lesions.
leishmaniasis treatment
Bed rest, oral hygiene, suralimentation.
Drugs of choice: meglumine antimonate - at 20-60 mg / kg deeply / m 1 r / d.. for 20-30 days. At relapse leishmaniasis or lack of effectiveness of treatment should be to re-injection rate for 40-60 days. Effectively supplemental assignment allopurinol 20-30 mg / kg / day. 3 ingestion.
Alternative formulations at relapses and pathogen resistance to the selection drug: amphotericin B - 0.5-1.0 mg / kg intravenously every other day. In the absence of the chemotherapy effect - in addition interferon alpha (human recombinant).
Forecast
In 3-10% of treated patients develop skin changes in the form of discolored spots and borodavkoobraznyh nodules on the face and extensor surfaces. In patients with mucocutaneous leishmaniasis possible lesions of the mucous nasopharynx.
In the early diagnosis and timely treatment of leishmaniasis recover more than 90% of patients. If untreated, 95% of adults and 85% of children die within 3-20 months.
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