Symptoms And Treatment Of Visceral Leishmaniasis

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Symptoms And Treatment Of Visceral Leishmaniasis
Symptoms And Treatment Of Visceral Leishmaniasis

Video: Symptoms And Treatment Of Visceral Leishmaniasis

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Video: Visceral Leishmaniasis | Leishmania Donovani Disease | Medicine Lectures | V-Learning 2023, February
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Visceral leishmaniasis symptoms and treatment

Visceral leishmaniasis is an infectious disease that occurs in South America and Asia, Africa and the Mediterranean. In most cases, it affects children 1-5 years old, adolescents or young people under 25 years old and is fraught with complications for the internal organs. 50 thousand people (10% of the total number of infected) die from leishmaniasis every year.

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Visceral leishmaniasis is an infectious disease that is fraught with complications for the internal organs.

Causative agent

The causative agent of the disease is the protozoan parasite Leishmania donovani infantum.

The life cycle of parasites consists of 2 stages: finding in the form of oval, flagellate forms in humans or mammals and the subsequent existence of Leishmania in the digestive canal of phlebotomine mosquitoes, which are carriers of infection. In the body of insects, they acquire flagella within 5 days, increasing in length to 10-15 × 4-6 microns and actively multiplying.

Infection routes

Visceral leishmaniasis is a zoonotic disease. This means that the source of infection is animals that live in nature, as well as in cities and rural areas.

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The source of infection is animals that live in natural nature. For example, foxes.

These include dogs, foxes, and rodents. Leishmania donovani infantum parasitize inside the cells of these mammals. The carrier of leishmaniasis is the female mosquito. An insect becomes infected with parasites when it drinks the blood of a sick animal. Once in the gut of a mosquito, Leishmania donovani infantum multiplies in it.

In leishmaniasis, this happens because 7 days after the parasites have entered the insect's body, they block the mosquito's digestive tract, preventing it from swallowing. As a result, when an insect drinks blood from a person, it is forced to regurgitate parasites and their secret into the wound formed from the bite.

Thus, the causative agents of leishmaniasis end up in human skin. But most of them enter the system of mononuclear phagocytes (histiocytes of connective tissues, macrophages of the liver, spleen, bone marrow cells, etc.), where they provoke degenerative changes that lead to other diseases.

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The causative agents of infection enter, for example, the macrophages of the liver, where they provoke degenerative changes that lead to other diseases.

Visceral leishmaniasis symptoms

An infectious disease has an incubation period, which with leishmaniasis can last from 21 days to 12 months, but more often from 3 to 5 months. The most common time of infection is summer, and the first symptoms of infection are found in autumn and winter.

First, the victim develops a primary affect at the site of the bite - a small dense nodule (papule) of pale pink color. In the clinic of leishmaniasis, there are 3 periods:

  • Elementary.
  • Manifest.
  • Terminal.

Each of these periods develops gradually and is characterized by its characteristic symptoms.

At the initial stage of the disease, a person feels weakness in the muscles, his skin turns pale, the spleen increases.

With leishmaniasis of the manifest period, a person's body temperature rises
With leishmaniasis of the manifest period, a person's body temperature rises

With leishmaniasis of the manifest period, a person's body temperature rises.

Increase in lymph nodes gradually
Increase in lymph nodes gradually

Increase in lymph nodes gradually occurs.

The patient's blood pressure decreases
The patient's blood pressure decreases

The patient's blood pressure decreases.

Sometimes a person has a heart murmur
Sometimes a person has a heart murmur

Sometimes a person has a heart murmur.

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The clinic of manifest period leishmaniasis is as follows:

  • the appearance of wave-like fever with accompanying sweating, temperature + 37 … + 40 ° С, chills. It can last 2-3 days, then disappears, and apyrexia sets in (the time interval between attacks). Then the fever reappears. With leishmaniasis, this symptom may appear and disappear over several months;
  • painless enlargement of lymph nodes;
  • decreased blood pressure or tachycardia;
  • dysentery;
  • anemia;
  • the appearance of heart murmurs;
  • with visceral leishmaniasis, the spleen becomes thickened and enlarged (in some people, it takes up to 2/3 of the abdominal cavity, reaching the pelvic area below and the 6th rib above).

The terminal period of the disease is characterized by a decrease in muscle tone, weight, and general weakness.

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The terminal period of the disease is characterized by weight loss.

Other symptoms of leishmaniasis include the following changes:

  • atrophy of the muscles of the abdominal wall;
  • dilated abdominal veins;
  • a sharp protrusion of the spleen forward (drooping);
  • the appearance of edema on the hands and feet;
  • the appearance of depigmented spots (leishmanoids) on the skin;
  • in some cases, people develop ascites (dropsy of the abdominal cavity).

Leishmaniasis is not always characterized by the above set of symptoms. The clinic depends on which country the infection is spreading in. For example, in Latin American countries, the disease also affects the mucous membranes of the hard palate, pharynx and nose of a person, and ulcers form on them. And in East African countries, the first sign of leishmaniasis is skin pigmentation. For darkening of the skin, the disease is called "black fever".

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In some cases, with terminal leishmaniasis, people develop ascites (dropsy of the abdominal cavity).

Possible complications

Patients (especially in poor countries of the world) do not always turn to doctors on time, so the infection more and more affects their body and leads to a number of complications and death.

Severe cases of the disease can lead to rupture of the spleen and anuria (lack of urine). If the blood of the infected increases the content of urea and other metabolic products containing nitrogen, hyperazotemia will occur, then azotemic coma and often death will occur.

Visceral leishmaniasis is also the cause of phlegmon (purulent inflammation of the connective tissue), tuberculosis and sepsis (blood poisoning). These diseases are often fatal.

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Visceral leishmaniasis is the cause of blood poisoning.

Diagnosis of the disease

Leishmania donovani parasitize in the human body, causing great harm to his health and destroying organs and tissues, therefore, the sooner the victim of the infection goes to the doctor, the sooner he can get rid of this disease.

But in order to exclude an error and confirm the diagnosis, patients are prescribed several studies.

A general blood test shows an increase in ESR up to 50-70 mm / h and a decrease in the number of leukocytes (leukopenia). The method of specific diagnosis of leishmaniasis is a parasitological examination of smears under a microscope. Smears are taken from the bone marrow by puncture and found in the cells of Leishmania donovani infantum.

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A general blood test shows an increase in ESR up to 50-70 mm / h and a decrease in the number of leukocytes (leukopenia).

Sometimes a biological sample is made on hamsters, infecting them with material taken from the patient and observing the animals. Because some of the symptoms of leishmaniasis are similar to sepsis, typhoid, and brucellosis, doctors do a differential analysis with them.

Visceral leishmaniasis treatment

Doctors use antimony preparations (Solyusurmin, Pentostam, Glucantin) to treat an infectious disease. These drugs are given to patients by intravenous or intramuscular injection. When other bacterial infections join the disease, antibiotics and sulfonamides (Monomycin, Amphotericin B) are prescribed.

The patient must adhere to bed rest, eat well and follow all hygiene rules. Patients are monitored for 4 months. there is a risk of relapse. But often those who have suffered from the disease acquire a strong immunity to it.

Prevention

The prevention of leishmaniasis is the control of mosquitoes. In places where infection is detected, people should wear closed clothing made of dense fabric, use repellent agents, and sleep under mosquito nets. In areas where winged insects are common, residents are inoculated under the skin several months before their activation. As animals become infected with leishmaniasis, they are identified and then destroyed.

Explanatory work (leaflets, meetings with doctors) plays an important role in the prevention of the disease. Tourists should not visit places with outbreaks of infection. At the first sign of illness, you should consult a doctor. At an early stage, leishmaniasis is easier to get rid of and complications can be avoided.

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