Vasilyeva-Weyl disease

Vasilyeva-Weyl disease (synonym: infectious jaundice, Icaro-hemorrhagic leptospirosis is an acute infectious disease characterized by fever, liver damage, kidney failure, jaundice and hemorrhagic phenomena. Pathogen - mobile-pallidum Leptospira icterohae-morrhagiae.
The main reservoir of the pathogen in nature are rats. People become infected when bathing, often by drinking contaminated water and food.
Pathogenesis. Upon entering the body through the damaged skin and mucous membranes Leptospira quickly into the blood and then in parenchymatous organs. Fueling all organs, Leptospira collapse of their tissues. The decay products of tissue and pathogen lead to the development of hepatocellular hepatitis (see), hemolysis , and jaundice (see).
Pathological anatomy. The skin and mucous membranes icteric painted. The liver is enlarged, yellow. Spleen giperplazirovannah, flabby. In all organs are marked hemorrhage.
The clinical picture. The incubation period 6-19 days. The disease begins abruptly with chills, fever to 39-41 degrees and sharp headaches. The characteristic muscle pain, especially in the calf muscles, and sometimes nausea, vomiting. Face hyperemic, conjunctiva sclera injected. On the lips herpes. On 5-6-th day on the body appears hemorrhagic rash. Language dry, lined with gray-brownish tinge. Belly swollen. The liver and spleen enlarged. Possible nasal, intestinal and uterine bleeding. In blood neutrophilic leucocytosis, hypochromic anemia, accelerated ROHE. Urine little. Urine protein, erythrocytes, hyaline and granular cylinders. Fever patients is of a wavelike character. The first wave of 4-5 days, after which the temperature decreases to normal; re-raising through 5-11 days and lasts 5-10 days. Rarely observed the third wave. The first reduction of temperature usually coincides with the appearance of jaundice, dark urine. Cal regular color. Complications: bleeding, otitis, mumps, myocarditis. CFR - 4-8%.
Laboratory diagnostics. For detection of Leptospira in the first 6 days make blood cultures, for 2-4 weeks - sowing urine and cerebrospinal fluid in a special environment. From 8-10th day of illness put reaction agglutination. This reaction can be sent to the laboratory 10-15 drops of blood or serum on filter paper. Dried blood fit for staging agglutination reaction within a month.
Treatment. Compulsory hospitalization of patients, bed rest. Effective penicillin (100 000 UNITS 5-6 times a day intramuscularly to adults for 6 - 7 days). Needs good care, drink plenty of water, infusion of intravenous drip method 5% solution of glucose in 500 ml of 1 to 2 times a day, with bleeding - intravenous infusion of chloride calcium, vitamins C, K, rutin. With strong muscular pains - amidopyrine, analgin. According to the testimony of cardio-vascular equipment.
Prevention. Observance of sanitary regulations for food enterprises, trading networks, deratization, sanitary propaganda, and so on, See. also Leptospirosis.