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Measles

Table of contents
Measles
Diagnosis

Measles — the high-contagious viral illness which is characterized by fever, intoxication, Qatar of upper respiratory tracts and eyes, specific enantemy, makulo-papular rash.

Etiology. The activator — RNA-viruliferous, possessing high virulence and small stability in external environment and to action of physical and chemical factors.

Epidemiology. Infection occurs from patients with an airborne way through mucous membranes of a conjunctiva of eyes and upper respiratory tracts. The susceptibility is high. Babies possess the oroimmunity inherited from mother. In the subsequent all children are susceptible to measles. The postponed disease leaves durable immunity. The postvaccinal immunity, though less resistant, but quite long (8 — 10 years) and on intensity approaches natural. Due to the carried-out planned inoculations incidence of measles of children significantly decreased, but incidence of adults increased (especially in organized collectives).

Pathogeny. Primary fixing and a reproduction of a virus happens in cells of a ciliary epithelium of respiratory tracts and in alveolotsita. The lymphoid system, and also vessels are surprised. In an incubation interval there comes the virusemia. Damage of airways develops from the first days of an illness in the form of Qatar of a mucous membrane of a nose, a throat, a trachea. The plethora, hypostasis and a limfogistiotsitarny infiltration of the Derma, mainly around vessels, the phenomenon of a focal plethora of a brain, hypostasis of covers of a brain are noted.

Clinic. An incubation interval — from 9 to 17 days. At persons to whom entered gamma-globulin with the preventive purpose it can increase till 21 days. The illness arises sharply from temperature increase, emergence of cold, a photophobia, cough, sneezing, a headache, hoarseness of a voice. At survey the conjunctiva hyperemia, puffiness a century, a nictitating spasm, a serous, and then and purulent discharge from a nose is noted. On a mucous membrane of a mouth there are Velsky's spots — Filatova — Koplika and a clumsy enantema. Localization of spots on a mucous membrane of cheeks opposite to small molars is characteristic. Sometimes during the catarral period there is poorly expressed punctulate, scarlatiniform or makulezny, in some cases urtikarny rash which is giving way to typical clumsy rash. Its first elements arise behind ears, on a ridge of the nose, then within a day rash quickly extends to all person, a neck, partially to upper part of a breast and back. For the 2nd days rash covers all trunk, and on the 3rd — upper and lower extremities. Continuous fields of an erythema are formed in places.

The type of the patient with measles is typical: eyes are red, diapyetic, eyelids are thickened, the person bloated, the nose and an upper lip are edematous, plentiful allocations from a nose. Mucous membranes of an oral cavity and a pharynx are diffuzno hyperemic. At physical research the tracheobronchitis phenomena, signs of "infectious heart" — expansion of dullness and muting of cardiac sounds, tachycardia are found, arrhythmia, arterial hypotonia is possible. At uncomplicated disease body temperature is normalized, rash turns pale, gradually turning into the light brown pigmented spots, the catarral phenomena and symptoms of intoxication decrease. All signs disappear in the same sequence in what they appeared. Deflorescence can be followed by a small scaly peeling of skin.

With use of protivokorevy immunoglobulin, and also with introduction of active specific immunization easy forms of measles became frequent (mitigirovanny).

Extremely hard the hemorrhagic form of measles which is found very seldom proceeds. At it hemorrhagic rashes and multiple hemorrhages in skin, mucous membranes are noted. From complications pneumonia most often meets. They are early, virus and bacterial, and late, mainly bacterial. Besides, measles can be complicated by a keratitis, encephalitis, meningitis, otitis, a pyoderma, enteritis, colitis.



 
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