Leishmaniasis: treatment, symptoms in humans

leishmaniasis - a large group of protozoal infections, which are caused by protozoa of the genus - Leishmania. It flagellates intracellular parasites. In humans, the disease develops after the bite of an infected organism (mosquito), belonging to the genera Phlebotomus and Lutzomyia.

Overview

Most representatives of Leishmania genus-group in relation to the epidemic are considered dangerous to humans. They are able to parasitize inside the cell structures of various organs and tissues. For the complete transmission of the causative agent of its life cycle need to consistently change the two carriers. In his first stage of Leishmania will have flagella. All this time she is in the body of arthropods. Go to the mature form of the pathogen can bezzhgutikovuyu only in the human body. In this case, the mosquito will serve as a passive carrier.

However, not all severe leishmaniasis zoonotic, that is the natural reservoir for them to be animals. Revealed two species of the pathogen that are purely anthroponotic infections (only in humans them). This zoonosis characterized sufficiently narrow distribution area.

insta story viewer

Morbidity is mainly recorded on the African continent and in South America. This is due to the fact that the primary reservoir of the pathogen can only be restricted species, and vectors are mosquitoes. Symptoms and treatment of leishmaniasis in humans can vary depending on the physiological characteristics of the organism.

Causes

The presence of the causative agent of an infectious disease, which belongs to the genus of flagellate protozoa Leishmania.
The presence of natural foci of the pathogen. They are limited habitat of the animals that have given infectious pathology, and vectors - mosquitoes.
The ill person or animal to be epidemiologically dangerous to others for a long time. This limited period of time, a finding of Leishmania in the bloodstream and the patient's skin integument, ie actually during all stages of leishmaniasis.
Less dangerous epidemic in terms of patients with visceral course of the infection process, since in this case the least Leishmania available for blood-sucking insects.
Infection occurs in mosquito bites a human or animal patient. When injected into the intestinal tract of an insect pathogen infection of amastigotnoy form becomes promastigotnuyu. A week after becoming infected mosquito becomes infectious for susceptible human or animal body and remains so throughout his life.
In endemic regions, the infection recorded and cases of human infection in health care, for example, as a result of blood transfusion.
After the disease produces immunity, however, it is strictly species. That is, such an infection can re-develop after infection by another member of the genus Leishmania in humans.

As the infection develops?

When infected insect bite promastigotnaya form of agent penetrates the skin of a human where in transformed bezzhgutikovuyu form (amastigote).
In place of introduction of Leishmania formed with an inflammatory process characteristic of the disease in the form of granuloma papules. If developing visceral form of the infection, the pimple disappears gradually, and when the skin form of the destruction of the skin continues. At this point the ulcer is formed, which after recovery heal with scar formation.
From the primary tumor lymph causative agent is stored in the regional lymph nodes, which triggers the development of lymphangitis.
On the skin in the same period formed characteristic of this infection "serial leyshmaniomy". They are secondary granulation foci around the "entrance gate" of infection.
When mucocutaneous forms leyshmaniomy pathological process are formed and on the mucous membranes airways, which eventually can lead to destructive changes in the soft and cartilaginous tissues these bodies.
With the development of the visceral form of leishmaniasis affects the patient's internal organs, making it difficult to cure. Leishmaniasis is accompanied by disruption of the immune system due to immunosuppressive action of the pathogen. This is manifested by fever and severe acute intoxication. Develop various morphological disorders of internal organs, leading to their dysfunction.
In response to the penetration of leishmaniasis pathogen, the immune system produces specific antibodies, but they hardly able to fulfill its protective function as Leishmania are protected cells in which they are parasitize.
Once past infection in a patient immune to Leishmaniasis formed. However, it is strictly species. Consequently, the causative agent of secondary infection, but of a different kind of Leishmania, is quite possible.

Classification

Standard classification for the infection there. However, based on symptomatic manifestations Most authors identifies two main clinical course:

The cutaneous form, which is characterized by a primary lesion of the integument of the patient.
In visceral disease the infectious process spans the diseased organs.

Depending from the primary site of infection spread epidemiologists emit:

zoonotic disease, wherein the main reservoir is sick animal;
if the source of infection is a person, then talk about anthroponotic infection.

The symptoms of leishmaniasis in humans

Depending on the clinical course of detectable symptoms leyshmanioznoy infection is divided into visceral and cutaneous forms.

Visceral leishmaniasis is characterized by the following symptoms:

The incubation period for this form sufficiently long and can last up to six months.
It is characterized by a gradual increase of symptomatic manifestations. The acute form is rare.
The first signs - is growing symptoms of acute intoxication with fever. However, possible short periods of remission.
When viewed in this period revealed an increase in regional lymph nodes, which is not accompanied algiyami.
Pec and spleen were significantly increased. On palpation they are tight but not painful. It is broken and functioning of these bodies. Therefore, the identification ascites or portal hypertension with leishmaniasis not uncommon.
It can detect symptoms of central nervous system and, in particular, the spinal cord.
Start the terminal phase is characterized by the appearance of areas of dark pigmentation of the skin, cachexia symptoms and edematous-ascitic syndrome.

Cutaneous leishmaniasis has a short incubation period, which lasts on average up to three weeks.

There are several clinical forms, which have their symptomatic nuances, but they characterized by the primary leyshmaniomy which is formed on the bite of infected insect pathogen. From protuberance formed after bite ulcers formed with sero-purulent discharge. It heals a scar.

Diagnostics

The presence of symptomatic manifestations of the disease process.
Epidemiological confirmation of infection possibility, that is, the patient must be, or come from an endemic area for leishmaniasis.
Bacteriological examination of discharge of the primary or secondary Leishmania allocated pure culture of the pathogen.
When microscopy natural material of ulcerations and specific staining also possible to determine the presence of Leishmania.
If necessary, can be subjected to microbiological investigation punctate cerebrospinal fluid or material collected by biopsy of the liver and spleen.
For rapid diagnosis can be used serological tests.