Very often people are faced with skin diseases: either a rash appears, then a wound, it is still not clear what, it seems, like a bite, but it is somehow strange. Very often, a mosquito bite can develop into an infection, one of the forms of which is such an ailment as leishmaniasis. We will talk about this disease today. So what is leishmaniasis?
The concept
Leishmaniasis is an infection that occurs not only in humans, but also in animals. Its causative agent is the protozoa of the genus Leishmania, and it is transmitted through the bites of mosquitoes Lutzomyia.
The simplest Leishmania is distributed mainly in hot countries: Asia, Africa, South America.
Most often, the sources of the disease can be already infected people, animals of the canine family (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 that cause this disease is very long. Mosquitoes are the first to be infected. After that, the infection enters the digestive system, where not yet fully ripe forms of leishmaniasis mature and turn into a mobile flagellum. Accumulating in the larynx of a mosquito, during a new bite they fall into the wound and affect the epithelial cells or internal organs of a person or animal.
Leishmaniasis: varieties
There are several types of this disease, and each of them is dangerous for the human body in its own way:
- Cutaneous.
- Slimy.
- Visceral leishmaniasis.
- Mucocutaneous.
- 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 and even months after it is bitten by an insect carrier. Another symptom of the disease can be a fever, which can also begin a few days after a bite. Enough time can pass, in some cases, about a year. The disease also affects the liver and spleen, and anemia can be a consequence.
In medicine, the first sign of leishmaniasis is an enlarged spleen: in size, it can become larger than the liver. Today, there are 4 forms of leishmaniasis:
- Visceral. This is one of the most difficult forms of the disease. If you do not start early treatment, then the disease can lead to death.
- Cutaneous leishmaniasis. It is considered one of the most common forms. Immediately after the bite, pain appears in its place. This form of the disease can be cured only after a few months, and even after that, a person will remember him, looking at the scar left by the disease.
- Diffuse-cutaneous leishmaniasis - this form of the disease is widespread, its appearance is very similar to leprosy and is very difficult to treat.
- Mucous form. It starts with ulcers on the skin, which subsequently lead to tissue damage, especially in the mouth and nose.
The concept and symptoms of visceral leishmaniasis
Visceral leishmaniasis is a form of infectious disease caused by leishmania. There is an ailment during the spread of this type of microbes by the hematogenous route from the primary site of infection to any of the human organs: the liver, spleen, lymph nodes, and even to the bone marrow. Microorganisms in the body multiply very quickly, which leads to damage.
Most often, children are affected by this disease. The incubation period is quite long, sometimes lasting up to five months. The disease begins at a slow pace, but in the category of infected people who come to endemic areas, the disease can develop rapidly.
Visceral leishmaniasis symptoms are quite common. In almost all patients, they are one and the same: general malaise, weakness throughout the body, lethargy, and a complete lack of appetite. Fever begins very quickly. It passes through the wave, while body temperature can reach 40 degrees. Then comes a slight relief, which again gives way to high temperature, which is also very difficult to bring down.
You can also see signs of a disease such as visceral leishmaniasis on the skin. Symptoms the following: pale skin with a grayish tint and often with hemorrhages. It is worth paying 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 may be single, and therefore, during the first examination, it may not be noticed. 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 canine family made a bite, in the body of which there is a causative agent of visceral leishmaniasis.
A constant symptom that is worth paying attention to is an enlarged 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 is no pain at the same time. The liver does not grow so fast, but very serious dysfunctions can occur in it, up to ascites.
If the bone marrow is affected by the disease, then the signs are manifested by thrombocytopenia and agranulocytosis, which may be accompanied by angina. The first thing that can be seen on the human body is the rapid appearance of colored pigment spots.
Cutaneous leishmaniasis
Leishmaniasis disease is very common and has several forms, one of them is cutaneous leishmaniasis. The reproduction of the pathogen occurs in the tissues of the human body, where Leishmania ripen very quickly and turn into flagellate larvae. This is called the primary focus of the disease, while granuloma is formed. It consists of epithelial cells and plasma cells, macrophages and lymphocytes. Decay products can cause significant inflammatory changes that can reach lymphangitis or lymphadenitis.
Symptoms of the skin form
The incubation period of the skin form of leishmaniasis is about a month and a half. There are several main stages of the disease:
- The appearance of a tubercle on the skin and its rapid increase. Its dimensions are within 2 cm.
- An ulcer appears after a few days. First, it is covered with a thin crust, which subsequently falls off, and a pale pink bottom with weeping appears on the surface, then an abscess forms. The edges of the ulcer are slightly elevated and friable.
- Scar. After a couple of days, the bottom of the ulcer is completely cleaned and covered with granulations, in the future all this is scarred.
The main signs of skin form
There is not only a rural form, but also an urban one, and they differ little from each other, but it must be remembered that there are several basic signs that make it possible to distinguish them.
The main and very important circumstance is the correct and thorough history taking. A long stay in an urban or rural environment will indicate in favor of one of the forms of the disease. The rural type always proceeds in its primary form, but the urban type can take all of the existing species.
Mucocutaneous form of the disease
In addition to the forms of the disease described above, there is another quite common and very dangerous - this is mucocutaneous leishmaniasis (espundia). Its causative agents are mosquitoes.
About 3 months can pass from an insect bite to the first signs of a disease. In the place where the person was bitten by a mosquito, a deep ulcer forms. It involves the mucosa, lymphatic system, and blood vessels. All this leads to very complex and serious complications, while the forecasts are not encouraging.
Human leishmaniasis in any of the existing forms is very dangerous, as it affects the internal organs that are poorly treated, such as the spleen and liver. It is for this reason that doctors recommend that you go to the hospital at the first ailment; in the early stages of the disease, you can quickly recover with minimal consequences.
Other varieties of leishmaniasis disease
We have already described several basic forms of such an ailment as leishmaniasis, but there are several more of its types, which may not be so common, but also dangerous for humans:
- Sequential leishmanioma - the presence of a primary form with the addition of secondary signs in the form of small nodules.
- Tuberculoid leishmaniasis. Photos of patients prove that the signs of the disease appear at the site of the primary form or at the site of the scar. In this case, the primary defect causes the presence of a small tubercle of soft yellow color with dimensions not larger than the head of the pin.
- 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 a chronic process.
What is leishmaniasis, we figured out, and how to diagnose it correctly, we will tell further.
Types of diagnosis of leishmaniasis
The clinical diagnosis of a patient with leishmaniasis is made on the basis of epidemiological data and the clinical picture. Laboratory diagnosis will help to accurately confirm the presence of the disease. Leishmaniasis is detected by the following methods:
- Research on bacteria: take scraping from an ulcer and tubercle.
- Microscopic examination: a smear or a thick drop is taken from the patient. Using this method, you can detect the presence of Leishmania, colored according to Romanovsky-Giemsa.
- A biopsy of the liver and spleen is performed, in the most severe cases, bone marrow puncture is performed.
- Serological methods, such as CSC, ELISA and others.
There are a huge number 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 disease.
Treatment
What is leishmaniasis, and how to diagnose it correctly, we have already described. Now let's talk a little about how his treatment is carried out.
With the visceral form, pentavalent antimony preparations are used:
- Pentostam. It is administered to the patient intravenously, previously diluted in a 5% glucose solution. The drug can be used intramuscularly. The course of treatment lasts for a month.
- Glucantim. The drug is used in the same way as Pentostam. If the disease is complex, then the dose can be increased and the course of treatment extended for another month, but this can only be done with the permission of the attending physician.
- "Solusurmin." The drug can be administered intravenously or intramuscularly, treatment should begin with 0.02 g per kg of body weight. Over a period of 20 days, the dose increases to 1.6 g / kg.
Also, with a very severe form of the disease, treatment with Amphotericin B gives excellent results. The initial dose is 0.1 mg / kg. Gradually, it increases, but not more than 2 g per day. The drug is administered intravenously, previously it is dissolved in a glucose solution.
In the most difficult cases, when all drugs are used and did not bring the desired results, a surgical intervention is prescribed - splenectomy. After such an operation, the patient quickly returns to normal, but there is only a risk of developing other infectious diseases.
With the skin form of the disease, you can use all the drugs described by us above, and also prescribe the heating and UV.
The consequences of leishmaniasis
The prognosis and outcome of treatment after an infectious disease such as leishmaniasis are mixed. Despite the fact that the visceral form proceeds with great complications, and it is very dangerous for the patient’s life, with timely treatment, the ailment passes without a trace and does not cause much harm to the body.
As a result of the skin form, especially its diffuse version, scars and scars may remain on the skin. And in some rather complicated cases, even changes in the skeleton may occur.
Possible complications
Complications after leishmaniasis disease are possible (photos of patients with this disease can be seen in our article). The later the disease is detected and the treatment process is started, the higher the risk of severe complications. With leishmaniasis, they can take the following form:
- Hepatic insufficiency, weighed by ascites and cirrhosis.
- Severe form of anemia and DIC.
- Amyloidosis of the kidneys.
- Ulcers in the digestive tract.
In the skin form of the disease, complications are associated mainly with the addition of a secondary infection. It is manifested by phlegmon and local abscesses, but in the absence of properly selected treatment can develop into a severe septic form.
What is leishmaniasis? This is a very serious infectious disease, which has different forms, each of which is quite dangerous for humans. But there are several prevention methods that will help to avoid an ailment or prevent its severe form.
Disease prevention
The general principle for the prevention of leishmaniasis is protective measures. We must try to protect ourselves from mosquito bites, which are carriers of the disease. Regular disinfection should be carried out and rodents should be combated, and animals should be kept away from the canine family, which were brought up from the forest.
And drug prevention will only help in protecting against the skin form of the disease. So, a person who goes to endemic areas is vaccinated.
Leishmaniasis is a rather serious disease, about half a million people die from it every year, so you should treat it with full responsibility and, at the first sign, run to the doctor. Only the early stages of the disease can be cured without further consequences.
But it is already established in our country that all “forgotten diseases” are not funded, therefore no one will vaccinate the population until the person himself buys the vaccine and asks for it to be administered. And so it turns out that the disease is very famous, and there is simply not enough finance for the proper treatment. Therefore, it is better to do everything possible on your own to prevent infection.