Beginning >> Diseases >> Infectious >> Leyshmanioza


Leushmaniosis — the acute infectious protozoan disease of the person and animals caused by intracellular parasites of a sort a leushmania. A carrier — mosquitoes. Also wildings participate in distribution of leyshmanioz house (a dog, a sandwort, a gopher, a jackal). Visceral and skin clinical forms are observed.

Etiology. The activator — the one-celled parasite belonging to type of protozoa. There are two forms: aflagellar, intracellular in an organism of the sick person and an animal and flagellar — in an organism of a female of a mosquito — a carrier of the infectious beginning.

Epidemiology. A leushmaniosis — a zoonotic prirodnoochagovy infection. This disease is widespread in extensive territories of a subtropical and tropical belt (The Middle East, Central Asia, the Mediterranean, East and Central Africa, the Central and South America). In the countries of the former USSR visceral forms of an illness are absent, and skin — sporadic come to light in Central Asia, Transcaucasia, Azerbaijan, Georgia and the Southern Kazakhstan. The maximum of diseases fall on August and September.

Pathogeny. The activator gets through skin. On site a sting through various time after infection primary affect in the form of a skin pustule, a small knot appears. At a visceral form of an illness the infectious beginning from primary center gets to a blood stream, there is a generalized infection with specific symptomatology of the general serious illness with defeat of the hemopoietic bodies. At skin forms of a leushmaniosis the center of an infection is limited to thickness of skin where the granuloma — the center of a productive inflammation having an appearance of a dense small knot, specific to this infection, which, nekrotiziruyas, forms in an ulcer of various size develops. The number of ulcers corresponds to number of stings — from single to multiple.

The clinic is various depending on an illness form. At a visceral leushmaniosis an incubation interval — from 20 days to 10 months. The beginning is gradual. The main symptoms — fever with a wavy current and remissions, defeat of the hemopoietic bodies — a liver, spleens, an anemization, a leukopenia, thrombocytopenia, sharp shift of an albumino-globulinovy index, the organism exhaustion reaching a cachexia. Dark gray coloring of skin — the sign which entered definition of an illness — "kala azar" (black fever). The liver and especially a spleen reach the huge sizes.

At a skin form the disease proceeds sharply, with a short incubation. The leishamanioma which arose on site a sting quickly increases, becomes covered by a crust under which the ulcer is formed. Its bottom with small granulations, is covered scanty purulent separated.

Differential diagnosis. Increase in the sizes of a spleen and liver at early stages of an illness can cause suspicion on a typhoid in the patient with a visceral leushmaniosis. But the hepatolienal syndrome has distinctive features. At a visceral leushmaniosis the bottom edge of a dense spleen goes down to an entrance to a pelvic cavity; at a typhoid and a paratyphoid And a spleen soft, its bottom edge hardly acts from under a costal arch. At patients with a leushmaniosis the liver dense, the big sizes, is easily palpated, at a typhoid it is more difficult to define it.

At a brucellosis, especially like the Maltese fever, and at a visceral leushmaniosis the illness proceeds with very similar wavy temperature reaction and a leukopenia. However the gradual onset of the illness, the progressing anemization, dark coloring of skin, a dense consistence of a liver and spleen are distinguishing characters of a visceral leushmaniosis.

At blood diseases like a lymphogranulomatosis, an acute myeloleukemia and a lymphoid leukosis, as well as at a visceral leushmaniosis, the liver and a spleen, but character of symptoms various increase. If the visceral leushmaniosis proceeds with the expressed leukopenia, then the specified leukoses — with very high leukocytosis. The lymphogranulomatosis, as well as a visceral leushmaniosis, proceeds is long with wavy fever and a system hyperplasia of lymph nodes while at a leushmaniosis the spleen and a liver mainly increase to the big sizes.

Ulcers at a skin form of a leushmaniosis and at an anthracic anthrax after rejection of a scab have a strong likeness. Detection of an anthracic microbe clears up diagnosis.
In differential diagnosis use of a method of detection of the activator of a leushmaniosis in the patient's organism is decisive.

Prevention. Efficiency of prevention of leyshmanioz among visitors in many respects depends on knowledge them the centers of these diseases and features of activity (attack) of mosquitoes. On the basis of such data limit visit of unsuccessful areas and apply necessary protective measures (repellents, overalls, processing by insecticides of possible places of breeding of mosquitoes near housing). The specialists occupied at works in the districts which are strongly infected with a skin leushmaniosis are recommended to do precautionary specific intradermal vaccination.

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