Benign inoculation reticulosis
- Fellinoz's symptoms
- Fellinoz's reasons
- Fellinoz's treatment
Benign inoculation reticulosis (Xing. the disease of cat's scratch, a high-quality lymphoreticulosis) - the acute infection which is transmitted from cats and characterized by primary affect, regional lymphadenitis, fever, a gepatosplenomegaliya is more rare damage of eyes and the central nervous system.
Source and tank of an infection - cats at whom V. henselae is the representative of normal microflora of an oral cavity. The person catches at close contact with a cat (licking, scratches, stings and so forth). Immunokomprometirovanny persons are most susceptible to a disease. Incidence has sporadic character or is shown in the form of family flashes.
Incubation interval - from 3 to 20 days. In the field of entrance gate, in the place of scratches there is primary affect - a dense not pruritic papule of purple-red color, a sore or a pustule which gradually disappear, leaving permanent pigmentation. Then in 1-3 weeks there is an increase in regional lymph nodes, is more often elbow, axillary, painful at a palpation, dense, not soldered to surrounding fabric. At a half of patients soon in the center of a node the softening is planned and when opening dense yellowish-green pus is emitted. At others lymph nodes gradually decrease in a size, resolve or scleras ozirutsya. Usually one lymph node increases. Regional lymphadenitis can be followed by fever, intoxication of different degree of manifestation and duration - from 5 to 20 days and more. The increased lymph nodes remain about 3 months, at a part of patients - till 1 year. Seldom, at hit on a conjunctiva of saliva of a cat, conjunctivitis - a hyperemia, hypostasis, granulomas sometimes ulcerating develops. Also as well as at damage of skin, there is regional lymphadenitis. At generalization of an infection symptoms of the general intoxication amplify, body temperature increases till 38-39 "With, atozny, rozeolezno-papular rash is observed erity, the liver, a spleen increase, meningeal symptoms appear. Disease is high-quality, but the long current at which aggravations and a recurrence proceed up to 12-24 months is sometimes observed. At patients with AIDS the general and a zevanny infection is followed by damage of hypodermic and intradermal vessels that is shown by angiomas, hemorrhages of various sizes sometimes reminding Kaposha's sarcoma. Differential diagnosis is possible by results of a histologic research.
The activator - a small gram-negative stick - Bartonella henselae. A disease of cat's scratch, along with a number of less known diseases of the person - fever of Oroya, a peruviansky wart, trench (Volynsk) fever, a bacillar angiomatosis, purple (peliozny) hepatitis and a splenitis, a chronic lymphadenopathy, bacteriemic states and an endocarditis caused by other types of bartonellas are united in group of a bartonellosis.
Penetration of the activator through the injured skin or, more rare, through a mucous membrane of an eye leads further to development of inflammatory reaction in the form of primary affect. Then on lymphatic ways the microbe gets into regional lymph nodes that is followed by developing of lymphadenitis. Morphological changes in lymph nodes are characterized by a retikulokletochny hyperplasia, formation of granulomas, and after microabscesses. The disease usually is followed by hematogenous dissimination with involvement in pathological process of other lymph nodes, a liver, the central nervous system, myocardium. Heavy and long, and it is frequent and atypical disease is observed at patients with HIV infection.
Until recently antibacterial therapy was considered as ineffective. However with the advent of new generations of antibiotics from group of macroleads (a ketolead and similar to it) there were perspectives of etiotropic influence. At the expressed intoxication and suspicion on the current complicated by bacterial superinfection of treatment also other antibiotics of a broad spectrum of activity can be used. Are in most cases limited to purpose of the antiinflammatory, desensibilizing and disintoxication means. At suppuration of lymph nodes surgical treatment - a section or a puncture is made for removal of pus.