The concept of a generalized form of yersiniosis
Septic or generalized(Common) form of yersiniosis begins acutely, in some cases gradually. The most common early manifestations of the disease are chilling, or chills, headache, dizziness, pain during movement of the eyeballs, weakness, loss of appetite, aching muscles, fever combined with inflammation of the upper respiratory tract infection (sore throat, nasal congestion, dry cough) .
Symptoms of the disease
After a few days (sometimes 1 day)nadpupochnoy pain in the region or around the navel, sometimes in the right upper quadrant and nausea. Half of the patients becomes more frequent stools 2-3 times a day, stool mushy or liquid, without impurities. The characteristic symptoms of yersiniosis is an aversion to food, unpleasant taste, bitter taste and dry mouth, loss of taste sensation. The height of the disease in this form usually occurs in 3-4-th day of illness, sometimes later. The temperature can rise to 39-40 ° C, repeated chills, worse headache and other symptoms of intoxication. The temperature curve is often in waves, sometimes permanent.
The duration of febrile periodvaries widely -. 2 days to 7 months, the majority of patients is less than 2 weeks. One of the most common symptoms of a common form of yersiniosis is rash. The most common skin rashes appear on the 2-3 day from the beginning of the disease, but may be in a period of a few hours before the end of the 2nd week. They are located on the chest, abdomen, back, arms and legs, is characterized by localized rash on the palms and soles, while patients experience a burning sensation (sometimes regardless of the presence of rash), there are swelling and redness of the skin. Often localized rash on the face, can be grouped around the knee, elbow, ankle, shoulder joints. Almost half of patients have mild skin itching. By the nature of the rash is most often punctate, rarely fine and krupnopyatnistoy. The duration of the period of the rash often is 1-4 days, but the rash may persist for 1-2 weeks. Possible podsypaniya in different periods of the disease, and the nature and location of the rash every time might be different. On the 12-15 th day of illness usually begins peeling the skin of the fingers and toes, or defurfuration face, hips, shoulders.
The second symptom is loss frequencyjoints. Arthralgia usually develop on the 3-4th day he onset of the disease, sometimes in 2-4 weeks. It affects the knee, shoulder, ankle, wrist, interphalangeal joints. Pains occur in several joints at once. The intensity of joint pain from mild to moderate, lasting from a few days to 1-2 months. Possible arthritis, especially of small joints, there are different intensity of pain in the muscles of the back, legs, neck, heel and soles when walking.
Some patients are increasing and becomingpainful peripheral lymph nodes, submandibular often, at least - axillary and inguinal, may increase the tonsils. The lungs are heard often dry wheezing.
Observed stabbing pain in the heart,tachycardia (even with a normal temperature), the ECG - changes indicative of degenerative changes of the myocardium, infectious cardiomyopathy, myocarditis in rare cases.
The vast majority of patients with 3-6-th day of illness increases the liver, spleen less.
Sometimes patients note cramps and pain inurinating that becomes rapid. At the height of the disease possible deterioration of vision due to the development of iridocyclitis. Characterized by various autonomic disorders: strong sweating, hot flashes, cold hands and feet, paresthesia, blood pressure variability and heart rate, dizziness. Moreover, these symptoms occur usually in the early stages of recovery. Some patients lose weight up to 5-10 kg, even after brief course of the disease. The period of recovery lasting, asthenia persist for a long time, weakness, decreased performance, dystonia, sleep disorders, pain in the joints, muscles, the heart.
Septic variant of generalized iersinioza
In some cases, there is a septicvariant common form of yersiniosis. It usually develops in patients with various comorbidities (diabetes, liver cirrhosis, tuberculosis, chronic alcoholism, blood diseases, endocrinopathies) and immunodeficiency (congenital or acquired). Characteristically severe, prolonged acyclic for high (40 ° C and above), fever, severe intoxication, shaking chills, profuse sweats, enlarged liver and spleen, jaundice, severe abdominal pain. Mortality in these embodiments, the flow reaches iersinioza despite treatment with antibiotics, high numbers. In favorable cases, the recovery will be very slow.