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Angina in tularemia
Last reviewed: 23.04.2024
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Tularemia is an acute infectious disease with a natural foci characterized by fever and lymph node involvement.
In 1910, the American bacteriologist G. McCoy discovered a disease in ground squirrels, similar to plague according to pathological anatomical changes. In 1911, G. McCoy and C. Chapin (Ch.Chapin) isolated a small bacterium from the suslivi that were afflicted with this disease and named it strong.tularense in the Tulare district of the State of California (USA), in whose territory sick animals were found . In 1921, the American therapist E. Francis (E.Francis) called the disease tularemia, using for this the specific name of the pathogen. In the former USSR, the causative agent of tularemia was isolated in 1926 by SV Suvorov and co-workers. When examining sick people in the Volga delta near Astrakhan.
[Epidemiology of tularemia
The source of tularemia are sick animals. The natural focality is maintained by small mammals (water and common voles, house mouse, muskrat, hare, hamster, etc.). Ill and fallen animals, their secretions contain a large number of pathogens. A person is highly susceptible to this disease, infected with contact, aspiration, alimentary, transmission (insect bites) ways. In a number of cases, the disease is of a professional nature (hunters, butchers, furriers, agricultural workers, etc.). Sick people are not infectious.
Immunity with tularemia
In patients with tularemia, long-term immunity is formed. With the introduction of live tularemia vaccine, artificial immunity develops, which lasts 5 years or more.
The diagnosis is based on epidemiological, clinical and laboratory data. To confirm the diagnosis, use an intradermal allergic test with tularemia antigen tularin.
Differential diagnosis is carried out primarily with the bubonic form of the plague in the natural foci of this infection (India, Pakistan, Mongolia, Burma, Indochina, Central Asia, Transbaikalia, in Europe - the Volga-Urals Focal Point and the North-Western Caspian). When the plague is more pronounced toxic syndrome, characterized by sharp soreness and lack of clear contours of bubo.
Symptoms of angina with tularemia
The causative agent of tularemia enters the human body through the skin, mucous membranes of the eyes, respiratory tract, and gastrointestinal tract. Entrance gates determine the clinical form of the disease. At the site of penetration of the pathogen in the transmission pathway of infection, primary affect is often developed - a limited inflammatory process with primary regional lymphadenitis (primary bubo).
The causative agent and its toxins penetrate into the blood, which leads to generalization of the process, damage to distant lymph nodes (secondary buboes) and various organs.
An angino-bubonic form occurs when water is taken from an infected pond or in a bath. Patients complain of sore throat, difficulty in swallowing, perspiration. Tonsils are enlarged, more often on the one hand, covered with a greyish-white coating. In the future, they form deep slowly healing ulcers, similar in appearance to gangrenous tonsillitis.
Similar changes can be observed in the soft palate, mucous membrane of the oral cavity and lower lip. The bottom of the ulcer is covered with a diphtheria coating of a yellowish-gray color, not soldered with the underlying tissue. Anginosis-bubonic form of tularemia occurs on the 3rd-4th day after the appearance of lymphadenitis and can be taken for angina of Simanovsky-Plaut-Vincent or diphtheria of palatine tonsils. The duration of tularemia angina is from 8 to 24 days. Often the primary affect that occurs on the amygdala remains unnoticed, and the disease progresses in the form of a pronounced bubonic form, in which the inflammation covers almost all the lymph nodes of the neck, often developing into abscesses and phlegmon of the area. Other clinical forms of tularemia in this manual are not considered, as they fall within the competence of infectious disease specialists.
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Treatment of angina with tularemia
Treatment is carried out in a hospital for infectious patients. Prescribe antibiotics, detoxification solutions (water-electrolyte, glucose, hemodez, polyglucin, etc.), antihistamines (diphenhydramine, pipolpene, suprastin, etc.), vitamins C and group B. On bubo - dry heat, with its suppuration (symptom fluctuations) - wide opening and removal of detritus followed by draining with tampons with hypertonic solution and their replacement 3 times a day.
With angin-bubonic form - gargling with warm antiseptic solutions, decoctions of medicinal herbs, plentiful drink. When the eyes are affected - sulfacil sodium, antibiotics, ointments.
More information of the treatment
Prevention of tularemia
Combating rodents and bloodsucking insects, adherence to anti-infectious measures by workers in the relevant professions, the use of personal protective equipment, vaccination with tularemia live dry vaccine.
Prognosis for tularemia
The forecast is favorable. With pulmonary and abdominal forms - serious.