- Esherikhioz's symptoms
- Esherikhioz's reasons
- Esherikhioz's treatment
Esherikhioz treats intestinal infections which causative agent are diareegenny Escherichia coli. Esherikhioz proceeds with clinical symptoms of an acute gastroenteritis or a coloenteritis, in certain cases with heavy intoxication and the phenomena of dehydration.
Clinical manifestations of an esherikhioz depend on properties of the activator. At an enteroinvasive esherikhioz the incubation interval in 1 - 3 day after which acute intestinal infection which symptomatology reminds a shigellosis develops is observed. Enterotoxigenic эшерихиоз can get a choleroid current, and enteropathogenic it is similar to symptoms of salmonellosis. Various forms of a disease, including gastroenteritichesky, enterokolitichesky, gastroenterokolitichesky, generalized can be observed (a colisepsis, eyuninita, pyelonephritises, cholecystitises). About hemorrhagic colitis as one of forms of an esherikhioz, speak at the acute bloody diarrhea caused by Escherichia coli with hemorrhagic properties. The disease can easily proceed in the form of watery diarrhea, but at the weakened elderly people and children the hemolitic and uraemic syndrome sometimes develops.
Separate gram-negative strains of Escherichia coli, in particular I57:N7 serotype, produce toxins, similar shigellezny, capable to damage an internal wall of vessels of a colic wall. Локализуясь in intestines, toxins are an origin of dysenteric symptoms. At absorption they are capable to damage an endothelium of vessels of adjacent bodies, for example renal that leads to development of hemorrhagic nephrite. Infection occurs after consumption of the inseminated meat or not pasteurized milk. The fecal way of infection is quite often observed.
Hemorrhagic colitis begins sharply, at the beginning of a disease strong spastic abdominal pains disturb, diarrhea which soon becomes bloody is observed. Temperature reaction usually is absent, however at some patients body temperature can will increase to 39 °C. At preservation of symptoms of a disease up to 10 days tell about easy a current. At a rektoromanoskopiya the hyperemia and hypostasis of a mucous membrane takes place. At an irrigoskopiya the hypostasis of a mucous membrane creating a picture as "thumbmark" is in most cases visible. About 5 — 10% of cases of hemorrhagic colitis soproozhdatsya by a hemorrhagic syndrome, an acute renal failure and hemolitic anemia. Quite often thrombocytopenia develops. Most often these syndromes take place at children of younger age and at senile age.
Specific laboratory characters for the infections caused E. coli, does not exist. Though the specified microorganism well grows on bacteriological environments, its exact definition is complicated by the fact that it is necessary to receive the biochemical characteristic of the activator allocated at crops. There are data on an immunochemical diagnostic method of hemorrhagic colitis by detection of specific antigens E. coli in bioptata.
In hard cases there is considerable hypostasis of a mucous membrane with ulcerations and pseudo-polypostural changes, and at a radiological isslekdovaniye the symptom of "thumbmarks" in a cross colon is observed. Therefore the differential diagnosis with ischemic colitis can present considerable difficulties. Ischemic colitis, can cause damage of a large intestine up to her gangrene, but much more often it is shown by a bloody diarrhea, pains in the left ileal area and short-term fever. Defeat, as a rule, segment and is the most frequent in the field of a splenic bend, on border of arterial blood supply between upper and lower mesenteric arteries. The radiological characteristic is characterized by a symptom of "thumbmarks" which at a kolonoskopiya look as a combination of polipovidnoizmenenny sites to ulcerations. The histology can have similarity to ulcer colitis or a disease Krone and even with pseudomembranous colitis. The correct diagnosis is helped by the group nature of a disease of the colitis caused E. coli 0157H7 while ischemic colitis arises sporadic preferential at the men of advanced and senile age having the expressed atherosclerosis of peripheral vessels. Nevertheless, E coli0157:H7 can come to light in certain cases ischemic colitis.
5 E.Coli forms are known: enterotoxigenic (ETEC), enteroinvasive (EIEC), enteropathogenic (ERES), enterogemorragichesky (ENES), enteroadgezivny (EAES). Recently the heavy clinical current of an enterogemorragichesky esherikhioz is noted. Its manifestations quite often is complicated by a gemolitikouremichesky syndrome.
Enterogemorragichesky strains E. coli are sensitive to a wide range of antibiotics, but their use needs to be dosed strictly as death of microbes leads to sharp increase in an intestinal gleam of enterogemolitichesky toxin. Due to this fact, the bed rest, a rigid diet and symptomatic therapy is necessary for the patient. In case of complications the intensive care, including a hemodialysis and a plasma exchange is necessary. Forecast, as a rule, favorable. At diagnosis of hemorrhagic colitis carry out isolation of patients. Adjust processing of allocations of patients, careful observance all being in an infection focus of personal hygiene. Health control of pasteurization of milk and beef in places of their implementation is necessary for prevention of a food way of transmission of infection. The majority of infections caused E. coli, are result of intra hospital infection. Their flashes can be reduced due to careful processing of the medical tools used at inspection of patients (enemas, catheters, endoscopes, etc.).