- Brugioz's symptoms
- Brugioz's reasons
- Brugioz's treatment
Brugioz (Latin of brugia - a sort of gelminot of filarias) - the parasitic disease caused by threadlike worms - filyara which larvae circulate in blood and adult individuals affect lymphatic system.
Allergic manifestations can develop approximately in 3 months after infection. Microfilarias come to light in blood not earlier than in 9 months. The disease begins with various allergic manifestations. On skin, especially on hands, painful elements like an exudative erythema appear, lymph nodes in inguinal areas, on a neck increase and in axillary hollows, often there are painful limfangita, a funiculitis, an orchiepididymitis, a synovitis from the outcome in a false ankylosis, women have a mastitis. At a long recurrent current of a funiculitis and an orchiepididymitis arises to a gidrotsela. Fever is characteristic, bronchial asthma and bronchial pneumonia quite often develop. In 2-7 years after infection the disease enters the second stage which is characterized generally by defeats of skin and deep absorbent vessels with development of a varicosity, disturbance of a lymph flow, ruptures of these vessels. There are painful limfangita with regional lymphadenitis. At this time within several days at the patient the expressed phenomena of the general intoxication against the background of high temperature of a body and severe headaches are noted. Vomiting is often observed, the delirious state sometimes develops. The attack usually comes to an end with plentiful sweating. As a result of ruptures of absorbent vessels the expiration of a lymph and reduction of intensity of lymphadenitis is observed.
Phases of relative wellbeing periodically are replaced by the next exacerbations of a disease. On site limfangit there are dense tyazh, the affected lymph nodes are also exposed to fibrous consolidation. Increase in inguinal and femoral lymph nodes is characteristic Initial swelling of lymph nodes of pain does not cause, however at the subsequent development of limfangit severe pains in nodes develop. Defeat can be one - or bilateral, the sizes of nodes from small to 5-7 cm in the diameter. Often in parallel the so-called lymphoscrotum (chyle treatment of tunica vaginalis) and a chyluria develop. The lymphoscrotum is clinically shown by increase in a scrotum. At palpation of skin of a scrotum expanded absorbent vessels easily are defined. At ruptures of these vessels a large number of quickly coagulated lymph follows. The expiration of a lymph from the damaged vessels can continue several hours.
In the countries of North Africa, India and China the chyluria or a lymphuria often occurs at patients brugiozy. The patient notices that urine got a milky-white shade. In certain cases urine becomes pink or even red, sometimes it happens white in the morning and red in the evening or on the contrary. Presence at blood urine along with a lymph is explained, obviously, by ruptures of small circulatory expanded absorbent vessels. Microfilarias come to light in urine only at night. Sometimes it is preceded by small pains over a pubis or in inguinal areas. The ischuria owing to coagulation of a lymph and formation of flakes in uric ways is characteristic. At a lymphuria in urine there are an impurity of a lymph, protein in a significant amount, blood impurity is possible, but there are no fat traces. In an urocheras lymphocytes are found.
Bodies of the dead of filarias resolve usually completely or calcinated. However in certain cases the died parasites are the reason of development of abscesses which lead to heavy complications, such as an empyema, peritonitis, a purulent inflammation of genitalias.
The third (obstructive) stage of a disease is characterized by elephantiasis. Elephantiasis of the lower extremities develops in 95% of cases, is slightly more rare - upper extremities, generative organs, certain sites of a trunk and very seldom than the person. Clinically elephantiasis is shown by quickly progressing lymphangitis with accession of dermatitis, cellulitis in combination with fever which in certain cases can serve as the main symptom of a disease and is a consequence of accession of a bacterial infection. Skin becomes covered by warty and papillomatous growths over time, sites of ekzemopodobny change of skin, not healing ulcers appear. Legs can reach the huge sizes, they take a form of shapeless blocks with thick cross folds of the affected skin. Scrotum weight usually makes 4-9 kg, and in some cases to 20 kg, the case when scrotum weight at the patient reached 102 kg is described. In case of elephantiasis of the person the upper eyelid is surprised more often. At a brugioza elephantiasis arises usually only on extremities, defeat more often unilateral, skin remains smooth.
Brugia malayi nematode activator (Brug, 1927). Length of a male of 22 — 25 mm, thickness of 0,09 mm, the tail end it is spiralno curtailed, bears two unequal spicules of various form. Females: length is up to 60 mm, thickness is up to 0,2 mm. Two strains of a parasite are known: with night frequency and night subfrequency.
Adult filarias parasitize in absorbent vessels, microfilarias — in circulatory.
The disease is widespread in the countries of Asia: India, China, Korea, Vietnam, on Philippines, in Malaysia, Thailand, Indonesia.
Century of malayi is transferred by mosquitoes carriers of Mansonia, Aiansonia, Anopheles and Aedes. Brugiozy with night frequency only the person can be an invasion source
For treatment of a brugioz (destruction of puberal stages) outside the USA anthelmintic drug of a wide range, in combination with ivermectin is recommended албендазол (albendazole). Effectively also a combination of an albendazol with dietilkarbamaziny.