Spotty fever of the Rocky Mountains

Description:

Other names of pathology - mountain fever, a tick-borne rickettsiosis of America, tifo-malarial fever.

Symptoms of Spotty fever of the Rocky Mountains:

The course of spotty fever can be various. Allocate the following its forms:

    * erased when symptoms of a disease are expressed extremely slightly;
    * lungs when symptoms of a disease are expressed also not strongly, the condition of the patient remains almost normal, quickly enough there is a recovery;
    * medium-weight forms;
    * severe forms, with extensive damages of skin and internals when the condition of the patient substantially suffers;
    * fulminant forms.

At the same time all symptoms of a disease develop within a short period of time, they initially are heavy, the condition of the patient suffers is expressed, there can come death. However most often the disease proceeds in medium-weight and heavy forms.

There is an eclipse period which averages from 2 to 14 days. Onset of the illness, as a rule, rather bystry: the patient begins to test a fever, body temperature quickly enough rises to 39-41 °C, and sometimes and to higher values. Constantly headaches, pain in joints and muscles disturb. In more hard cases there can be nausea and vomiting, bleedings from a nose, disturbances of consciousness of various degree of manifestation. In some cases the first signs begin to develop in time of the eclipse period. Then the patient shows complaints to a febricula, weakness, weakness, a fever, moderately expressed headaches.

Fever at this disease has rather peculiar character. Rises in body temperature to considerable indicators happen in the evening days while in the morning it remains absolutely normal. On average the feverish period proceeds from 2 to 3 weeks. Body temperature in the subsequent decreases not at once, but gradually, no more than within 3-4 days.

The first displays of a disease arise not on skin, and on mucous membranes of an oral cavity, in the form of a set of small spots of hemorrhage. The accompanying signs which in some cases help to suspect the right diagnosis at the patient are the urezheniye of heart rate, lowering of blood pressure. When listening heart its work seems a little muffled.

Skin manifestations arise for the 2-5th day from damage of mucous membranes. There is rash which represents red spots. They exist not for long and shortly are replaced by small small knots over which skin also gets pinkish and reddish coloring. First of all the centers of defeat arise on elbows and wrists, further they quickly extend to hands, to legs. Defeat takes also palms and soles, area of a breast, back, a pilar part of the head. In the last days diseases rash can also develop on face skin and a stomach. Here it has less expressed character, than in other places.

Every new day of a disease the skin centers of defeat get more and more intensive coloring. At the end of the first - the beginning of the second week of a disease they increase in sizes, grouped and merge among themselves. From these days spots of hemorrhages are prevailing on skin. At a heavy current these elements can connect among themselves again, getting dark red or purple coloring. Often at the same time sites of a necrosis of skin, especially in the field of generative organs, on finger-tips of hands, on auricles can appear further. Emergence of sites of necrosis of a mucous membrane and more deep-located fabrics in the field of the sky is possible. After body temperature is normalized, rash passes. On places of the former centers of defeat there are sites of a peeling and excess adjournment of a pigment of melanin.

At emergence of the cutaneous centers and their further progressing the condition of the patient is considerably broken. The brightest signs of it are the intensive, constantly disturbing headache, increase in sensitivity of skin to painful irritants. The patient is uneasy, at night cannot fall asleep, these or those kinds of disturbance of consciousness are in certain cases noted. The nonsense and convulsive attacks reminding epileptic can take place. When checking reflexes from sinews of hands and legs they are raised, besides, pathological reflexes begin to come to light, i.e. those which never occur at normal people. In more difficult situation there can come full paralysis of a nerve responsible for an innervation of any bodies, sensitivity or muscles of a neck and the head. At development of such disturbances from a nervous system further they long time are recovered. Usually these disturbances at the patient remain from several weeks to several months.

In the disease heat period at inspection of such patient it is possible to reveal delay of a cordial rhythm, the strongest lowering of blood pressure (up to faints). If, on the contrary, acceleration of cordial activity develops, then it is much less favorable concerning recovery and further life a sign.

Appetite at such patients is considerably reduced, quite often they in general refuse any food. Tendency to locks is noted. The sizes of a liver and spleen are increased, quite often there is a yellowness of integuments. At all diseased at a research of the general analysis of urine in it it is raised protein content. When performing the general blood test detection of acceleration of the erythrocyte dimentation test (EDT) is in certain cases possible.

At fulminant forms of a disease which in literature are described only as isolated cases and are a big rarity, the patient from the very beginning of a disease can fall into coma. Further within several days there comes death.

During recovery the condition of the patient is normalized not at once, but gradually. The broken functions of internals, especially the central nervous system (a head and spinal cord) are recovered extremely slowly.

At a part of the diseased the basic disease can be complicated further by accession of other infections or disturbances from internals. Most often inflammatory processes from an eye iris of the eye act as those, formation of blood clots in large hypodermic venous vessels (thrombophlebitises), pneumonia, bleedings, disturbance of mobility or its full loss in this or that group of muscles.

Reasons of Spotty fever of the Rocky Mountains:

Spotty fever of the Rocky Mountains concerns to group of the diseases rickettsioses caused by microorganisms of a bacterial origin from group of so-called rickettsiae. The microorganism causing this disease has very important property distinguishing it from relatives: rickettsiae of spotty fever are formative and to breed preferential in cells of an organism and their kernels. Besides, on the surface the activator bears a huge number enough unique on the structure and the nature of antigens. These two factors in many respects define symptoms of a disease and feature of its treatment at the diseased. Rickettsiae of this version are quite unstable in the environment: at their heating to temperature of +50 °C or uviolizing they quickly perish.

Treatment of Spotty fever of the Rocky Mountains:

Therapy of spotty fever of the Rocky Mountains in all cases by all means has to be complex and comprehensive. The most important is appointment of various groups as such patient of antibacterial drugs. It has to be made only by the doctor having the corresponding qualification. The course of therapy is appointed to the entire period of a disease, and also within 2 days after the termination of fever and normalization of body temperature. Special attention has to be paid to care of the patient's skin for the purpose of prevention of infectious complications.

Additional ways of treatment at this kind of a rickettsiosis include purpose of the heart, vascular drugs increasing arterial pressure. If the patient has the consciousness disturbances which are followed by excitement and convulsive attacks, then to it appoint various psychotropic drugs, tranquilizers, the calming drugs. For the purpose of the prevention of formation of blood clots anticoagulative drugs are used. At the expressed disturbances of a condition of the patient at heavy degree of a disease appoint drugs of adrenal hormones.

Also it is always necessary to pay special attention to hygiene of an oral cavity of the patient. The bed rest and absolute rest, the diet enriched with vitamins and nutrients are appointed.

Also active fight against mites carriers of rickettsiae is made.

Forecast. In all cases it is rather serious. At a severe disease it is almost always adverse. During some flashes of the 20th century mortality from spotty fever of the Rocky Mountains reached 80% and more. Presently it averages no more than 10-20%.