Typhus typhus- the disease is caused by Provachek rickettsiae, characterized by a cyclical course with fever, typhoid state, a peculiar rash, as well as damage to the nervous and cardiovascular systems.
The source of infection is only a sick person, from whom body and head lice, sucking blood containing rickettsia, transmit them to a healthy person. A person becomes infected by combing bites, rubbing the excrement of lice into the skin. At the very bite of lice infection does not occur, as in their salivary glands causative agent of typhus is absent. The susceptibility of people to typhus is high enough.
Symptoms and course. The incubation period lasts 12-14 days. Sometimes at the end of incubation, there is a slight headache, body aches, chilling. The body temperature rises with a slight chill and by 2-3 days is set at high numbers (38-39 ° C), sometimes it reaches a maximum value by the end of 1 day. In the future, the fever has a permanent character with a slight decrease on 4, 8, 12 day of illness. Early there is a sharp headache, insomnia, a breakdown occurs quickly, the patient is excited (talkative, mobile). The face is red, puffy. On the conjunctiva of the eye, small hemorrhages are sometimes seen.In the throat diffuse hyperemia, point hemorrhages may appear on the soft palate. The tongue is dry, not thickened, lined with a grayish-brown patina, sometimes hardly protruding. The skin is dry, hot to the touch, in the first days of sweating almost does not happen. There is a weakening of heart tones, rapid breathing, enlarged liver and spleen (from 3-4 days of illness). One of the characteristic signs is a typhoid rash. The rash appears on the 4-5 day of illness. It is multiple, abundant, located mainly on the skin of the side surfaces of the chest and abdomen, on the crook of the arms, it captures the palms and the feet, it never happens on the face. The rash occurs within 2-3 days, then gradually disappears (after 7-8 days), leaving pigmentation for some time. With the onset of rash, the patient's condition worsens. Sharply increased intoxication. Excitation is replaced by oppression, retardation. At this time, a collapse may develop: the patient is in prostration, the skin is covered with cold sweat, the pulse is frequent, heart sounds are deaf.
Recovery is characterized by a decrease in body temperature, accelerated lysis at 8–12 days of illness, a gradual decrease in headache, improvement in sleep, appetite, and restoration of the activity of internal organs.
Typhoid fever.Acute infectious disease caused by a bacterium from the genus Salmonella. The pathogen can be stored in the soil and water for up to 1-5 months. Dies when heated and the action of conventional disinfectants.
The only source of infection is a sick person and a bacterium carrier. Typhoid sticks are carried directly by dirty hands, flies, and sewage. Outbreaks associated with the use of infected food (milk, cold meat dishes, etc.) are dangerous. Symptoms and course. The incubation period lasts from 1 to 3 weeks. In typical cases, the disease begins gradually. Patients noted weakness, fatigue, mild headache. In the following days, these phenomena increase, the body temperature begins to rise to 39-40 ° C, the appetite decreases or disappears, sleep is disturbed (daytime sleepiness and insomnia at night). There is a delay in stool, the phenomenon of flatulence. By the 7th-9th day of the disease, a characteristic rash appears on the skin of the upper abdomen and lower chest, usually on the anterolateral surface, consisting of small red spots with clear edges, 2-3 mm in diameter, towering above the skin (roseola). To replace the disappearing rosealam may appear new.Characterized by a kind of inhibition of patients, pallor of the face, slow pulse and lower blood pressure. Dispersed dry rales are heard above the lungs - a manifestation of specific bronchitis. The tongue is dry, cracked, covered with a dirty-brown or brown patina, the edges and the tip of the tongue are free from plaque, with imprints of teeth. There is a rough rumbling of the cecum and pain in the right ileum, the liver and spleen on palpation increased. The number of leukocytes in the peripheral blood decreases, especially neutrophylls and eosinophils. ESR remains normal or increases to 15-20 mm / h. By week 4, the condition of the patients gradually improves, the body temperature drops, the headache disappears, appetite appears. Severe complications of typhoid fever are intestinal perforation and intestinal bleeding. In recognizing the disease, timely identification of the main symptoms is of great importance: high body temperature lasting more than a week, headache, weakness - decreased motor activity, loss of strength, sleep disturbances, appetite, characteristic rash, sensitivity to palpation in the right iliac abdomen, enlarged liver and spleen.From laboratory tests to clarify the diagnosis, bacteriological (immunofluorescent) blood cultures are used on Rappoport medium or bile broth; serological studies - Vidal reaction and others.
The most effective antibiotics of the tetracycline group, which is prescribed by 0.3-0.4 g 4 times a day. You can use chloramphenicol. Antibiotics give up to 2 days of normal temperature, the duration of the course is usually 4-5 days. For detoxification, 5% glucose solution is administered. Apply oxygen therapy. With a sharp arousal barbiturates, chloral hydrate are shown. Nutrition and vitamin therapy are of great importance. The right patient plays an important role: complete rest, fresh air, comfortable bedding and underwear, daily toilet of the skin and mouth.
The main antimicrobial drug is chloramphenicol. Assign 0.5-0.75 g, 4 times a day 10-12 days to normal temperature. A 5% glucose solution, an isotonic solution of sodium chloride (500-1000 mg) is injected intravenously. In severe cases, corticosteroids (prednisone at a dose of 30-40 ml per day). Patients should comply with strict bed rest for at least 7-10 days.