Tsutsugamusha fever
Contents:
Description:
Tsutsugamusha (Latin rickettsiosis tsutsugamushi) — the acute natural and focal transmissible rickettsiosis which is characterized by primary affect, a lymphadenopathy.
On severity allocate an easy current, a moderately severe current and a heavy current. In a form the disease can proceed subclinically and atypically
Symptoms of Fever of a tsutsugamusha:
The incubation interval most often lasts from 7 to 11 days, but can sometimes proceed also up to 21 days. In the first days of a disease temperature of the patient reaches 41 °C. The hyperemia, bradycardia is noted. From 3 to 4 days the sizes of a liver and spleen begin to increase. For 4 — 7 day on skin of a stomach, a breast, extremities and persons the rash passing for 5 — 8 day acts. Complications: thrombophlebitis, decubituses, infectious psychosis.
Reasons of Fever of a tsutsugamusha:
The activator — Rickettsia tsutsugamushi (R. orientalis). The activator has the same properties, as other rickettsiae. The antigenic structure of R. orientalis allows to allocate a number of serovars: Gilliam, Karp, Kato, Fan. All strains differ on virulence and on antigenic properties. There are strains killing with 80 — 100% of experimental white mice, and strains which cause at them only easy clinical manifestations. Rickettsiae are unstable in external environment, instantly perish at boiling. The strains of R. orientalis allocated in our country belong to Gilliam serovar.
Treatment of Fever of a tsutsugamusha:
As well as at other rickettsioses, the most effective etiotropic remedies are antibiotics of tetracycline group and levomycetinum (chloramphenicol). Tetracycline is appointed inside on 0,3 — 0,4 g 4 times a day within 5 — 7 days, the expressed effect begins already in 24 h after purpose of an antibiotic. Levomycetinum is appointed on 0,5-0,75 g by 4 times a day within 5-7 days, the effect comes to light in 36 h. At shorter course of an antibioticotherapia quite often (at 30 — 50%) in 2-5 days short-term palindromias are observed. Considering a possibility of tromboembolic episodes, as well as at treatment of patients with a sapropyra, appoint heparin in the same doses. At stratification of a consecutive bacterial infection appoint in addition antibiotics (or himiopreparata) taking into account an antibiotikogramma of the allocated bacteria.
