Disease of leishmaniasis: symptoms, treatment, photo

In the subtropics and tropics, it is not uncommon to find leishmaniasis. The disease is transmitted to a person through mosquito bites. The causative agent of the disease is the simplest of the Leishmania genus. This pathology is registered in 88 countries, of which 72 are developing.

a brief description of

Live and develop leishmania in the human body or various animals. Quite often they are found in foxes, jackals, dogs, some rodents. To date, there is no information on the period of infectiousness of animals and humans. There is only one known. If there is a given parasite on the skin or blood, then the host is the source of infection.

Very dangerous are those who live in the body of leishmania. They live in the spleen, liver. Sometimes parasites settle in the bone marrow. As noted above, such a disease is not only a human scourge. Often found leishmaniasis in dogs, domestic rodents.

Historical reference

Leishmaniasis was discovered by PF Borovsky in 1898. Having found the parasites in the smears of the Pendin ulcer, the doctor first described them. This is why the disease "Borovsky's disease" is also called the leishmaniasis. Significantly later, the pathogen will be assigned to a specially created genus Leishmania. And the path of transmission of pathology was established only in 1921.

For today, leishmaniasis is a rare disease, which can only be infected in countries of the tropics, subtropics.

What is a parasite?

The most common disease is leishmaniasis cutaneous. The causative agent of the disease is leishmania. It is impossible to consider the parasite with the naked eye. Its dimensions are microscopically small. The length of the leishmania is about 3 μm. The parasite has a spherical or oval shape, in the middle of it there is a nucleus. The front of the leishmania contains a flagella, the posterior part is a blepharoplast.

The parasite feeds on the contents of the cells of animals, humans. The protozoa multiply through fission. In front of the flagella. So begins the process of reproduction, which results in infection of the body.

Ways of distribution

The disease is easily transmitted. The scheme is quite simple. Insects, by biting an infected person or animal, transfer parasites to a healthy body. After a while, the patient is diagnosed with leishmaniasis.

Several tens of species are known to cause disease. About twenty of them pose a danger to human life. Most often they cause leishmaniasis cutaneous. The fact that parasites are not sensitive to antibacterial therapy complicates the treatment of the disease.

The carriers of the disease are mosquitoes. After the bite of an infected person, insects become infected. And a week later they are the source of the disease. These bloodsucking insects infect the patient with the cutaneous form of the disease. The human body can produce antibodies. Once he has recovered from this form, the patient has a permanent immunity to the disease.

With cutaneous leishmaniasis, the ailment can be transmitted not only through the blood to the mosquito. An insect can get infected with a ulcer detachable.

Classification of pathology

There are three types of disease:

1. Leishmaniasis cutaneous. The disease manifests itself in large foci of expressed papules.
2. Leishmaniasis skin-mucous. Such a disease is characterized by ulcers on the mucous membranes of the mouth, throat, nose.
3. Leishmaniasis visceral. This form is diagnosed if leishmania enters the lymphatic vessels. With the flow of liquid it spreads throughout the body. Affect internal organs. Basically it is the spleen, lungs, heart, liver. This form does not have the ability to form in the future immunity to pathology.

A clear demonstration of the disease Leishmaniasis photo, located below. It shows the cutaneous form of the disease.

Separate pathology, depending on who was the reservoir and source of infection. Thus, leishmaniasis cutaneous and visceral can be of two forms:

• Anthroponous - the source of the ailment is a person;
• Zoonotic - the causative agent of the disease passes from animals.

Symptoms of the visceral form

Characterizes this form of a long incubation period. From the moment of infection until the first signs of an ailment can pass from 20 days to 5 months. Gradually visceral leishmaniasis develops. Symptoms in the initial stages are as follows:

• Characteristic general weakness;
• Pallor of the skin;
• Decrease in appetite until its complete absence;
• The spleen is slightly enlarged;
• Apathy is noted;
• The body temperature rises (the maximum is 38 C).

Progression of the disease is characterized by the addition of new symptoms. Unintentional attempts at treatment aggravate leishmaniasis. Symptoms in humans are as follows:

1. Significantly increased temperature (reaches 40 C). This feature has a wavy character. The patient alternates with normal hyperthermia.
2. Cough. This symptom occurs when the respiratory apparatus is injured.
3. Enlarged lymph nodes. Are revealed at survey. The increase is noted near the affected organs.
4. Painfulness of the liver, spleen during palpation. There is a significant increase in these organs.

If you do not start fighting with pathology, leishmaniasis continues to progress. Treatment is greatly complicated. The patient's condition continues to worsen:

• Exhaustion of the patient;
• The spleen becomes huge;
• The surface of the skin is dry, extremely pale;
• Frequent dizziness;
• There is swelling in the legs;
• Heart rate decreases;
• The volume of the abdomen increases (fluid accumulates in the abdominal cavity);
• Diarrhea occurs;
• Violated potency.

The final stage is characterized by a reduced tone in the muscles, the appearance of puffiness of the whole body, pale code caps. As a result, the patient dies.

Sometimes the chronic course of the pathology is diagnosed. Virtually no signs of the disease. Such a clinic is observed if the seeding of internal organs by leishmania is minimal.

Symptoms of cutaneous pathology

This form is often registered in Saudi Arabia, Afghanistan, Brazil, Syria, Iran, Peru. The incubation period can last from 10 days to 1.5 months.

At the initial stage on the surface of the skin there is a formation, characteristic for the bite of an insect. On this place with time a furuncle, visually resembling a tubercle, is formed. Palpation of this place causes painful discomfort. After one or two weeks in the center of the tubercle there is a site of dead tissue - necrosis. This place has a black color. Soon it passes into an ulcer. From the center of the wound is a yellow-red liquid - pus.

Secondary tubercles begin to appear near the primary ulcer. Acquiring the shape of a wound, they eventually merge. One large ulcer forms on the surface of the skin.

Regional lymph nodes in the patient may be enlarged in the diagnosis of "Borovsky's disease". Cutaneous leishmaniasis is characterized by the healing of wounds within 2-6 months. However, the scars remain on the site of the ulcer.

Thus, the main symptoms of cutaneous pathology are:

• The appearance of tubercles - leishmaniom;
• The destruction of the skin at the site of the tubercle;
• Expression;
• Wound healing and scar formation.

Symptomatic of cutaneous mucosa

This type of disease leishmaniosis in its manifestations practically does not differ from skin pathology. The only difference is the spread of pathology to the adjacent mucous membranes.

The parasite discovered in the New World is causing this form. Skin-mucous pathology initially resembles a bite of an animal. Subsequently, patients have mucous membranes. Sometimes the ailment deforms the face.

With this pathology, the following symptoms are added to the above-described symptomatology of cutaneous leishmaniasis:

• Coryza;
• Nasal congestion ;
• Difficulty swallowing;
• Nasal bleeding;
• Erosion and ulcers in the mouth (on the lips, gums, tongue);
• Ulcers in the nasal cavity.

Physicians distinguish two types of complications of this form. If a secondary infection joins the ailment, the patient may develop pneumonia. In the event of the use of respiratory organs, a lethal outcome is possible.

Diagnosis of the disease

In countries where the disease is widespread, patients who combine clinical symptoms and test results are expected to have leishmaniasis.

Another patient is required to make a final diagnosis of the tissue under a microscope for the purpose of identifying parasites, or a blood test that can detect antibodies. Known in medicine is a skin test called a "black skin" test. Such a study is imperfect, so for the diagnosis of the disease is almost not applied.

It should be remembered that many diseases can cause weight loss, fever, an increase in organs, skin damage. Most ailments can mimic the symptoms of leishmaniasis. These are typhoid fever, malaria, Chagas disease, toxoplasmosis, tuberculosis, syphilis, histoplasmosis. Therefore, the final diagnosis can be made only by eliminating other pathologies.

If suspected of leishmaniasis, cutaneous diagnostics begins with a careful collection of an epidemiological anamnesis. The fact of the patient's stay in the area known for outbreaks of the disease is being determined.

Analyzes to confirm the diagnosis are as follows:

• Examination of material taken from ulcers and tubercles;
• A blood test (according to Romanovsky-Giemsa);
• Bone marrow puncture;
• Biopsy of the liver, lymph nodes, spleen;
• Biological tests;
• Serological reactions (ELISA, DSC).

Methods of treatment

As previously mentioned, antibiotics in the treatment of pathology are ineffective. They are prescribed only in one case - if a bacterial infection joins the leishmaniasis. For different forms of the disease, their own methods of combating the disease are selected. If the patient is diagnosed with leishmaniasis cutaneous, the treatment is based on the use of local medications. The visceral form needs a series of injections.

Diseases that occur in mild form do not need any special treatment. Such ailment passes through a certain period of time independently. He does not leave unpleasant consequences.

If the patient has a low level of immunity, he is necessarily prescribed therapeutic treatment. Because the disease is quite difficult. Absence of necessary medical measures is fraught with severe consequences for the patient, and sometimes fatal.

An ailment occurring in severe form implies surgical intervention. During the operation, the patient is removed from the spleen.

Treatment of cutaneous pathology

Methods of struggle depend on the form, stage and course of such pathology as leishmaniasis. Treatment may include the following methods:

• Drug therapy;
• Surgical method;
• Physiotherapeutic procedures;
• chemotherapy.

The surgical method is used if there is one small lesion on the surface of the skin. This ulcer is excised operatively.

For therapeutic purposes, the following physiotherapy techniques can be used:

• Elimination of pathology by laser;
• Cryodestruction - the place of injury is destroyed by cold;
• Current therapy - electrocoagulation.

Radical methods of therapy are combined with antibacterial and anti-inflammatory drugs.

Medication is based on the following drugs:

1. "Metronidazole." The course of treatment is usually about 10 days. The drug is taken perinatally three times a day. The single dose is 250 mg.
2. Medicines of pentavalent antimony. Often these are the preparations: "Solyusurmin", "Glucuktim". They are prescribed with the inefficiency of the drug "Metronidazole", used for 2-3 days. These medications are administered topically and intramuscularly. The recommended dose is 400-600 mg of medication per day.
3. "Pentamidine." This remedy is the drug of choice. It is used twice a week for 2-4 mg / kg.
4. Local antiseptic, disinfecting ointments. They lubricate affected areas. Effective for such pathologies are "Monomycin", "Gramicidinum", "Rivanova" (1%), "Akrikhinovaya" (1%) ointment.
5. Furacillin. Recommended lotions from this solution.

Drug treatment is often carried out by certain courses. Between them, it is recommended to take a break of about 2-3 weeks. The dosages given above are the averages. During treatment, the rates are selected for each patient individually.

At the first stages of the disease, antiprotozoal agents ("Solyusurmin", "Gluconim") are injected directly into the affected area. Such injections are advisable to spend about 3-5 days.

Treatment of visceral form

With this form of pathology, three groups of medicines are in demand:

1. Means of pentavalent antimony. Often, the therapy includes "Solyusurmin", "Pentotam", "Neostibazan", "Glucantim". The drugs are administered intramuscularly or intravenously. The dosage of these medications depends on the age. The maximum rate consists of 20 injections.
2. Aromatic diamidines. This medication is "Pentamidine", "Stylamidin". Such funds are prescribed with ineffective treatment with the above-mentioned preparations of antimony pentavalent. The patient will need to complete 3 courses. Between which a break is made in 10 days.
3. Amphotericin B. About this drug it is a question, if all the above mentioned drugs do not give the necessary therapeutic effect. The duration of therapy can be about 8 weeks.

The treatment can include:

• Antibacterial drugs: "Metacyclin", "Rifampicin";
• Antifungal agents: "ketoconazole";
• Antimicrobial medicines: "Furazolidon".

ethnoscience

Effective methods can be used by healers for the elimination of pathology. Only it should be remembered that such methods can not replace the therapy prescribed by the doctor for the disease "leishmaniasis cutaneous". Treatment with folk remedies should act as additional methods of combating pathology.

When the cutaneous form of the disease is recommended:

1. The use of tonic. It is useful to take tinctures of aralia, magnolia vinegar, ginseng, eleutherococcus, leuzea. They perfectly strengthen the protective forces of the whole organism, contribute to overall improvement. It is advisable to use any of the drugs twice a day for drops of 30.
2. Freshly squeezed juices. It is extremely useful for patients to drink beverages from carrots, potatoes, cabbage.
3. Decoctions, infusions from oats. Herbal teas from currant leaves, rose hips, honeysuckle.
4. Compresses on tubercles. This method is used only if furuncles are not opened. For compresses use concentrated decoctions of tansy flowers, willow bark.
5. Spruce coniferous trees - spruce, fir, pines. In the form of a flat cake, it should be applied to the affected area and secured with a bandage.

Using these methods, be sure to consult a doctor. Some drugs contain contraindications and, instead of curing, can bring unpleasant consequences.

Prophylaxis of ailment

The main measures to prevent the disease is the destruction of sources of infection - rodents and mosquitoes - in the areas of their reproduction.

The spoilage of places in which rodents live, is made within a radius of 15 km from the settlement where prevention is carried out. This distance corresponds to the range of mosquito travel.

To prevent the spread of cutaneous pathology, it is necessary to prevent the reproduction of stray animals. It is recommended that you always check for home infections.

Systemic prevention measures include:

1. Accomplishment of residential areas. It is necessary to eliminate the breeding grounds of mosquitoes and rats.
2. It is recommended to remove landfills.
3. Do not flood the cellars.
4. Timely repair all pipelines.
5. Regular preventive disinsection of residential and basement premises should be carried out regularly.

Protect the dwelling from bloodsucking insects with mosquito screens. In addition, it is recommended to use repellents. Such simple methods will prevent the onset of leishmaniasis.

Prevention during visits to sites that are dangerous, is based on specific immune therapy. Unfortunately, until today, an active vaccine against the disease has not been developed.

Conclusion

In most cases, the prognosis of the disease is favorable. If we talk about cutaneous leishmaniasis, then it rarely leads to death. Although often leaves behind a disfiguring scars. In the absence of proper therapy, the visceral form almost always leads to a lethal outcome as a result of severe exhaustion or organ failure. It is possible to avoid this, but only in time, starting the fight against unpleasant pathology under the guidance of a competent doctor.