What is leishmaniasis? Forms of leishmaniasis

Very often people face skin diseases: a rash will appear, then wounds, it is still not clear what, like a bite, but some kind of it is strange. Very often the mosquito's bite can develop into an infection, one of the forms of which is a disease such as leishmaniasis. It is about this disease and talk today. So, what is leishmaniasis?

The concept of

Leishmaniasis is an infection that manifests itself not only in humans, but also in the animal. Its causative agent is the simplest of the genus Leishmania, and it is transmitted through mosquito bites Lutzomyia.

The simplest Leishmania are found mainly in hot countries: Asia, Africa, South America.

Most often, the source of the disease can be already infected people, animals of the family of dogs (foxes, wolves or jackals), grown at home, and rodents.

An infectious disease with a difficult and long healing process, dangerous not only for humans, but also for animals, is Leishmaniasis. The life cycle of bacteria causing this disease is very long. In the first place, mosquitoes are infected. After that, the infection enters the digestive system, where not yet fully ripe forms of leishmaniasis mature and turn into a mobile flagellate form. Collecting in the larynx of a mosquito, during a new bite they fall into the wound and affect the cells of the epithelium or the internal organs of a person or animal.

Leishmaniasis: Varieties

There are several types of this disease, and each of them in its own way is dangerous for the human body:

• Cutaneous.
• Slimy.
• Visceral leishmaniasis.
• Skin and mucous.
• Viscerotropic.

The main symptoms of leishmaniasis

The main symptoms of this disease are ulcers on the human body. They can appear in a few weeks or even months after it is bitten by an insect carrier of the infection. Another symptom of the disease can be fever, which can also begin several days after the bite. The time can pass quite, in some cases and about a year. Also, the disease affects the liver and spleen, the consequence may be anemia.

In medicine, the first sign of leishmaniasis is the enlargement of the spleen: it can be larger in size than the liver. To date, there are 4 forms of leishmaniasis:

1. Visceral. This is one of the most complicated forms of the disease. If you do not start prompt treatment, then the ailment can lead to death.
2. Cutaneous leishmaniasis. It is considered one of the most common forms. Immediately after the bite there are painful sensations in its place. Cure this form of ailment can only after a few months, and even after that a person will remember him, looking at the scar left from the disease.
3. Diffusive-dermal leishmaniasis - this form of the disease is widespread, its appearance strongly resembles leprosy and is very difficult to treat.
4. Mucous form. It begins with ulcers on the skin, which subsequently lead to tissue damage, especially in the oral cavity and nose.

The concept and symptoms of visceral leishmaniasis

Visceral leishmaniasis is one of the forms of infectious disease caused by leishmania. There is an ailment when this type of microbes spreads by hematogenous way from the primary focus of infection to any of the human organs: the liver, spleen, lymph nodes and even the bone marrow. Microorganisms in the body multiply very quickly, which leads to its damage.

Most often this disease affects children. The incubation period is long enough, sometimes lasts up to five months. The disease begins slowly, but in the category of infected people who come to endemic areas, the disease can develop rapidly.

Visceral leishmaniasis symptoms are fairly common. In almost all patients, they are the same: general malaise, weakness in the whole body, lethargy, complete lack of appetite. The fever begins very quickly. It passes through a wave, while the body temperature can reach 40 degrees. Then comes a small relief of the condition, which again gives way to a high temperature, which is also very difficult to knock down.

You can also see on the skin the signs of such a disease as visceral leishmaniasis. Symptoms With the following: pale skin with a grayish tinge and often with hemorrhages. Pay attention to the lymphatic system - the lymph nodes will be enlarged.

The main signs of visceral leishmaniasis

The main symptom of the disease is the initial defect, which can be a single one, and therefore can not be seen at the first examination. It looks like a small, hyperemic papule covered with a scaly top. It occurs in the place where the insect-carrier or an animal from the family of dogs, which has an agent of visceral leishmaniasis, made a bite.

A constant symptom, which is first of all worth paying attention to, is the enlargement of the spleen and liver. It is the spleen that increases very rapidly and after a couple of months after infection can occupy the entire left side of the peritoneum. To the touch, the organs become dense, but there are no pain sensations. The liver does not grow so quickly, but it can have very serious impairments in functions, up to ascites.

If the bone marrow is affected by the disease, the symptoms are manifested by thrombocytopenia and agranulocytosis, which may be accompanied by angina. The first thing you can see on the human body is the rapid appearance of colored pigment spots.

Cutaneous leishmaniasis

Disease leishmaniasis is very common and has several forms, one of them is cutaneous leishmaniasis. Propagation of the pathogen occurs in the tissues of the human body, where the leishmania ripen very rapidly and turn into larvae without larvae. This is called the primary focus of the disease, with the formation of a granuloma. It consists of epithelial cells and plasma cells, macrophages and lymphocytes. Decay products can cause significant inflammatory changes that can reach lymphangitis or lymphadenitis.

Symptomatic of cutaneous form

The duration of the incubation period of cutaneous leishmaniasis is about one and a half months. You can distinguish several basic stages of the disease:

1. The appearance of a tubercle on the skin and its rapid increase. Its dimensions are within 2 cm.
2. The ulcer appears after a few days. First it is covered with a thin crust, which subsequently disappears, and on the surface there is a soft pink bottom with moknutiem, in the future an abscess is formed. The edges of the ulcer are slightly raised and friable.
3. Scar. After a couple of days, the bottom of the ulcer is completely cleansed and covered with granulations, in the future all of this will be scarred.

The main signs of cutaneous form

There is not only a rural form, but a city form, and they differ little from each other, but one must always remember that there are several basic features that make it possible to distinguish them.

The main and very important circumstance is a correct and careful collection of anamnesis. Long stay in the urban or rural environment will point in favor of one of the forms of the disease. The rural type always flows in its primary form, but the urban type can take all of the existing species.

Skin and mucosa of the disease

In addition to the above-described forms of the disease, there is another fairly common and very dangerous - it is the skin mucous leishmaniasis (espuda). Its pathogens are mosquitoes.

From an insect bite and up to the first signs of the disease, it can take about 3 months. On the place where a man was bitten by a mosquito, a deep ulcer is formed. It involves the mucous membrane, the lymphatic system and the blood vessels. All this leads to very complex and serious complications, while the forecasts are not comforting.

The human leishmaniasis in any of the existing forms is very dangerous, since it affects the internal organs, which are poorly treated, such as the spleen and liver. It is for this reason that doctors recommend, at the first malaise, to go to the hospital, in the early stages of the disease it can be quickly cured with minimal consequences.

Other varieties of leishmaniasis

We have already described several basic forms of such a disease as leishmaniasis, but there are several more of its types, perhaps not so common, but also dangerous for humans:

1. Sequential leishmanioma - the presence of a primary form with the addition of secondary signs in the form of small nodules.
2. Tuberculoid leishmaniasis. Photos of patients prove that the signs of an illness appear on the site of the primary form or on the site of the scar. In this case, the primary defect causes the presence of a small tubercle of tender yellow color with a size no larger than the head of the pin.
3. Diffuse leishmaniasis. This form of the disease most often occurs in people with a low level of immunity and is characterized by extensive ulcerative lesions of the skin and chronization of the process.

What is leishmaniasis, we figured out, and how to properly diagnose it, we will tell further.

Varieties of diagnosis of leishmaniasis

Clinical diagnosis of the patient with leishmaniasis is based on epidemiological data and clinical picture. To confirm the presence of the disease will help laboratory diagnosis. Leishmaniasis is identified by the following methods:

• Study on the bacteria: take scraping from the ulcer and the tubercle.
• Microscopic examination: the patient takes a smear or a thick drop. This method can detect the presence of leishmania, colored by Romanovsky-Giemsa.

• A liver and spleen biopsy is performed, in the most severe cases, bone marrow puncture is performed.
• Serological methods, such as RSK, ELISA and others.

There are a lot of methods for accurate determination, and each of them will show the most accurate data and indicate the presence in the human body of a disease such as leishmaniasis. Diagnosis in a short time will determine the severity of the ailment.

Treatment

What is leishmaniasis, and how to diagnose it correctly, we have already described. And now let's talk a little about how his treatment is carried out.

In the case of visceral form, pentavalent antimony preparations are used:

1. "Pentotom". It is administered to a patient intravenously, previously diluted in a 5% solution of glucose. The drug can also be used intramuscularly. The course of treatment lasts for a month.
2. "Glucantim". The drug is used in the same way as "Pentotam". If the disease is a complex form, the dose can be increased and prolonged treatment for another month, but this can only be done with the permission of the treating doctor.
3. "Solyusurmin." The drug can be administered intravenously or intramuscularly, you need to start treatment with 0.02 g per kg of body weight. Gradually, within 20 days, the dose increases to 1.6 g / kg.

Also, with a very severe form of the disease, the treatment with "Amphotericin B" gives excellent results. The initial dose is 0.1 mg / kg. Gradually it increases, but no more than 2 g per day. The drug is injected intravenously, it is first dissolved in a solution of glucose.

In the most difficult cases, when all the drugs are used and did not bring the desired results, a surgical intervention is prescribed - splenectomy. After such operation the patient very quickly comes to norm, but here only there is a risk of development of other infectious diseases.

With the cutaneous form of the disease, you can use all the drugs described above, and also prescribe heating and UV.

Consequences of leishmaniasis

The prognosis and outcome of treatment after such an infectious disease as leishmaniasis are mixed. Despite the fact that the visceral form proceeds with great complications, and for the life of the patient it is very dangerous, with timely treatment the disease goes completely and does not do much harm to the body.

As a result of the cutaneous form, especially its diffuse variant, scars and scars can remain on the skin. And in some, quite complex cases, even bone marrow changes may occur.

Possible complications

Possible complications after the disease leishmaniasis (photos of patients with this ailment can be seen in our article). The later the disease is detected and the treatment process is started, the higher the risk of the most severe complications. With leishmaniasis, they can take the following form:

• Hepatic insufficiency, weighed down with ascites and cirrhosis.
• Severe form of anemia and DIC syndrome.
• Amyloidosis of the kidneys.
• Ulcers on the mucosa of the digestive tract.

With the cutaneous form of the disease, complications are mainly associated with the addition of a secondary infection. It manifests itself as phlegmon and local abscesses, but in the absence of properly selected treatment it can develop into a severe septic form.

What is leishmaniasis? This is a very serious infectious disease, which has various forms, each of which is quite dangerous for humans. But there are several methods of prevention that will help to avoid an illness or prevent its severe form.

Prevention of disease

The general principle of preventing leishmaniasis is protective measures. We must try to protect ourselves from the bites of mosquitoes, which are carriers of the disease. Regular disinfection should be carried out and the rodents should be struggling, trying to keep away from themselves the domestic animals of the dog family that were taken to be raised from the forest.

And medicinal prophylaxis will help only in protection from the cutaneous form of the disease. So, a person who goes to endemic areas, is vaccinated.

Leishmaniasis is quite a serious disease, about half a million people die of it every year, so it's worth it to take it with full responsibility and at the first signs to run to the doctor. Only the early stages of the disease can be cured without further consequences.

But so it is in our country that all "forgotten diseases" are not financed, so no one will vaccinate the population until the person himself buys the vaccine and asks for it. So it turns out that the disease is very well known, and the correct management of the treatment simply does not have enough finance. Therefore, it is better to do everything on your own to prevent infection.