Laryngitis with Glanders

Glanders is an infectious disease of animals and humans, characterized by the development of septicopyemia with damage to the skin, mucous membranes and other organs and tissues.

Pathogen - Pseudomonas mallei - Gram-negative bacillus, which does not form spores and capsules, remains in water and soil for up to 1-1.5 months. The causative agent glanders was first discovered in 1881 by a Romanian researcher V.Babes in tissue sections and pus, taken from the glanders ulcer of a sick person. Regardless of it, the causative agent of the sapa was discovered by Loftier, Schtitz in 1882. The main source of the disease are sick domestic animals - horses, camels, mules, donkeys, in which the disease proceeds with the formation of festering ulcers on the nasal mucosa. Infection of a person occurs when there is a discharge from the nose of sick animals to the damaged skin or mucous membrane of the oral cavity, nose, larynx. Infection from a sick person is unlikely. Mostly people whose occupations are related to animals (cattle breeders, shepherds, veterinarians, groomsmen, jockeys, riders) are ill. Currently, glanders among humans are found in the form of rare individual diseases.

Pathogenesis and pathological anatomy glanders.

The causative agent of glanders penetrates the human body through damaged skin, mucous membranes, conjunctiva, respiratory tracts, less often through the digestive tract; With blood and lymph spread throughout the body. Septicopyemia develops with the formation of purulent inflammatory foci on the skin, mucous membranes, muscles, bones, joints and internal organs (more often in the lungs, kidneys, spleen). In the place of introduction of the pathogen initially appears red-purple papule, surrounded by a bright red border, then a pustule with bloody contents is formed, which ulcerates. The ulcer has a sebaceous bottom covered with mucus-purulent secretions of greenish color. In the future, necrosis of affected tissues occurs with their destruction.

After 5-7 days, the skin appears multiple secondary nodules and papular rashes, turning into pustules and ulcers scattered throughout the body, but with a predominant localization on the face. In the muscles, deep abscesses are formed, and then fistulas, through which a thick greenish color of pus stands out for a long time. When lesions of the lungs clinically and radiologically, small focal pneumonia is detected. As a rule, an enlarged spleen is palpated, and less often the liver. In the blood - pronounced inflammatory changes.

The clinical picture of glanders.

The disease occurs in acute or chronic form. In the acute form, the incubation period lasts 4-5 days. The disease begins acutely with chills, raising the body temperature to 100-104°F. The temperature fluctuates considerably during the day, accompanied by a chill and lasts for a long time at a high level. Patients are concerned about a headache and muscle pain, weakness, sweating, sometimes nausea and vomiting of toxic origin.

When the upper respiratory tract, and in particular the larynx, is affected, profound painful ulcers appear on the mucous membrane, completely disrupting swallowing and phonation. In the acute course of the disease, these ulcers are accompanied by a pronounced toxemia, quickly ending with the death of the patient.

The chronic form of glanders occurs in the form of chroniosepsis with the predominant lesion of the skin, lungs and nose. Often, nose damage is only the initial phase of a descending infection that affects the larynx and further - the trachea, bronchi and lung tissue. The chronic form can last several years with periodic remissions and exacerbations.

Diagnosis of glanders laryngitis

The diagnosis is based on a characteristic clinical picture, pathoanatomical changes, epidemiological data (contact with sick animals) and laboratory results, and in particular bacteriological - bacterioscopy and microbial culture. To do this, use the discharge from the nose, the contents of abscesses, pustules, ulcers, blood. Serological diagnosis, complement fixation, agglutination, indirect hemagglutination and skin allergic test with mallein are also used, which is also applied to suspicious sap animals, in particular horses. Most often, the animal is injected with mallein into the conjunctival sac: with a positive sample 3-4 hours after the administration, purulent conjunctivitis of varying severity develops.

The prognosis for acute glanders laryngitis is almost hopeless; At early treatment with the use of broad-spectrum antibiotics, immunoprotectors, multivitamins, antihistamines, effective detoxification agents (infusion of saline solutions, hemodesum, rheopolyglucin), recovery may occur. However, all these activities are aimed primarily at preventing secondary infection and combating intoxication, while anti-microbial glanders of antibiotics and sulfonamides have not been obtained to date.

Prevention includes veterinary and sanitary supervision of animals for the detection of patients with sap (they are destroyed), careful compliance with the rules of individual protection when caring for suspected sap animals (wearing overalls, aprons, boots, gloves, gauze masks, sunglasses, smoking ban and Food intake during work, storage of work clothes at the place of work in special cabinets, etc.).