Angina in case of alimentary-toxic aleukia

Alimentary-toxic aleukia is a mycotoxicosis that occurs when products are eaten from products overwintered in the field (millet, buckwheat, wheat, rye, barley, oats, rice). These cereals are affected by the fungus Fusarium sporotrihiella, which produces mycotoxin, which has both a local damaging effect, causing local aseptic inflammation of the "burn" type, and a general toxic effect on the body.

[1], [2], [3]

Symptoms of sore throat with alimentary-toxic aleukia

The disease occurs in four periods:

1. initial or general toxic stage (headache, weakness, fever, nausea, vomiting, sweating, headache, stomatitis, glossitis, gastroenteritis, etc.);
2. the leukopenic stage is manifested by changes in blood (a decrease in the number of leukocytes, erythrocytes, platelets, hemoglobin content, relative lymphocytosis arises); on this background the conditionally pathogenic microbiota of the oral cavity is activated;
3. angina-hemorrhagic stage (point hemorrhages on the skin and mucous membrane of the mouth, pharynx, stomach, intestines, nasal, uterine, intestinal and other bleeding, necrotic or gangrenous angina, at this stage, fever takes septic character due to emerging bacterial inflammatory phenomena in pharynx and other lymphoid formations of the upper respiratory tract and gastrointestinal tract, accompanied by toxemia, in the blood there is a decrease in the platelet count, agranulocytosis, in this period the most frequent complications Pneumonia, phlegmon and extensive abscesses of various localizations, sepsis;
4. the reconstructive stage, observed with timely and correct treatment; its duration in the absence of serious complications does not exceed 10-14 days.

Healing of necrotic and disappearance of hemorrhagic phenomena occurs against the background of a lytic decrease in body temperature, which indicates the exit of the organism from the state of acute toxicosis. However, some symptoms of intoxication (subfebrile, weakness, malaise, etc.) can persist for a long time.

Diagnosis is facilitated by establishing the fact of eating foods made from the overwintered grain in the field.

Treatment of sore throat with alimentary-toxic aleukia

At the first symptoms of acute intoxication, it is necessary to wash the stomach according to the method used for oral poisoning with various poisons and poor-quality products (probe method). Contraindications to probe stomach washing are large diverticula and narrowing of the esophagus, long periods (more than 6-8 hours) after eating products made from sprouted cereals.

To wash the stomach use a thick stomach probe with a funnel. The probe is injected into the stomach according to a conventional technique to a mark of 50 cm. Gastric lavage consists of two stages. At the first stage, the funnel is first placed at the level of the patient's knees somewhat obliquely (so as not to introduce air into the stomach) and begin to slowly raise while simultaneously filling it with washing liquid (water, 2% sodium bicarbonate solution, 0.2-0.1% potassium permanganate solution ) of room temperature. The funnel is raised above the level of the patient's mouth. The liquid quickly passes into the stomach as the funnel rises and constantly replenishes. It is impossible to allow complete emptying of the funnel and the transition of the entire liquid into the stomach, since after the liquid, when the system is completely emptied, air starts to flow into the tube, which makes it difficult to remove the contents of the stomach afterwards. At the second stage, the funnel, in which the liquid level tries to keep at the mark of the narrow part, is lowered down to the level of the patient's rut and waited until it is filled with the contents of the stomach, after which it is overturned over the pelvis and the entire procedure is repeated anew to the holes until through the stomach will run from 10 to 20 liters of wash liquid. The first and last portions of wash water are delivered to the laboratory for study. After washing the stomach, the patient is given a laxative.

Further treatment is carried out in the hospital, where a gradual transition to a balanced diet is provided, which should include milk, lactic acid products. Assign vitamins, calcium preparations, transfusion of blood components, conduct intensive detoxification therapy. To prevent bacterial complications, antibiotics, sulfonamides are prescribed, bleeding - blood resuscitating agents of resorptive and local action in accordance with the available indications.

The prognosis is favorable with timely started treatment; it worsens with the onset of sepsis or internal bleeding.