Brief description of the disease
Leishmaniasis - is an infectious disease that is caused by protozoan parasites - Leishmania. In the role of disease vectors are the small blood-sucking insects, mostly - mosquitoes and sandflies. In urban areas leishmaniasis spreads through sick people and dogs. The disease has spread in Uzbekistan, the Caucasus, Turkmenistan, on the territory of some countries in Asia and Africa. Outbreaks of infections recorded in the period from May to October, when the causative agent is most active. In the risk group persons newly arrived in the endemic focus. Permanent residents of the troubled regions of cutaneous leishmaniasis sick much less often.
Types of leishmaniasis
Experts identify two main forms of the disease: leishmaniasis cutaneous leishmaniasis and an internal (visceral).
Visceral leishmaniasis begins gradually. The incubation period lasts from 10-20 days to several months. In the early stages of leishmaniasis manifests itself in small bowel disorders and the growth weakness. Typical features include leyshmaneoza enlargement of the spleen, lymph nodes and liver. It comes to the fact that in the midst of the spleen disease is enormous, and because of the weight gain is lowered into a small basin. Also, patients have a change of color of the skin (becoming pale earthy) and the emergence of various kinds of rashes, for the most part - pustular. In some cases, visceral leishmaniasis can cause swelling, anemia, bleeding and the development of weight loss.
Accurate diagnosis is made after a puncture of the bone marrow and the spleen for the presence of Leishmania.
City cutaneous leishmaniasis
Symptoms of cutaneous leishmaniasis occur within 3 - 8 months. At the place where pests have penetrated into the body, there is a small bump diameter of 1-4 mm. With the development of leishmaniasis, it increases in size and covered with flaky crust. Removing tubercle may form a bleeding ulcer covered purulent plaque and infiltration, which causes the expansion of the disintegration of the zone of the skin lesion. Such sores on the body, there are from 1 to 10 units. Typically, they are located on the face and hands, that is, in places that are accessible to mosquitoes.
Cutaneous leishmaniasis rural type
This form is characterized by a short incubation period. At the site of entry of pathogens appears conical mound. It grows quickly in size and often reaches 1-2 cm in diameter. The central protuberance necrosis tissues which form after rejection ulcer. If ulcers bit, they are quite extensive, reaching 6 cm in diameter. A large number of small ulcers (tens and hundreds of entities) restrains an increase in certain affected areas. When the diagnosis of cutaneous leishmaniasis symptoms stay on for several months, after which the sores clean.
Note also that both urban and rural cutaneous leishmaniasis can develop into a chronic form, which a number of features reminiscent of lupus.
Diagnosis of the disease
All forms of leishmaniasis should be distinguished from sarcoidosis, leprosy, syphilis and Bugorkova lupus. Differential diagnosis is based on anamnestic data and information on the stay of patients in endemic areas. Final data on the presence of infection experts receive after study analysis that can determine the presence of Leishmania in the body.
As to the specific differences considered infection from other diseases. If lupus affects mainly children, leishmaniasis, which often requires treatment for adults and is not dependent on the age of the patient. In addition, the bumps on the skin when leishmaniasis is much denser, which means - no effect of falling through the probe. Also worth noting is that the rash is not prone to ulceration, although located on the scars. Last - a deep and elongated, while lupus often superficial scars.
From Bugorkova syphilis cutaneous leishmaniasis different place localization rash. As a rule, it is located in open areas of the body is less dense tubercles ulcerate later does not give positive serological reactions to syphilis. There are differences in the nature of scarring. If they are inverted leishmaniasis, while Bugorkova syphilis - mosaic.
Leishmaniasis - Treatment and Prevention
Patients prescribed monomitsin. It is given intramuscularly three times a day. Standard dosage - 250,000 units. The course of treatment lasts for 10-12 days until such time as cutaneous leishmaniasis does not disappear completely. At an exacerbation of symptoms is recommended monomitsinovuyu ointment.
Prevention of cutaneous leishmaniasis based on the fight against mosquitoes and mosquitoes, destruction of stray dogs and rodents. In recent years, cutaneous and visceral leishmaniasis are trying to avoid using preventive administration of live cultures of the pathogen.
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