Granulotsitarny эрлихиоз
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Description:
Erlikhioz — the acute infectious disease which is characterized by fever, the general intoxication, a headache, a mialgiya and an arthralgia and emergence of rash in a part of patients. Belongs to a zoonosis.
Symptoms of the Granulotsitarny erlikhioz:
The incubation interval in half of cases lasts less than 8 days. The onset of the illness reminds flu and is followed by fever (100% of patients), a fever (98%), an indisposition (98%), a headache (85%), nausea (39%) and vomiting (34%). In some cases cough (29%) and confusion of consciousness (17%) develop later. Rash and epileptic seizures - a rarity. Thrombocytopenia, a leukopenia, anemia and increase in activity of aminotransferases in serum are often observed. At a trepanobiopsiya the marrow hyperplasia can be revealed. At advanced age the disease proceeds heavier, but also children are subject to an infection too.
Without treatment the disease proceeds in a medium-weight or severe form, lasts from 3 to 11 weeks (at adults) and can end with death. The case when at the child who was not receiving antimicrobic therapy, temperature stuck to only 10 days is known. In general, 56% of patients need hospitalization, 7% get to intensive care unit and 5% die. At autopsy reveal the fungal pneumonia caused by Aspergillus fumigatus, Cryptococcus neoformans or Candida albicans. Developing of these opportunistic infections demonstrates decrease in immunity. It is interesting that at the sheep infected with Ehrlichia phagocytophila are broken function both neutrophils, and T - and V-lymphocytes.
Simultaneous infection of the person with a granulotsitarny erlikhioz and laymskoy is not excluded by a disease, a granulotsitarny erlikhioz and babeziozy - causative agents of all three diseases are transferred by the same tick of Ixodes scapularis (Ixodes dammini). Really, at many patients with a laymsky disease antibodies to the activator of a granulotsitarny erlikhioz are revealed, and find both microorganisms in some mites. It is quite possible that multi-infection proceeds heavier.
Reasons of the Granulotsitarny erlikhioz:
By 1995 in 11 states of the USA about 150 cases of a granulotsitarny erlikhioz - generally in the north of the central part and in the northeast were registered. The laymsky disease has similar geographical distribution.
The first message on a granulotsitarny erlikhioz was made in 1994 (Bakken J. S. et al., 1994). Since then it is diagnosed even more often, but borders of the natural centers are not defined yet. The majority of cases is observed in habitals of Ixodes scapularis (Ixodes dammini), but some - in habitals of the southern kind of Ixodes scapularis, Ixodes pacificus (in the west of the USA) and Ixodes ricinus (in Europe).
The activator of a granulotsitarny erlikhioz was found in mites of Ixodes scapularis (Ixodes dammini) in the north of the central part and in the northeast of the USA, in deer - in the north of the central part of the USA and in California, in horses and dogs - in the north of the central part and in the North East of the USA, and also in Sweden. Believe that as a tank of the activator serve rodents and deer, but it is not proved yet.
The activator of a granulotsitarny erlikhioz at the person is almost indistinguishable from Ehrlichia equi (in California this erlikhiya is transferred by Ixodes pacificus and causes a disease in horses), from Ehrlichia phagocytophila (in Europe Ixodes ricinus is transferred and causes a disease in deer, cattle and sheep).
Transfusion to horses of the blood taken from sick people causes in them granulotsitarny эрлихиоз, having had which, they gain immunity against Ehrlichia equi.
It is quite probable that the activator of a granulotsitarny erlikhioz at the person, Ehrlichia equi and Ehrlichia phagocytophila are strains of the same species of a bacterium.
The peak of incidence falls on June-July, but at visit of habitals of mites of the sort Ixodes the granulotsitarny erlikhioz can catch at all seasons of the year. Most often men (79% of cases) and elderly people are ill (a half of patients starkhe 58 years).
Treatment of the Granulotsitarny erlikhioz:
Effective remedy - doxycycline. Among 35 patients, treated doxycycline, at 94% temperature fell down during 24-48 h. At one patient who was not receiving doxycycline, the activator was found in blood for the 28th days of a disease (by means of PTsR).
Prevention - protective clothes, repellents, regular and careful survey of all body. The found ticks are taken as soon as possible.
