Leprosy

Leprosy – the chronic infectious disease caused by an acid resisting mycobacterium of a leprosy (Hansen-Nayssera's stick). At this infection skin, a peripheral nervous system, eyes and internals are surprised preferential. In the world of patients with a leprosy contain more than two million now. Men have this disease twice more often than women. Have a leprosy at any age, however children about one year are ill extremely seldom.

The disease a leprosy is a little infectious. The only tank of a leprosy – the sick person. Infection with an infection occurs in the airborne way or at direct contact with the patient.

Clinical symptoms of a leprosy

Immunological and clinical displays of a disease are characterized by a big variety (from a tuberculoid form of an infection to lepromatous). The first symptoms of a disease of a leprosy are usually shown on integuments of the person in the form of one or several hypopigmented or hyper pigmented plaques or spots. On the site of damage of skin most often there is a partial or total loss of sensitivity. At contact with the patient the healthy person on skin can have single centers of defeat with a hyposensitivity. Affected areas of skin can spontaneously be eliminated within several years, but also in this option not to do without specific treatment. At an early tuberculoid leprosy there are accurately delimited spots of hypopigmentation of integuments. Later the centers of defeat increase, their edges are rounded and rise, getting a ring-shaped form. Damage of nerves leads to an atrophy of muscles. Very often contractures of foot and a brush develop. Defeat of facial nerves quite often leads to the lagophthalmia, a keratitis and a keratohelcosis leading to sight loss.

At a lepromatous leprosy the centers of defeat are presented by the hypopigmented spots, nodes, plaques or papules. Borders of the centers of defeat are outlined not clearly, and their central departments which are slightly raised over the surface of skin, convex and condensed, but not concave, as at a tuberculoid leprosy. Between the centers of defeat diffusion infiltration is usually observed. At a lepromatous leprosy ears, a face (eyebrows, cheeks, a nose), elbow joints, wrists, knees and buttocks are considered as favourite sites of localization of the centers of defeat. At this stage of a disease side sites of eyebrows very often drop out, and ear lobes droop later, and face skin shrivels and thickened (the lion's person).

Early symptoms of a leprosy are the complicated breath, nasal bleedings, hoarseness of a voice, laryngitis and obstruction of the nasal courses. At defeat of front department of eyes the iridocyclitis and a keratitis develop. At men scarring and infiltration of testicles lead to infertility. Very common symptom of a leprosy development of a saddle nose as a result of perforation of a nasal partition and formation of a small hollow in a middle part of a ridge of the nose is considered.

Treatment of a leprosy

In 1943 for treatment of a leprosy sulfonic medicines were offered. In addition to them appoint compounds of ethane thiol or derivative thioureas, an antibiotic Rifadinum and derivatives of isonicotinic acid.

The antibiotic Rifadinum has high antileprotic activity and good tolerance at intake. The antibiotic is easily soaked up from a digestive tract, getting into body tissues. This drug is especially effective at a lepromatous leprosy. It provides a bystry bacteriological negativation.

Treatment of a leprosy has to be made by several medicines. Usually it is Rifadin, Klofazimin and Dapsone. The combination of Rifadinum and Dapsone will be rather effective for a boundary and lepromatous and boundary form of a disease. At a lepromatous form of a disease it is desirable to use all three drugs. During treatment of a leprosy objective methods of assessment of efficiency of the carried-out therapy, including biopsies and scrapings have to be applied. Treatment of a disease needs to be continued until by means of laboratory diagnostic methods negative takes are not received with firmness. The optimum duration of treatment is not established, but it is recommended to adhere to the therapeutic mode not less than two years.

Prevention of a leprosy

Infection of the child with a disease with a leprosy occurs not vnutriutrobno but only at contact with mother. To avoid infection of the newborn, it should be isolated from mother right after the birth.

Especially carefully it is necessary to inspect persons who were in contact with the patient with a leprosy a long time. The immediate family of the patient needs to take leprominic samples. In areas where disease outbreaks were revealed, it is necessary to carry out mass inoculations by a tuberculous vaccine of BTsZh. The revealed patients need to be isolated in clinics for rational therapy.