Pseudotuberculosis – an infectious disease with a fecal-oral transmission mechanism, which is characterized by damage to the gastrointestinal tract, joints and characteristic exanthema. Despite the eloquent name, this pathology has nothing to do with tuberculosis.
Every year, the increase in the incidence of pseudotuberculosis is increasing, which is associated with urbanization, an increase in the number of vegetable stores, violation of sanitary standards for food conservation and, accordingly, an increase in the number of rodents. Pseudotuberculosis affects people of all age groups.
The disease can occur at any time of the year, but is most often recorded in the winter-spring period. For more information about the etiology of pseudotuberculosis, as well as the classification and clinical manifestations of different forms of the disease, read on estet-portal.com in this article.
The causative agent of pseudotuberculosis – bacterium Yersinia pseudotuberculosis
The causative agent of pseudotuberculosis – bacterium Yersinia pseudotuberculosis – was first isolated in 1883 by French scientists L. Malassez and W. Vignal. The disease got its name in 1885, when S. Eberth noted changes in the organs of animals with this pathology, which resembled those of tuberculosis, but could not isolate mycobacterium. Thanks to this, the disease acquired the name "pseudotuberculosis".
Yersinia pseudotuberculosis – gram-negative rods, facultative anaerobes, for which rodents are the natural reservoir.
The main route of transmission of pseudotuberculosis is food. Yersinia enters the human body with unwashed vegetables, dairy products, insufficiently processed meat. By producing a large amount of endotoxins (lipopolysaccharide, edematous-hemorrhagic, thermolabile and thermostable factors), the bacterium initiates the development of a characteristic infectious process.
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How does the introduction of the pathogen into the human body with pseudotuberculosis
An infectious process in the human body can only occur after the penetration of a large amount of Yersinia pseudotuberculosis into it. Due to the invasion of the pathogen, catarrhal inflammation of the mucous membranes of the oral cavity develops, as well as catarrhal-erosive changes in the gastric mucosa.
Subsequently, Yersinia penetrate into the ileum and caecum, colonizing its mucous and submucosal ball, as well as lymphoid compounds. Perhaps the formation of microabscesses of the mesenteric lymph nodes. In the case of generalization of the pathogen in the body, many organs and systems are affected.
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Pseudotuberculosis: classification and clinical forms of the disease
There are several approaches to the classification of pseudotuberculosis. According to the duration of the disease, pseudotuberculosis is divided into:
- Acute: disease duration less than 3 months;
- subacute: disease duration is 3 to 6 months;
- Chronic: the duration of the disease is more than 6 months.
According to the degree of severity, mild, moderate and severe pseudotuberculosis is distinguished.
The incubation period of the disease can range from 3 to 18 days, but on average – 7-10 days.
The following clinical forms of pseudotuberculosis are distinguished:
- generalized form;
- intestinal form;
- mesenteric lymphadenitis;
- terminal ileitis;
- septic form.
There are also secondary focal forms of pseudotuberculosis, which include joint lesions, Reiter's syndrome in pseudotuberculosis, hepatitis, meningitis and myocarditis.
Manifestations of various clinical forms of pseudotuberculosis
The existence of a large number of different clinical forms of pseudotuberculosis indicates a wide variety of clinical manifestations of the disease. The following key clinical manifestations of different forms should be highlighted:
1. generalized form: most common. It is characterized by a rise in temperature to subfebrile and febrile values, severe headache, catarrhal manifestations of the disease (sore throat, pain when swallowing). Sometimes there is dyspepsia. An objective examination of the patient is determined by hyperemia of the face and neck, puffiness of the face (symptom of the hood), redness of the skin of the hands and feet (symptom of gloves and socks). Against the background of a hyperemic face, a pale nasolabial triangle may stand out. A characteristic rash appears on days 1-5 of illness.
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It is localized on the lateral surfaces of the trunk, abdomen, inner surfaces of the upper limbs and thighs. The greatest amount of rash is determined in the natural skin folds of the body, as well as in the periarticular zones. In most cases, the rash – small-spotted, but can also acquire hemorrhagic character. The tongue is covered with a white coating, which disappears about a week after the onset of the disease. After that, it becomes "raspberry" - acquires a characteristic shade. This form requires differential diagnosis with scarlet fever. In about a third of patients, kidney damage may also be recorded;
2. intestinal form: characterized by abdominal pain, nausea, vomiting. Sometimes there are symptoms of distal colitis, as well as hepatospenomegaly. Rashes are recorded in 25% of patients with this form of the disease for 1-2 days, but it quickly disappears;
3. mesenteric lymphadenitis: characterized by pain in the right iliac region. There may be symptoms of peritoneal irritation. This form requires differential diagnosis of pseudotuberculosis with acute appendicitis;
4. Terminal ileitis: Abdominal pain is most often paroxysmal in nature, may be accompanied by nausea and vomiting. The caecum during palpation may be painful, dense, rumbling;
5. cpeptic form: characterized by manifestations of systemic manifestations of an infectious disease: severe intoxication, jaundice, hemorrhagic rashes, polyarthritis, myocarditis, pneumonia and CNS damage.
Thus, the variety of clinical manifestations of pseudotuberculosis requires knowledge of its pathognomonic clinical signs from the physician.
The polymorphism of the clinical manifestations of pseudotuberculosis can significantly complicate the diagnosis of the disease.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Dermatology" section. You might also be interested in Dangerous Tick Bites: Clinical Manifestations of Lyme Borreliosis.
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