- Gistioplazmoz's reasons
- Gistioplazmoz's symptoms
- Gistioplazmoz's treatment
Histoplasmosis is among deep, system mycoses and is caused by a dimorphous mushroom of Hiastoplasma capsulatum.
Infection occurs aerogenno, at inhalation a mushroom dispute. Especially there is a lot of them in the soil contaminated excrements of birds and bats. Getting to alveoluses, disputes turn into drozhzhepodobny cells. Then the infection extends in all internals. The centers of defeat are exposed to a caseous necrosis with the subsequent calcification, reminding Ghosn's centers. The activator has property to parasitize in cells of retikuloenlotelialny system therefore histoplasmosis is called sometimes a reticuloendothelial tsiotmikoz.
Children are ill considerably to a bowl, than adults. Allocate two forms — disseminated and chronic pulmonary. At babies the first prevails.
The disseminated form begins as:
• an acute pneumonia — temperature increase, short wind, cough; pathological process in lungs, unlike bacterial pneumonia, always has widespread character therefore various plentiful rattles are listened on both sides and have scattered character; radiological intersticial pneumonia — strengthening of the pulmonary drawing due to infiltration of an interstitium of lungs is defined that gives to a X-ray pattern rough, coarse, looped character;
• the condition of the child quickly worsens because of involvement in pathological process of many internals; are characteristic: generalized increase in peripheral lymph nodes and gepatosplenomegaliya.
As well as at many other fungal processes, are absent ostrovospalitelny reaction from indicators of peripheral blood: SOE is increased very moderately or normal, the blood count is not changed. The eosinophilia is noted not always. However the accession of a consecutive bacterial infection which is quite often complicating a basic disease can change a blood picture. Death most often comes from respiratory insufficiency, profuse gastrointestinal bleeding or sepsis.
Suspicion of histoplasmosis has to arise in connection with the instruction on contact of the child with birds, soil dust, and also at detection of unusual bilateral intersticial pneumonia.
The diagnosis is verified with the help:
- skin test with histoplasmin. This test is similar breakdown to Mant, is read in 48-72 hours and estimated as positive if infiltrate (papule) of the sizes of 5 mm in the diameter and more takes place; positive test testifies to an organism sensitization, however if it is for the first time revealed at sharply sick child, then can have diagnostic value, over time it dies away;
- definition of an antiserum capacity in the reaction of binding complement (RBC): the initial caption 1:8 is characteristic of an active form of a disease;
- immunodiffusion test with M-antigen of a gistoplazma is considered more reliable, than RSK;
The final diagnosis can be made on the basis of detection of the activator or yeast cells at crops of material about the patient (a phlegm, kcal), or in tissue specimens of a liver of lymph nodes, marrow.
Drug of the choice is Amphotericinum In which is entered intravenously kapelno, daily once a day, hens of treatment are made by 2 weeks. Palindromias are possible, rates of drug can be appointed by the poet repeatedly.