Pseudotuberculosis in children: symptoms and treatment

Pseudotuberculosis in children or Far Eastern scarlet fever is an infectious disease and develops when infected with a gram-negative bacillus.

The disease is quite difficult, intoxication of the child’s body occurs, joints and organs of the abdominal cavity, as well as skin integument, are affected. The musculoskeletal system is attacked by an infection no less.

It is worth noting that despite this name, the pathology has nothing to do with Koch's bacillus, which causes tuberculosis. The question arises: why did she get such a name? The fact is that the disease in question leads to a morphological change in organs that are similar to tuberculosis. If you do not start treatment of the pathology in a timely manner, serious complications may appear.

In this article, we will consider the symptoms, treatment and prevention of pseudotuberculosis in children, and also talk about the ways of infection and the possible consequences.

A bit of history

Far Eastern scarlet fever, as you already understood, is a synonym for the main theme of our material. Sometimes pseudotuberculosis is called mesenteric lymphadenitis, but from the change of names the essence remains the same.

Specialists in the field of medicine are of the opinion that the most correct name for the pathology is yersiniosis. This is due to the fact that the causative agent of the disease is E. coli from the genus Yersinia. Symptoms of pseudotuberculosis in children include chills, a rash, intoxication, and fever. We will talk about the signs in more detail below.

They began to talk about such a disease for the first time in 1883, when the main pathogen was discovered. But only after seventy years, namely in 1953, they found the first patient who was diagnosed with yersinia. At that time, doctors already knew the existence of gram-negative rods, which were the causative agents of pseudotuberculosis.

Much was already known about these anaerobes, for example, that they do not form spores and are characterized by their unpretentiousness to the environment. Bacteria intensively multiply at a temperature of twenty degrees, but there are many cases that have fixed this process at lower temperatures. They can be in water or soil for a long time, they survive after freezing. From this we can conclude that gram-negative bacilli are very resistant bacteria, and removing them from the body is not as easy as it might seem.

Causes of pathology

To date, it has been established that animals are carriers of the disease. Especially dangerous in this sense are small rodents, cattle, poultry, horses, dogs and cats. Pigs also belong to this group, but an infected person poses no threat. It is worth noting that pseudotuberculosis in children and adults is transmitted by the fecal-oral route, that is, through food products that were in the habitat of bacteria.

It is quite easy to catch an infection when eating unwashed fruits and vegetables, dairy and meat products that have not undergone heat treatment, juices, compotes, dried fruits. Pathology can occur at any time of the year. At risk are children and adolescents under the age of seventeen who consume large amounts of fast food. Doctors sometimes diagnose the disease in people eating in cafeterias. Pathology is revealed based on the manifestation of signs and symptoms. Treatment of pseudotuberculosis in children should be timely and effective, then the prognosis is quite favorable.

The main ways of infection

In this case, the infection enters the body through the oral cavity along with drinks and food. After which the virus goes to the intestines, clings to lymphoid formations. Then, active reproduction begins, and the pathogen through the lymphatic paths enters the mesenteric nodes, where it begins to wield.

Is pseudotuberculosis contagious in children? As already noted, contact with an infected person is not dangerous, the virus is transmitted through animals.

The above path of infection is not always found in practice. Sometimes the pathogen enters immediately into the fluid connective tissue, where it begins intensive reproduction. In this case, bacteremia is detected, which lubricates the overall picture of the pathology. Through the blood, the pathogen enters all internal organs, affecting the spleen, kidneys, lungs, etc.

I must say that part of the bacteria when it enters the body immediately dies, secreting endotoxin. Instead of the desired relief, the patient will receive intoxication. As a result, the following diseases and reactions often arise: arthritis, myocarditis, Quincke's edema, urticaria, etc.

Forms of the disease

How does pseudotuberculosis manifest in children? It depends on the prevailing sign and location of the virus. In this regard, in medicine, there are several main forms of the disease. Let's consider them in more detail:

1. Gastrointestinal. Here, the pathology is very easy to confuse with conventional poisoning, because the symptoms are quite similar. There is a fever, body aches and apathy. After some time, they are supplemented by cough, pain and burning in the throat, insomnia, rash with pseudotuberculosis in children. In addition, jaundice and dark urine are often observed, if treatment is not started on time, it can result in meningitis.
2. Joint. It is easy to guess that in this case we will talk about damage to the joints. Outwardly, this is manifested by redness, the occurrence of swelling. There are also unpleasant pain.
3. Septic. A rather rare form of pathology, it does not stand out in anything, only a qualified doctor can be diagnosed. Among the signs are chills, sweating, fever.
4. Combined. This form is diagnosed if several types of pathology are detected in a child at the same time, which is very rare.

Symptoms of pseudotuberculosis in children

Often it happens as follows: symptoms appear in infants with weakened immunity, while those with a strong immune system almost don't notice the signs. So that there is no situation when the pathology is diagnosed too late, parents need to take their child for a regular medical examination at least once every six months.

So, the main signs of pseudotuberculosis in children:

• Diarrhea with profuse watery stools, pain in the abdomen associated with the justification of inflammation in the colon. At best, they will develop into bleeding sores, and at worst, they will provoke tissue necrosis.
• Redness and swelling at the sites of infection, myalgia and arthralgia.
• The appearance of a rash that is very similar to a rash with scarlet fever. Spots can be absolutely any size, there are no defined boundaries.
• Peeling of the face, upper and lower extremities, palms and feet.
• Nausea and vomiting, the presence of jaundice, allergic reactions, possible Quincke edema.

It is important to understand that complications such as gastroenteritis or enterocolitis can occur due to this pathology. Autoimmune processes provoke the appearance of other diseases: arthritis and myocarditis.

Experts say that the incubation period lasts usually eighteen days. At about the fifth or sixth day, the first symptoms of the disease are observed, the child's temperature rises sharply to thirty-eight or forty degrees, and the fever begins. If pseudotuberculosis is started, then hyperthermia can last from ten to thirty days.

Course of the disease

As you know, the main causes of the disease in children are games in the sandbox and unwashed hands, coupled with food. In this case, the pathogen enters the body through the oral cavity, and then intensively multiplies in the lymph nodes. At risk are babies from the age of one year. Until this moment, children are relatively safe due to breastfeeding.

When diagnosing, doctors should pay attention to the manifestation of the disease. If peeling of the skin of the face and neck is observed, loose stools, jaundice and an enlarged liver are detected, this is pseudotuberculosis in children (photos of babies faced with this ailment are presented in the article).

When it comes to babies, doctors often identify typical and atypical forms of pathology that entail a blurry picture. Experts also talk about the severity and duration of the disease, which are interrelated. For example, the acute form torments the baby for thirty days, the protracted one attacks for about three months, and the chronic one for four months or more.

It is worth paying attention that the symptoms may differ, because each organism reacts in its own way to the invasion of infection. Do not be surprised if, with pseudotuberculosis, children will have a runny nose, cough, reddening of the throat, cold sores on the lips, conjunctivitis. This whole picture is complemented by loss of appetite, weakness, fever and severe headaches. In almost all cases, after a few days, a rash occurs that lasts about a week, and then is replaced by peeling. If measures are not taken in time, the rash will appear in the groin, bends of the limbs and sides. Some children experience nausea, vomiting, and bloating. As you understand, there are a lot of symptoms of pseudotuberculosis, therefore it is better to consult a specialist so that he understands everything and suggests effective therapy.

Diagnostics

The doctor always starts the first appointment with an anamnesis (collection of information) and an external examination. The first assumptions appear already at this stage, because with the naked eye you can notice redness of the skin, peeling, etc. Usually this information is not enough to make a full diagnosis.

Then the doctor suggests that the child undergo additional studies to better study the situation. In most cases, the doctor recommends:

1. Bacteriological measures. This group includes analysis of feces, blood, sputum and cerebrospinal fluid. Crops are done three times during the first week, and the result is prepared in about fifteen days.
2. Immunological methods. Their goal is to identify antigens to the pathogen, considered in feces or any other biological material.
3. PCR diagnostics. With its help, you can find the DNA of pathogens in the feces.

Therapies

Treatment of pseudotuberculosis in children should be carried out in a hospital setting. If a particularly severe case is detected, then bed rest is necessary until the fever disappears. It should be noted immediately that therapy should be comprehensive. After all, the application of all methods together gives an excellent result.

Consider the main ways in which they cope with pathology:

1. Reception of antibacterial drugs. Among them are Netilmicin, Cefotaxime and Gentamicin.
2. The use of detoxification agents (plasma replacement drugs, glucose-salt solutions). Here you can add more heart medications and vitamin complexes. These drugs are aimed at eliminating the symptoms, which is one of the most important parts of treatment.
3. Reception of non-steroidal anti-inflammatory drugs ("Naklofen", "Diclofenac sodium"). In the fight against the icteric form, such drugs as Karsil, Hepatosan, Essential Forte N showed the most efficiency. Therefore, if the patient has a problem of this kind, the doctor will definitely prescribe these medications.
4. Special diet. It is necessary to adjust the diet and adhere to proper nutrition for three or four months, even after the symptoms disappear. It is necessary to exclude spicy, fried and fatty foods, even concentrated broth is not allowed.

Effects

Despite all the danger of the disease, doctors give favorable forecasts. This is possible only if you contact a doctor in a timely manner and receive quality treatment. You need to understand that if you do not get to a specialist in a short time, serious consequences of pseudotuberculosis in children will arise. Self-medication is strictly prohibited, because in such a situation it is very easy to aggravate the patient's condition and complicate the work of doctors. As for the terms, experts say that within three weeks the child will be able to fully recover.

Ignoring the symptoms will cause complications of a different nature:

• acute renal failure, pneumonia;
• meningitis, damage to the membranes of the brain;
• Crohn's disease, characterized by inflammation of the gastrointestinal tract;
• Reiter's syndrome, it is expressed through conjunctivitis, arthritis and urethritis;
• acute form of appendicitis, requiring immediate removal of the appendix;
• myocarditis, polyarthritis, toxic toxic shock, bowel obstruction.

It is worth noting that this is an incomplete list of complications. The above consequences are most common. If you continue to ignore all the signs, there will be a relapse and subsequently death.

Since the child has not yet formed an organism, he is more susceptible to the attack of viruses and infections. In order to somehow protect the baby, parents need to strengthen their immunity from childhood. Then the chance of getting an infection will decrease significantly, and the child will be able to tolerate various diseases more easily.

Prevention

A few days after infection, the first signs and symptoms appear. Prevention of pseudotuberculosis in children is aimed at preventing the disease. After all, it is easier to follow certain rules in advance than to deal with pathology later.

There are certain preventive measures that are mandatory:

• rodent control, restriction of contact with animals;
• compliance with personal hygiene rules, special attention should be paid to washing your hands before and after eating;
• water supply must be controlled so that all sanitary standards are complied with; also do not consume foods that have not undergone heat treatment. Before eating, if you doubt the product, it is better to pour boiling water over it. Thus, all unnecessary substances disappear, and you can start eating without fear of infection.

The disease in question is considered quite dangerous and difficult to diagnose due to the abundance of symptoms similar to signs of other pathologies. In our material, we talked about the symptoms and treatment of pseudotuberculosis in children, and also studied the rules of prevention and possible complications. The disease in rare cases leads to death if you do not provide timely treatment and ignore the symptoms. For this reason, you should immediately contact a specialist if you find the first signs of the disease.