Scho also ailment diphtheria. Scho also diphtheria

In the given statistics, additional information is given, as well as diphtheria, and the cause of the symptoms. Described the peculiarities of the affliction of this sign. Okremo is presented with information, like and using different methods to carry out the treatment.

describe the affliction

Differentiation is referred to a group of infectious diseases of a very bacterial character. In the main, the upper part of the nobles of the dikhannya is in the upper part, in 95 it is the nasopharynx. However, the disease can be localized in the body organs. In the area of ​​penetration of diphtheria, fibrosis develops.

Bacterium, yak provoked sickness, vidіlyaє is strong. It is not safe to use until the best. As a result, there is an intoxication to the body.

It is known from the data of epidemiology, diphtheria appeared as early as BC. That is, up to 90 people died from being ill. Khvoroba bore the name "Syrian Virazki". Infection of lethal vapors of rіdkіsnі, workers of special sirovatsі.

The diphtheria is transmitted by the drift-drip path, the last episode of the Bula was recorded in the 90s. Growing up is not only in the moment of penetration of bacteria, but also in flurry of fabrics and organisms. Into the Pershu Cherga to be driven into the heart-vessel nervous systems... If symptoms, causes of ailments are evident, prophylaxis and treatment should be done earlier.

Classification of disease

Classification of diphtheria in Persha Cherga is seen as a penetration of an illiterate. Vono last for zapalennya:

• nose;
• shlyakhiv dikhannya;
• shkiri;
• larynx;
• articles of organs;
• oropharynx;
• eyes.

In 95 species of droplets, the main form of diphtheria is inflammation of the oropharynx, which is very rare. For the nature of the protokannya last for:

• toxic;
• type (plivkove);
• hemorrhagic;
• hypertoxic (fulminated);
• catarrhal.

Differentiation against light, medium or heavy forms. Vilikuvati will remain unmoved. Oropharyngeal infection can be of decile species - localized, toxic or enlarged. The hypertoxic form is very rare and often leads to a lethal result as a result of the high level of intoxication. Localized to extend into catarrhal, insular and membranous. Developed and combined forms of differential.

zabudnik zapalennya

Infected with a gram-positive bacterium in the viglyad of the great vignous stick. On її kіntsyah there are grains of volutin, which gives a microbi a kind of mace. Inakshe vin is called Leffler's stick. Vona viroblya is a special esotoxin, which for toxicity can only be developed with botulinum and pravtsev. It is strong until the end of the day, calmly endure freezing.

To navigate in a hungry viglyad life lives up to two lives, in young and water can be up to three. However, bacteria (the name is corynebacterium diphtheria) can rotten to tolerate disinfectants and high temperatures.

For example, alcohol drives sticks for hilin, 10 vidsotkov peroxide - for 10 min, and heating up to 60 degrees. The bacterium is highly sensitive to discord, such as chlorine and ultraviolet optimization. Bacil Leffler:

• tying bacteria with cells;
• ruin the myelin sheath of nerves;
• I will ruin the bilkovy synthesis, how to destroy the cells;
• ruinu with the resulting fabrics and judgments, which can be produced until the blood is soaked through them.

Bacteria cling to cells behind the help of villi. Then we can actively repair reproduction. At the end of the hour, a person who is sick for diphtheria needs to introduce a special term.

Mechanism of development of ill-health

Let bacteria multiply, do not penetrate into the roof. The pathogenesis of diphtheria is repaired by adjusting the temperature and tissue filling. Drinking the toxin into the roof. The fabrics are repaired with a fibrous age. Then fibrin is formed, and from the first fibers - siruvato-pearl barley. Vona trohi pіdnіmaєatsya over the surface. Knowing about the great difficulties, leaving behind a wound, bleeding is a necrosis of mucus.

The diphtherin toxin quickly expands at once from the lymph, along the hostile systemic universities. It's time to get to the heart, nerves and nerves, and the nerves of the cell. It’s a good idea to be locked in exercise. If a sick person doesn’t enter a special anti-diphtheria treatment, then all the organizations of the river are re-insured.

Perebіg zhvoryuvannya is rich in what to lay in the toxin. If you wobble even more, then the pathology goes to the important stage with no acceleration. However, it is more often possible to improve the efficiency of organs and systems.

The crumb of the oropharynx is often associated with diphtheria of the larynx.

cause sickness

The main reason for becoming ill is the transfer of health bacteria to people from the sick by every turn. The time period is trivial, as only at the confirmed infusion of the end of the incubation period before the appearance of bacteria.

It is possible to get infected from asymptomatic virus infection. At the same time, people have mucous presence of bacteria, but their organisms do not react to the toxin, so the disease does not develop. However, infecting their noses can be easily done. The main reasons for the diagnosis of diphtheria are:

• destruction of special hygienia (victorian postіlnoї, dishes, etc. for a sick person);
• іnfіkuvannya through products.

Susceptibility to illness is not visible - the infection is transmitted only in 15-20 times a day. In the zone of risk, there are no splits and people with poor health. Children up to 12 months for diphtheria are practically not ill, often for all they have a natural immunity. However, in the period from the 1st to the 5th rock, it grows even more receptive to the wake. Transferring sickness is important.

In the zone of risk, the most frequent occurrences are vikhovantsi d / budinks, schoolchildren, businessmen, recruits, or ailments in neuropsychiatric events. The main reason for the sleepless infections is the deterioration of hygiene, low immunity, improper health care, as well as the concentration of people in one and the same medical service.

Diphtheria can be restructed by stretching out all the rock. In the main, sickness grows up. A childish seasonal peak of diphtheria is brought to autumn-winter.

Incubation and transmission

Incubation period of diphtheria - the process of penetration of bacteria into the body before cob sign getting sick. The whole period can be trivial from two to ten days. In the whole hour of the bacterium, they quickly repair and swallow the whole body. The barnacle penetrates through the mucus:

• shkiri;
• nose;
• eyes;
• larynx;
• pharynx.

For many bacteria to grow to cells and to activate the process of reproduction. Dzherelom іnfіkuvannya can be as well as lyudin's illness, or asymptomatic nasіy. Differentiation is recognized for the risk of infection (period, if the person is not safe):

• transitory (1-7 days);
• triva (15-30 dB);
• short-hour (from 7 to 15 dB);
• protracted (from a month and more).

Є a number of nobles in the transmission of differential:

1. The main one is drip-drop. Bacteria are fed into the body of the people with bits of food. Tse vіdbuvaєtsya pіd hour channya, break down, cough.
2. With a contact-by-run way of infection, it is possible to expand through the information of bacteria of small items (post, towels, dishes, little toys).
3. In case of grub infection, it is introduced through dairy products.

For the information of healthy people, one contact is not enough because we get infected with no symptoms of noses.

Important! Diphtheria is not transmitted by parenteral or transmissive pathways. The shelter of such a sick person is not safe for people who feel sick.

diphtheria symptoms

Diphtheria in the main enemy of the oropharynx. In the photo of the throat you can see that there are tonsils (migdalini) in them. The price of the purchase of lymphocytes, which is considered for the development and removal of high-grade bacteria.

However, if you inhale a diphtherin stick when you inhale on the miracle, you’ll start immediately and start the ignition process. Symptoms of the pathology of the developmental form lie in the form of bacteria and immunity of people. Є A list of symptoms of diphtheria in older adults:

• bil, scho vinikє in the throat;
• zagalne nezduzhannya;
• improvement of lymph nodes;
• tovsti siri plots, how to cover the competition;
• chills;
• hoarseness;
• ізні vision;
• feverish woman;
• often it is not difficult to dichanna.

Symptoms of diphtheria in children are also, yak in grown-ups, for a blame breast period... I’ll show you to lay it down all the time of crushed chips. Without it, children are found in the zone of increased risk, right up to the acceleration and lethal result. In newborns, inflammation can appear in the navel area. In the period of thoracic vygodovuvannya urazhaetsya nis, after 12 months - the larynx and oropharynx. Signs of diphtheria in children before rock are rare in the region.

localized form

The form is localized to be diagnosed in chipped people. The symptomatology grows quickly, ale in trivial or an important character to pass over. Signs of an affliction:

1. On the mucus, there is a blistering zhovtuvato-sira splash in the throat. You can curl the surface more or less, see the force and quickly renew the knowledge.
2. In the throat there is a laughing or a prickly beat. When you see it, it’s going to go down in peace.
3. The temperature rises to 38-38.5 degrees;

V shyny vіddіlі lymph nodes grow. at palpation sickly visions do not show up. Seeing in the back of the head, lack of pain in the eyes of weakness, pain in the mind and head, drowsiness, decreased appetite.

catarrhal form

Catarrhal diphtheria of the oropharynx is rarely diagnosed. Symptoms of illness are practically everywhere. It can only be spared the mucous membrane of the mucous membrane, or it is not very thick. In some cases, there is a slight pain in the throat, as it can be done when you are shutting down.

expanded form

The head symptom of a broadened form is the growth of spills and water on the pharyngeal walls, the membrane of the testicle or the arch. Among the other signs are faintness and drowsiness, muscle spasms and pain in the head. The smell is strong in the throat. The temperature of growth is up to 39 degrees, only one day. In general, medical involvement is required.

toxic form

Toxic diphtheria supravodzhutsya strong temperatures. In the first place, I will grow up to 40 degrees and more. Іnshі symptoms:

1. Appetite visibility.
2. Gladness.
3. Sleepiness.
4. Blindness of curvy curves.
5. M'yazovi spasms and strong weakness.
6. Lomota in tili.
7. Potential headaches.
8. Mucous tongue, oropharynx and glands are swollen and corny. In a couple of days, a syria will be set up at a whole mission, which is easy to get to know, but not as quick and innovative. After 2 more, add the wine to transform into a splash, curling up all the sleeves. At the same time, the tongue is dry, an unacceptable odor is perceived in the company.
9. More pain in my throat.
10. Nabaryak shi. In the case of Russia, the head is vinikє strong beat.
11. Improvement of lymph nodes. All the stench is even more sore, as soon as you touch them, before the hour collapses with your head.

It’s getting better sooner rather than later, depending on the temperature. Kozhen degree dodatkovo yes 10 blows / min. With this form of pathology, toxins are rarely infused into the heart.

Fulminant form (hypertoxic)

The hypertoxic form is not infallible. It will develop bliscavically and you can provoke a fatal result in a couple of days. The temperature rises to 41 or more degrees. For a wide range of people, there is no need for additional help.

Mimovilny persistent sudomi and ailing spasms of malignancies occur. There is a breakdown in the quality of sleepiness - in the form of drowsiness to the Komi. Stimulates collapse, stronger clogging of the mucous oropharynx. Vaughn curl up with gray plavkoy. The number of slashes is decreasing.

hemorrhagic form

In case of hemorrhagic forms, bleeding from the nose in the oropharynx, yasny, hCT and pid shkiroyu is prevented. Symptoms appear in 4 days after the ear is ignited. The reason is the deterioration of the throat of blood, the loss of the throat, its lameness and penetration. The stench will shimmer with the smallest inviting infusion.

diphtherin croup

Differential croup - a whole set of symptoms in case of fired nozzles and larynx. Necrosis develops step by step in the penetration of an ill-tempered person. Slyzovy strongly nagryakayut, on them s'yavlyayutsya floats, dikhannya bother. The dermal stage of development has its own symptoms:

1. At catarrhal temperatures, the temperature rises to 38-38.5 degrees, there are signs of intoxication (headache, strong weakness), barking cough, hoarse voice.
2. On the stenotic one, the interdigitated prominences are twisted. It becomes difficult, noisier and quiet cough. Blue lips, part of the heart. To appear quietly in the quiet and rhinestones of death.

At the asphyxial stage, there is change. Sleepiness and dullness appear. Shkira nabuvak cyanotic vidtinku. The temperature of the room will drop as you go. Feces and slaughter come in mimovoli. It is seen by the judgment, expanding the zone, not being spared the sound of the light. Tse talk about pockojennya brain.

diphtheria of the nose

With diphtheria of the nose, the symptoms appear stepwise and turn weakly. Sickness manifests itself in a slight increase in temperature up to 37, 5 degrees, if you want to become more normal. The nose collapses through the mucous ridge and the narrowing of the passages. From nіzdrіv there is a slimy vision, which passes into the blood. Shkіra navkolno nose chervonіє, peel.

diphtheria of the eyes

Differential conjunctivitis evoke the enemy only one eye. It is even more rare to have a slight weakness and temperature adjustment up to 37.5 degrees. On the mucous, there is siro-zhovty nalit, which is rotten to see. You can expand on everything full-time apple. Worshipers swallow, shrink, palpate they see ailments. Very strong sounding. They can be repaired with mucous vision, which can pass into blood and blood.

Differentiation of statutory organs and shkiri

You cannot penetrate through a healthy shkіra without an ear. If the stench is consumed in the body through the wounds, then the symptoms are even worse. The main one is tovsta sira diphtheria plyvka, which curls a little dilyanka. To see it is important and quickly to pretend to know. With a whole shkіra navkolo nabryakє, and with a dot it hurts.

Differentiation of body organs of winyk in females and females. Slimy flare up, swell and very sore. Gradually, they are set up for a ride with a gray nalot, which is even more important to see.

diphtheria wuha

Differential inflammation of the air is developed on the basis of progressive ignition of the larynx. Supports hearing impaired on the side. Lyudina sees the noise and the noise. When I rip the drum, I fix it, I see it with blood. With a flattened vuha, brown-gray pots are visible.

diagnostics of illness

Do not diagnose diphtheria until after a visual aid. Laboratory diagnostics diphtheria:

1. With the bacteriological method, a swab is taken from the oropharynx. It’s safe to stay on the cordon of healthy and young people with plavkoy fabric. Visually, the diphtheroid in the smear can be done in the first 2-4 years from the moment the material is used. Danish method allowing for the presence and toxic power of bacteria.
2. Serological method reveals the steps of immunity, anti-toxic and bacteriological antibodies. Pislya otrimanikh tribute to robe about visnovka gosvoryuvannya.
3. The genetic method is the DNA of the beetle. Tse is a way to be called PLR.

Dodatkovo performed EKG, phonocardiogram, ultrasound of the heart. The activity of lactate dehydrogenase, aspartate aminotransferase, creatinophosphokinase is to be changed. When susceptible to nephrosis, blood biochemistry is robbed, back-to-back analyzes blood and slash, ultrasound nirok.

lykuvannya

Likuvannya diphtheria is carried out medically. Quarantine will immediately begin. In the first place, an antitoxic syrovatka is used for lykuvannya vicory. Tse udine naybilsh efficiently... Zastosovuєtsya for lіkuvannya be-any forms of zakvoryuvannya. A person who is sick for diphtheria should be injected with antidifterin syrovatka, to take revenge on toxoid, so that they can go viral in Kin's blood.

Some of the wonders are treated with special enzymes. Pislya tsiogo zastosovuyutsya for іn'ktsіy people. Before the injection, a drug tolerance test is performed. Protidifferent sirovatka is introduced from the shkiru or internal yazovo in the amount of 10-120 yew MO.

In case of a toxic form of diphtheria, an injection is delivered into a vein. However, if the toxin is already on the way, and the cells are poorer, then the syrovat is not good enough. Vona is effectively deprived of the disease in the first three days.

Antibiotics treatment will be carried out one hour. The stench will ruin the process of synthesis of bacteria in bacteria, overwhelm the multiplication of pathogenic microorganisms.

A high level of antibiotics means a diphtheritic stick. Likuyuyuyuyuvannya for the help of Erythromycin, Azithromycin and Clarithromycin.

Dodatkovo are recognized:

1. Dezintoksikatsіynі rozchini (Acesol), which stimulate the furnace for the weakening of toxins, which will speed up the vivedennya of the slaughter.
2. Vitamin B (1,6,12) and folic acid normalize the nervous system. Wicked to get rid of parallels and jade.
3. Nootropics (Piracetam and Lucetam) reduce the cerebral grudge, increase the strength of the central nervous system to a toxin.
4. Glucocorticosteroids (prednisolone) capture the nerves of the fibers, before the development of the parallels. The larynx bulge will be absorbed in one hour.
5. Desenbilizing drugs (Ebastin) to reduce the allergic manifestation of the toxin and reduce the intensity of the burning.

Signs of diphtheria in older adults have been diagnosed, and in case of deterioration in their bodies, it is possible to use hypothermia on the basis of hydrocortisone. Or, the procedure is carried out in a gourmet manner. In case of elimination of diphtheria in children, rinse the throat with a disinfectant solution with soda, manganese and furacilin.

It is meant to be number 2. She is guilty of being frayed or rough, warm. Soup cook on a weak broth, meat - low-fat varieties, we recommend boiled vegetables, fermented milk products... Fresh bread, milk soup, fatty riba are included in the race. You can't give ailing smoked meats, pickles, fatty food. Confectionery virobes and vegetables are included.

accelerating

The main accelerated diphtheria are infectious toxic shock, nephrosis and ailments of the upper respiratory tract. Neuritis and polyradiculoneuropathy develop on the side of the central nervous system. The heart-sudin system reacts to ailments in viglyad myocarditis. Most important inheritance in hyper- and toxic form. In a large number of options, the stink can produce a lethal result.

prophylaxis

Before the main visits of the prevention of diphtheria, chips are introduced on the basis of a special sirovatka. You can get stuck:

• D.T. Wax;
• DTP;
• Tetracock;
• Інфанрікс.

The vaccination method is widely used in pediatrics. The toxin changes take place in the scraps, which provoke anti-til viroblast. Writing a time-consuming injection, in the event of an infected bacterium, it will be malnourished. The first vaccination is carried out by the child at 3 months, then at 6 and at 18. The revaccination of ADS is carried out at 7 and 14 years. Then - through the skin 10 years.

For the prevention of diphtheria, it is necessary to ensure that we contacted people with ailments. Conduct a thorough disinfection. Obov'yazkovo izolyuvannya ailments. For the first hour, we got overwhelmed with caution. For ailments of angina, it is necessary to take a smear from the dysplasia for analysis.

Marvel at video:

Most often diphtheria is diagnosed in a mild form. Vaccination was carried out in an hour. In case of important forms, illnesses can lead to severe accelerated and lethal results.

Difterіya - tse gostre Infectious disease, It is not safe for life. Look at the sight of the blazing fire of the upper dickheads, notably the pharynx (approximately 90% of the droplets), the nose, the eyes in the miscellaneous parts of the body.

The main threat, however, is not inflamed, but extinguished with a toxin, like a viroblya bacterium - an anemic disease, in which case the heart-sudinous nervous system is affected.

The plantation of diphtheria and paths of the infected

Diphtheria Corynebacterium diphteriae- gram-positive bacteria in the viglyadi sticks with characteristic flask-like stitches on the fingers, which in smears are expanded in pairs, before the cut at the viglyadi Roman numeral V, one to one is worn. Differential sticks in the process of life see diphtheritic toxin, the enzyme neuraminidase and are biochemically active.

The synthesis of diphtheria toxin by microbial cells is controlled by a special tox gene. Bacteria can be involved in the process of living, simultaneously using it and their health is viroblyaty toxin (toxigenicity). I, navpaki, with a lot of non-toxic strains can nabuvat pathogenic power, for happiness, it grows in the edge.

Anxiety is transmitted by a drip-drip path from ailments to diphtheria, or from healthy noses to infections, meaning more - through objects and pobutu.

Riziku group

Most children are susceptible to infection with diphtheria in 3-7 years, but in the rest of the rock, the disease of children and adults has grown.
Dzherelom іnfektsії sick people for health nosії toxigenic bacteria. Most infectious people are hungry for diphtheria of the ear, nose and larynx, so as the stench is actively seen by children who are ill at times when they see it. Ailments on diphtheria of the eyes, shkiri can widen the infection with a contact path (hands, objects and pobutu). The health of the noses of bacteria is less infectious, but they have any signs that I will not allow them to control the spread of infections by them; As a result, a greater number of cases of diphtheria infected are caused by contact with healthy noses of diphtheria sticks.

The incubation period (an hour from the moment of infection before the first signs of illness appear) become 2-10 days.

diphtherin toxin

The toxin, which is circulated with a diphtheria bat, is stored in decile components. One of them is the enzyme hyaluronidase ruinu hyaluronic acid capillary and increased penetration, which leads to the exit from the court and the penetration of the accumulated tissues with blood plasma from the deposited fibrinogen. Another component is necrotoxin ruined by blood cells with the enzyme thrombokinase. Thrombokinase is transformed into fibrinogen in fibrin and on the surface of fibrin tissue. With diphtheria toxin on flashlights When pokrytі decіlcoma balls of epithelial cells, form fibrіnnaya pіvka, as it penetrates into the epithelium of the migdalin and is soldered to it.

The third (main) component is a dry toxin that blocks the process of cell reaction and the synthesis of protein molecules. They are very sensitive to the first day of capillaries, cells of myocardium and nerves of cells. In rezultatі rozvivaєtsya distrofіya mіokarda that іnfektsіyno mіokardit-toxic, generally produces poshkodzhennya kapіlyarіv to іnfektsіyno-toxic shock, poshkodzhennya Schwann klіtin (dopomіzhnі klіtini nervovoї tkanini) generally produces up demієlіnіzatsії nervovih fibers (ruynuvannya elektroіzolyuyuchogo ball mієlіnu of Venue of nervovih іmpulsіv torn down by nervovih fibers). In addition, the diphtheritic toxin of the wicklica is responsible for the intoxication of the organism.

Symptoms and stretching

diphtheria ziva call me to fix small advices temperature, slight soreness in case of kovtanny, ear and swelling of migdalin, the formation of a specific sludge nalot on them, improvement of the anterior upper lymph nodes. Collar of pills - wake up beads in the first 2-3 days of getting sick, ale the swelling of the gray or the zhovtuvato-gray color. Approximately in a day, the disease will end, or the money will end ( easy form, As a rule, in splintered types of diphtheria), or go into a more important toxic form, amumulated by the systemic action of diphtheria toxin.

The toxic form of diphtheria is even more important. Vaughn is characterized by even more high temperature tila (39.5-41.0 ° C), severe headaches, drowsiness, apathy. The shkira is old, dryness in the mouth, and the children may have bagatoraz blues and beating in the belly. The nabryak of migdaliks is old, we twist rapidly, we can make the entrance to the throat all the way up, widen on the soft and hard palate, often also on the nasopharynx, it gets difficult, the voice often gets googled. Nalit expands on all tissues of the oropharynx. Classical familiar toxic form of diphtheria the growth of pediatric cells in the region, and in some breast cancer, As a result, the shkіra swells with a jelly-like consistency. Front upper shiiny lymphatic universities Significantly better and more painful.

diphtheria of the nose the opposite on the smallest normal or lightly adjusted temperature tila, intoxication during the day. From the nasal passages, serous-gn_ine or bloody-gn_ine vision is visible. On the krillas of the nose, cheeks, foreheads and pidboriddids, there are wet little ones, and then dry skins. All the middle of the nose can be seen plural parts of the nalloti. The pathological process can also be hostile additional sinuses nose. In case of a toxic form, the growth of the nursery cells is prevented.

diphtheria of the eye the opposite is like a banal conjunctivitis and is characterized by a small amount of hypothermia and a large conjunctiva of the capital, a small number of serous-gnarly visions from the conjunctival mouse (catarrhal form). The filmy form is manifested by a swiveling swell of the povik, when it is evident on the conjunctiva, it is important to know the siruvato-white color. The toxic form can also be supressed with a bunch of cells near the ochnitsa.

diphtheria shkiri It leads to the fact that no one can ignore the school, the hyperemy, the presence of the hard-gray school on the screen, it means the educational information about the school.

diagnostics

Diagnostics of diphtheria should be carried out at the reception of the patient by looking at the sick person and the results of the analyzes. When looking for a diagnosis of diphtheria, one can see the following signs: the appearance of characteristic spits, as well as a difficulty in behavior and a whistling noise on inhalation, not typical for angina, a barking cough. Diagnosis of diphtheria for characteristic key signs when you get sick, if you are against it in an easy form, put it in a fold.

analysis:

Zagalny analysis of blood - signs of GOST ignition process.

Pre-smear smear under a microscope (bacterioscopy) - a characteristic type of bacteria is detected Corynebacterium diphteriae.

Bacteriological dosage - sowing biological material on a special living center and cultivation of colonies of microorganisms.

The value of the level (titer) of antitoxic antibodies (high titer is 0.05 IU / ml, and it is possible to prevent diphtheria).

Serologic dosage - the value of specific antibodies in syrovatz blood for additional methods RPGA, IFA and IN.

Differentiation of the disease requires differentiation from gastric tonsillitis (follicular and lacunar form), Simanovsky-Vincent's angina (fungal infection), syphilic angina, pseudo-film abscess with parainfectious disease In children, it is necessary to introduce a diagnosis of grape cereal.

lykuvannya

All ailments for diphtheria, regardless of the severity, will need to be hospitalized in the Infectious Disease.

Lіkuvannya polyagaє in offensive:

Diet - vitamins, calories, went through the retailer cooler processing.

Ethiotropic therapy (to be based on the reason for the disease) - the introduction of antidifteritis syrovatka (PDS), the dose and the number of times introduced to lie in the form of severity and form of discomfort. In the case of mild forms of PDS, it is administered one-time intramuscularly in a dose of 20-40 yew. MO, with a medium-heavy form - 50-80 yew. MO is one-time or, if necessary, again in the same dose after 24 years. When an important form is taken into account, the total dose is increased to 90-120 yew. MO or navit up to 150 yew. MO (infectious toxic shock, disseminated intravascular coagulation syndrome). When 2/3 of the dose is injected at once, and with a stretch of the first add to the hospitalization, 3/4 of the total dose is injected.

Antibiotics: in mild forms - erithromicin, rifampicin in the middle, in moderate and important forms - in the introduction of penicillin or cephalosporin. The triviality of the course is 10-14 days. Antibiotics do not inject on the diphtheritic toxin;

Mistseve lіkuvannya - rinsing and growing with disinfecting rosters.

Desintoxication therapy - glucose-salt solutions for additional consumption in a period of time (medium-heavy and important form).

Glucocorticosteroids - in moderate and severe forms.

Carry out the treatment of bacteria with antibiotics: tetracycline (children older than 9 years), erithromycin, cephalosporin on the basis of hypoglycemic therapy and the inferiority of chronic infections.

accelerating

In the midst of the most serious complications of myocarditis on the heart-vascular system, myocarditis, heart rhythm.

Neurological accelerated diphtheria of the development of the lesions of the small cranial and peripheral nerves and manifests itself in parallel accommodation, oblique ossification, paresis of the symptoms, and in more important junctions of the mucous membranes

Vtorinnimi uskladnennyami difterії Je takі vazhkі patologіchnі Stani yak gostrі torn down Mozkovy krovoobіgu (Thrombosis embolіya) metabolіchna entsefalopatіya, nabryak head mozk, toksichnі urazhennya nirok, difterіyny hepatitis and takozh іnfektsіyno-toxic shock i DIC-syndrome (syndrome dessіmіnіrovannogo vnutrіshnosudinnogo zgortannya - vazhke the destruction of the blood circulation system). The toxic form of diphtheria can lead to grievous nirkovo, heart-vascular, dichal or polyorganic deficiencies.

Nonspecific accelerated diphtheria є paratonsillar abscess, otitis media, pneumonia.

vaccination

Vaccination of diphtheria is carried out with toxoid, to inactivate with toxin. At the conclusion of the introduction into the body, antibodies are not established until Corynebacterium diphteriae, And before diphtheria toxin.

Differential toxoid should be entered before the warehouse of combined vaccines of DTP (asocyovana, tobto complex, vaccine against whooping cough, diphtheria and pravtsya), AaKDP (vaccine with a clintless cough component) AD-M. In addition, in Russia, the vaccines of the company "SanofiPasteur" have been registered: D.T. Vax (diphtheria-pravtsevium toxoid for vaccination of children in children up to 6 years) and Imovax D.T. Adyult (diphtheria-pravtseviy toxoid for vaccination of children over 6 years old and old), as well as Pentaxim (vaccine against diphtheria, pravtsya, cough, poliomyelitis and hemophilic infections with clymid-free cough).

For example, before the Russian calendar splitting, vaccination of children in vіtsі before the rock is carried out in 3, 4-5 and 6 months. The first revaccination is carried out in 18 months, the friend - in 7 years, the third - in 14. Before the guilty revaccination from the government and diphtheria of the skin 10 years.

Today's sleepers are sick of people all over the world. It is important to explain in the whole nutrition, to score a triviality with the first drops of the appearance of a characteristic nalot or mucus. It is clear that diphtheria is also a symptom and a sign of illness in an adult and a child.

Scho also diphtheria

In the main, ailments are characterized by the fiery organs of the upper dichal nobles, the urazhennye shkiri and the most sensitive areas of the body. If diphtheria is susceptible, the symptoms may not be all. The nature of the ailment is infectious, but it is not infallible because of the muscular manifestations, as inherits for the nervous and heart-vascular systems. The reason for їkh defeat is the removal of toxin, which is viroblyaa diphtheria - Corynebacterium diphteriae. The bacteria are transmitted by the drift-drip path.

see

Differentiation of growth in fallowness due to localization State Department of Infection... Exercise can emerge dickheads, Ochі, shkіra, vuha і statues organi. Due to the nature of the transition, the disease is typical aboard, catarrhal, toxic, hypertoxic, hemorrhagic. If you are a child of the stages, which will cause you to be seriously ill:

• easy (localized) form;
• middle (extended);
• important stage (toxic diphtheria).

Klinichny show diphtheria

Self-diagnosis is important. Diphtheria - symptoms may be similar to the manifestation of angina, but not necessarily infectious ignition... When an ailment begins, an analysis of the mucous is carried out. The zabudnik was drunk on the sprinkled dilyanki shkiri, de-started to multiply, opening the fire in the fire. Locally, necrosis of the epithelium occurs, hyperemia appears.

Exotoxin is a diphtheritic toxin, which circulates with diphtheria bacteria, expands along the blood-bearing and lymphatic pathways, and intoxicates the body. With the manifestation of autoimmune processes, it can be faster to develop faster, direct to the nervous system. When you think about it in the body, there are signs of diphtheria and there is an antibody, if the stench does not mean to lower the risk of becoming infected again.

Have grown-ups

In the last few years, the incidence of such infectious diseases in the middle of the mature population became more frequent. One hour you can get a lot of organs. It’s a nyposhirenіshayu form є a slime throat affliction, so it’s not easy to wander with angina. The sick person has fever, chills and a strong throat. Vinikak is an embankment of migdalin, and on their surfaces you can see a foggy deposit, healthy people... Would you like to start looking at the temperature as the temperature returns to normal.

As far as Lyudin is sickening with alcohol, a new person is developing a toxic and hypertoxic form. The stench provoke the widening of the embankments all over the place, wicked the sundom. The processes are fast. After a few years, a sick drop has an arterial grip and a toxic shock infusion. This often leads to fatal results. Symptoms of diphtheria in older adults are often more pronounced than in children.

Have children

To minimize the severity of symptoms in infected children, to reduce the scraps for the prevention of diphtheria. The stage will show symptoms in case of occurrence of the fact that the previous immunization was carried out. Children without chips are in the zone of risk of death. In newborns, the localization of ignition processes is spontaneous in the umbilical wound. In the case of a thoracic vygodovuvannya dilyankoyu urezheniya can be buty nis, for the fate - the larynx membrane and the oropharyngeal membrane.

Symptoms of diphtheria of the oropharynx

The most significant manifestation of the disease (95% of the cases). The incubation period of the warehouse is from 2 to 10 days. If the mucus of the oropharynx is hostile to diphtheria, the symptoms are similar to the manifestation of angina. characteristic familiarє shedding of a brude-white nalot on the migdalene. The stage of change is that, as symptoms are manifested, lie in the form of diphtheria, that at the first age it is important to turn up to the doctor for the analysis.

When the form is expanded

If the form is broadened, then diphtheria - and symptoms are important to note on early stage, Aje vona enemies are not just mydalini, but ale and suspicious fabrics. The core of the onset of intoxication:

• diphtheria water on the mydalins, my mouth and throat can be easily taken with a spatula, and there is a shelter on the place;
• tila temperature to move up to 38-39 ° С;
• vinikak golovniy bіl, bіl when kovtannі;
• the appetite is out of the ordinary.

toxic

The form of ailment is in children who have not undergone the vaccination procedure. It is characterized by a cozy ear, if the temperature rises rapidly up to 40 degrees. The patient is seen from the їzhі, the person is from the blues. The bladder of the shkiri is fluttering, the spasm of the juvenile muzzles is seen. The protuberance of the oropharynx and shia develop. Nalіt on fabrics with napіvprozorogo transforms into schіlny, with clear edges. Naybilsha is not safe from the symptoms to represent the court.

hypertoxic

In a group of patients, the development of a hypertoxic form is a patient, which may have an unpleasant premorbid background (for example, diabetes, alcoholism, a chronic form of hepatitis). At the present time of the stage the temperature increases. All signs of toxicity are promoted. Progress the destruction of the robot heart-vascular system... The presence of a tachycardia, the grip falls, it is molded children of blood... With such characteristic clinical pictures, the lethal result can occur in 1-2 dobi.

diphtheria croup

Show diphtheria in croupous form or diphtheria croup in the last hour spares you the middle of older children. There are three stages of ailment, which develop one after another:

• dysphoric - characteristic signs є barking cough, hoarseness;
• STENOTIC - loss of voice, soundless cough, aloof noise, tachycardia, blida shkira;
• asphyxia - the surface of the dyhannya, growth of cyanosis, the grip falls, the svidomist breaks down, the verdict is judged. The rest of the stage of the most insecure, the fragments of the necessary destruction in the body and people can die from asphyxia.

Symptoms of localized diphtheria

Practically, whether it is a manifestation of a disease, I will look like a classic picture. It is important for people to suspect diphtheria - it is important to discuss symptoms with the doctor of the yakomoga earlier. Tse allow zapobіgti її development in the early stages. The toxin, which is seen as bacteria in the zones of infection, expands in all directions, even in case of localized form, at once in the presence of infection. Tse mozhut buti:

• nis and nasopharynx;
• urazhayutsya mucous membrane of the eye;
• fabrics of article organs;
• shkіra, wounds and changes in the epithelial cover.

diphtheria of the eyes

The incubation period of the warehouse is 2-10 days. Differentiation of the eyes is more common for children from 2-10 years of age. A common form of congestion, like a vine on aphids, nasopharynx and other zones. A characteristic familiarity is the hyperemia of shkiri povik, vinyinennya prozorikh bulbashok, yak, bursting, put a scab on its own place. Pastupovo has grown into a painless ride. They develop diphtheria, croupous and catarrhal forms. A number of cicatrices can lead to deformity of the scar.

nose

Rise in the offensive: nasal diphtheria - symptoms and particularity. Having developed a larynx izolovanim, for the larynx, the trachea can be wondered on this one. Some of the nallots are widened and down the slope. Most often from the cycle of form, they are awaiting new natives and children up to 2 years. Yak і in the general description of the disease, in the ailing one is more susceptible to temperature fluctuations, weakness and apathy. Vinikє nasal congestion, hypochondriacal vision, dermatitis of urazheni shkiri. Vidbuvatsya zapalennya slushy, wont be covered with twists, fibrinous nalot.

State bodies and shkiri

Zones of battle can be statues of the organisation, dilyanka shkiri. How can diphtheria be diagnosed in such cases - symptoms like this? The qia form also has a complex character, and it has a complex character on the back of the throat. In the vicinity of the vipadkas, there is a lack of isolation. Hvoriy vidchuv pain with sechovipuskanny, slight itching in intimate zone... Pomitno pochervoninnya, quilted mucous membrane, suspended tissue As a result of the proliferation of bacteria, necrosis of clitin occurs, on every mice of the disease, it is found in the disease. To see the growth of lymphatic universities in the groin zone.

wound surfaces

As soon as on the surface there are some wounds, there you can eat the infection clinic. As a result, the body is struggling with infectious fever, the wound is swollen, and it becomes more painful. Vinikak bilo-zhovty nalit, which through a few days has grown into a shchilnu plyvka. Still, a sick person has a blisk in his eyes, a heartbeat.

Symptoms of specific symptoms

If diphtheria appears in a sick person, the symptoms may be less severe, less symptoms of intoxication, or worsening. even when correct love It is possible to fit from the most recent manifestations at the early stage. In case of toxic damage to the entire body through the blood and lymphatic channels, specific character and receive all systems and organisms:

• heart-sudinna - rupture of the robot of supra-nirkoval zalosis, heart meat, toxic myocarditis develops;
• nervova - you can get cute and autonomous ganglia, a bloating and lazyopharyngeal nerve;
• vidіlna - often accelerated toxic nephrosis, especially in quiet people, who often did not take off antidifterіynu syrovatka;
• blood-bearing - 75% of ailments can suffer from leukemia, monocytosis of fixations in 31%, and in 66%, SHOE indicators were improved. May be anemia or thrombocytopenia.

Video

One of the most infectious diseases is the diphtheria. Scho tse take, like a bagatom. Quite sickness, to what kind of school and age, and children, it is easy to not only likuvati, ale and diagnostics. Chipping from the diffusion of the obov'yazkov and entering the calendar chipping.

When specific bacteria enter the human body, a rapid development of the disease will be repaired. Differentiation against the state government and vimag of non-guilty love, in which you can speed up the importance.

Diphtheria. What kind of ailment is there?

At the same time, the mucous membrane of the nasopharynx and oropharynx is affected. In addition, zagalnaya intoxication develops, it suffers from the nerve and heart-vascular system. Firing superfoods of fibrin flakes Diphtheria can be of a good nature, without excessive toxicity.

It is not safe in the fact that with a lot of sickness there can be asphyxia of the larynx, parallax of the dyshally nobles, toxic myocarditis or the lack of supra-nirkoval diseases, which can lead to a lethal result. With such a disease, such as diphtheria, vaccination with the best method of prevention, which will allow you to eliminate it, if not the disease itself, then I want it to be quicker.

cause

Zbudnik zhvoryuvannya - Batsil Leffler, yaka duzhe stiyka do call-in injection... In standard minds, the efficiency is saved in two ways, in water, or for young people - three, with lower temperatures- close to five months. It’s just an hour of kip'yatinnya, for chloral dredging.

It is possible to become infected by a dribble-drip walk from a sick person to diphtheria or from a healthy bacterium. If it gets on the mucous membranes of the nasopharynx, the diphtheria stick is bliscated. At the same time, exotoxin is seen, which expands with the flow of blood, provoking the defeat of the heart meat, supra-nirkovy vines, nirok and peripheral nervous systems. The sick person has a fever and a slight decrease in temperature. Infected infection is seen through objects and food, food.

Susceptibility to the zhvoryuvannya of the arch of the temple. The reason for the high rate of vaccination, weak immunity, the apparent durability of the diphtheria stick to the latest injections.

See and stretch

Falsely from the localization, diphtheria of the oropharynx, organs of the dichotomy, and nose is observed. The eyes of the native people, the state of the organ, the shkira are suffering. As soon as the enemy has a few organs at once, then such a form of enmity is called combined.

Oropharyngeal diphtheria (close to 95% of cases). Some of the sick person's temperature slightly increases, symptoms of toxicity build up, aches and pains in the slopes and cysts, there is headache, weakness, weakness, decreased appetite.

Diphtheria of the oropharynx is localized, widened and toxic, hypertoxic.

Most often, the disease is protested in a localized (easy) form. When visually looking at the cob, beads appear on the mildews with clear cordons and a smooth structure, the mucous membrane of the yaskra-chervony kolor. In a ten hour, the old sirim or zhovtuvato sirim poured in. Yogo is not good to know. Yakshcho try to break it with a pair of tweezers, get a wound. More visibility in the throat is manifested during cocking.

The form has been expanded to grow older. It is characterized by the fact that it is not only the dimples, the ale and the small arches, the tongue, the pharynx, the swelling and the hardening of the throat, the ailment of the middle. Nalit znikaє in about two months.

In case of a toxic form, the temperature changes up to 39.5-41 ° C, the symptoms of intoxication to the body increase, more views in the abdominal area, severe headaches, drowsiness, apathy, swelling up organisms, blinking shkirny curves. I can see the bili nalit in my life. The development of a sickness is a barking cough, through the nodule of the larynx it is easy to dichati to the sick person, to prevent the loss of his voice.

For a hypertoxic form, there are more symptoms of intoxication. Lyudin is in an unknown country. Yakshcho lіkuvannya do not wait for a moment, a potentially fatal result. see the cut circulatory system, There is a visip on the body, blood in the mucous membrane, in the intestinal tract.

diphtherin croup

Differential (іstinniy) croup can be localized and expanded. The severity of being overwhelmed by the incapacitation is to be found at the level of dyshally deficiency.

Signs of diphtheria larynx develop step by step. In catarrhal period, the sick person has a barking cough, and the temperature rises. After one or two days, the cough becomes strong, the dichannia becomes more difficult, for an hour I breathe in a whistling sound.

In another period - STENOTIC, ailing to torment attacks of spasmodic cough, such as 2 to 30 hvili. When a person becomes cyanotic, the bladder of the nasolabial tricycle is indicated, due to the appearance of the appearance.

Pislya ts'go infusion is an asphyxiant period, for which is characterized by drowsiness, apathy, bliss of shkiri, sudom, lower arterial grip. As soon as I don’t need medical help for a sick person, I’ll have a fatal result.

This form of diphtheria is a problem for young children, people who have been abducted and people with weak immunity, who suffer from alcohol malignancies and maladies.

diphtheria of the nose

This form of ailment is not so important. She is characterized by the appearance of a nasty undead, the mucus of the nose is curled up in twists, nalot, nagging, exposing the cheeks and eyes. The temperature is either in between the norms, or slightly adjusted, the intoxication during the day. The area near the nose is irritated, there are wet and skorinki. In the case of a toxic form, the disease of the pediatric cells of the child is sick.

diphtheria of the eyes

Such a form of ill-health can be weakened by an extraordinary conjunctivitis. For an affliction is characterized by a peace of mind and an enlargement of the conjunctiva and capital. In case of catarrhal form, insignificant serous-gn_ainy vision is observed. With a membranous form on the conjunctiva, there are syro-bilis, as it is important to know, the temperature is slightly adjusted. The form of mastria cob is toxic. Povіki nabryakayut, sposterіgayutsya vіdіlennya bloody-gnіy character. Dilianki shkіra near the eyes are worn out and get wet, waddles near ochnitsі napryakaє.

Differentiation of shkiri, statutory organs, wuh

Such forms of diphtheria develop rarely and most often develop in complex with other types of ailments. All the meanings of the options may be displayed for this ailment: embryo, darkening of the skin and mucous membranes, fibrinous deposits on the area, fired up and sickly regional lymph nodes.

In case of diphtheria of the head state organs, the pathological process of seeding in foreskin... In women, wines can be widened to the crotch area, back aisle, Catch the food and drink. At the same time, the appearance of serous-bloody visions. It’s hard to come across a difficult one for those who are sick.

In case of diphtheria, the pathological process develops in the area, on the basis of health problems, wounds, eczema or a fungus. There is a hard-gray poured on the school and serous-ginny vision. Significant intoxication is not spared at all.

Okremo can see such a form of illness, like hemorrhagic diphtheria. So tse take? With this form, there is a risk of bleeding in the affected area. I was successful, it is important for me, because I know diphtheria or because of the serious injury of the judge. For the whole it is necessary to brutalize respect for the camp of the sick and the manifestation of these symptoms.

diagnostics

At a visual glance at the appearance of the characteristic beats, a difficult action with a whistling noise on a breath, a barking cough, a diagnosis of "diphtheria" is put. Diagnostics includes and additional methods of follow-up, which can be used in order to identify specific atypical form ailments.

In such vipadkas, it is difficult to get rid of a glare in the fact that a smear is taken from a sick person for diphtheria from the throat. This is a way of allowing the sight of an innocent and vivifying his toxic power.

Serological method is necessary for determining the level of stress immunity, detecting antitoxic and antibacterial antibodies.

With the help of the genetic method, you can read the DNA of the animal.

lіkuvannya diphtheria

Regardless of the severity of illness, diphtheria in older adults and children are found in the minds of the stationary. The ailment is guilty of dotrimuvatisya children and dotrimuvatisya postіlny regime. In order to neutralize the diphtheritic exotoxin and induce the intoxication of the organism, inject (PDS). The drug is guilty of buty injections of yakomog earlier, so it allows the uniqueness of the development to be accelerated. Particularly effective wine stretching 4 dB for a corncob. The drug is vikoristovyut navit at a dose of infection due to contact with human ailments.

In addition, a person who is sick is given a course of antibiotics, the number of children who are sick will decrease, and symptoms of intoxication will change. Name the vicoristovuyt "Ampicilin", "Amoxicilin", "Cephalexin", "Oksitsilin". If necessary, prescribe hormones (preparations of predisolone), antihistamines ("Diazolin", "Suprastin" and in.), Fever-lowering substances, vitamins.

To prevent stenosis, the ward is guilty of being kindly cured, ailing, the warmth of the pitta at the sight of tea, or milk with soda, steam ingalyatsiya. To change the hypoxia, to inject the solution with the help of the nasal catheter. As soon as the procedures do not help the polypsy of the sick person, it is called "Prednizolon".

Yakshcho, the patient of the State Winnickl has a dysfunctional lack, in which case it is necessary to have a term of entry into the picture. For tsієї meti vikoristovuyut nippers, elektrovіdsmoktuvannya. Zanadto important vipadki not to do without prompt engagement... A sick person should enter a dichny tube into the larynx or the trachea.

In case of important toxic diphtheria, diphtheria croup, infectious-toxic shock, and the other non-safe accelerated hospitalization of a sick person, they should be hospitalized in intensive care.

accelerating

A toxin, like a diphtheria viroblya stick, is inaccurately getting wet in the shelter, so it’s important and not safe. The smell is specific (toxic) and non-specific.

The development of specific ones most often occurs in toxic forms of illness, if possible, in other forms. Before acceleration of myocarditis, neuritis, nephrotic syndrome.

Myocarditis can be early or early. Early can win for 1-2 days. The perebig is important, the progress of the heart is inadequacy. Ailments have abdominal pain, bloating, and a part of the pulse. A systolic murmur in the heart is made, the rhythm is broken, and the arterial grip is reduced. The cookie is becoming more sensitive and sensitive.

Myocarditis, which develops at 3-4 times, grows with a good interruption.

The type of accelerated diphtheria is early and early peripheral paralysis. On the other hand, there is a strong development of early parallels. cranial nerves... The patient's voice grows old, it is difficult to understand when it is difficult, the reflex is visible from the soft child. Some illnesses cannot be read and other objects cannot be developed.

After 4-5 tendencies, there may be a decrease in tendon reflexes, indicating a weakness of the muscles, a deterioration in coordination.

As the enemy of the shia and the tulub, the person cannot be put in a sitting position, you can easily trim your head. Mossy development is parallel to the larynx, pharynx, diaphragms. Tse produce a voice until you lose it and show a soundless cough, a sick person is very important, he lives of retractions.

At the state of the stage of illness, one can develop. At the sech, a number of white blood cells are promoted, the norm of blood cells and leukocytes is increased. At the same time, the function does not break down.

Pneumonia, otitis media, lymphadenitis and inn.

forecast

The forecast is due to the fact that it is very important to prevent diphtheria from getting sick, because of the terms of the cob of syrovatina, and also because of the development of the growing period.

On the next day, a lethal result can occur mainly with a toxic form of diphtheria. The reason is infectious-toxic shock and asphyxia. After two or three years from the ear of ailment, death can occur as an important myocarditis.

prophylaxis

It’s more beautiful to cross the ailment, not to likuvati, especially so I’m not safe, like diphtheria. So tse take, mi vzhe z'yasuvali, ale how can you get it? The main world of prevention is vaccination, which is carried out according to the scheme, repaired in 3 months, in three stages. Vaccination against sickness should be included in the National calendar. Vikoristovuyut DTP vaccine, or іnshі, besides diphtheria toxoid. Doroslim needs a revaccination, schob pidtrimuvati immunity against diphtheria.

Do you want to rob the chips of diphtheria? Significantly, splitting is not a guarantee that you will not get sick, but ailments will be easily contradicted without important acceleration. Revaccination of grown-ups is carried out for skin ten years.

Competent prophylaxis of diphtheria allows not to admit an extension of the infection. It is necessary for the ailing one to securely isolate and cope with the people who were in contact with him. Emerging noses of corynebacterium diphtheria also insulate and indicate the need for treatment.

In children and schools, to introduce quarantine, suspicion, in which there is ailment, disinfection. The sickness is guilty of being overwhelmed in the stationary until the end of the day, as it suffers from two analyzes with a negative result.

The people, who have suffered a disease, have an unstable immunity. Ten years later, the wines can be reoccurred, but the ailment can be easily overcome.

When the terms of vaccination and revaccination are under-tackled, the tension of anti-hyperthermic immunity decreases, and changes are made for the development of ailments. In splintered diphtheria, it is in a light form, accelerated to ridkisnі.

Difterії - tse zagartovuvannya, pomirna physical design, Povnotsinne harchuvannya, perebuvannya on a fresh turn.

diphtheria

diphtheria (Diphteria) is a state of infection for infectious diseases, which is susceptible to toxigenic corynebacteria, which is characterized by fibrinous inflammation in the microscopic infection toxic lesions over the heart-vascular and nervous systems.

Historical views. Riddles about diphtheria є in the words of Hippocrates, Homer, Galen. Under the name "deadly twist of the gourd", "stifling ailment" її described lykari I-II century. not. On the cob XIX cent. diphtheria was seen in the capacity of self-reliant ailment by the French vcheny PF Bretonno, which I will call it “diphthera” (in Greek. In the end of the XIX century. Yogo student A. Trusso anatomical term"Diphtheria" replaced by the term "diphtheria".

Zbudnik of Infectious Disease by T.A. Klebs in 1883 and F. Leffler in 1884. Through a sprinkle of rock by E. Bering and E. Ru, an anti-diphtheria syrovatka was taken away, as it allowed to reduce the lethality of entrapment. In 1923 G. Ramon proponed immunization with anatoxin, which became a guide for the active prevention of ailments. As a result of vaccination, the incidence of illnesses in the Bagatio regions of the world, including in our country, has sharply decreased. However, repaired since 1990, V great places Russia, the first for everything in St. Petersburg and Moscow, due to defects in the vaccine prophylaxis, epidemic spalakhs of diphtheria began to be restructed, especially in older adults. At the same rate of congestion of the sklavs up to 10-20 people per 100,000 population with a lethality of 2-4%.

Ethiology. Zbudnik zhvoryuvannya - corinebacterium diphtheriae, or Leffler's stick. Differentiated corynebacteria - gram-positive, unruly, dispute does not settle, їх kіntsі clavate vyshchenі for rakhunok purchase of polyphosphate (so called grain of volutin, grain of Babesh - Ernst). In the smears, they grow in pairs, often, as a result of the viglyad evil - the viglyad of the Roman numeral V. In the case of Neisser farming, bacteria are barbed into brown cheeks, and the purchase of polyphosphate - in blue color.

Corinebacteria are kind to grow in the middle, to take revenge on the family and the shelter (the middle of Ru and Leffler). Optimal wash up in the middle of Klauberg (blood agar with additional salt teluru). There are three culturally biochemical types of C. Diphtheriae: mitis, gravis intermedius, of which the most virulent type is gravis.

Toxigenic and non-toxic by C. diphtheriae strains. Diphtheria wicked against toxigenic strains, so that corynebacteria, which produce exotoxins. Toxigenicity of the power of lysogenic strains of C. diphtheriae, which carry phages (zokrem,? -Phage), in the chromosome of such inclusions is a gene that can detect toxicogenesis.

The stage of toxigenicity of different strains can be developed. A single lethal dose (Dosis letalis minima - DLM) is the lowest amount of C. diphtheriae toxin, which can be used guinea pig weight of 250 g with a broach of 3-4 dB.

Dermonecrotoxin, hemolizin, neuraminidase and hyaluronidase are developed at the storehouse for C. diphtheriae exotoxin.

C. diphtheriae stiikі to low temperatures It takes a trivial hour to sit on the surface of dry objects. At the presence of a doctor and light, the stench quickly becomes active. When injecting disinfecting drugs in working concentrations, move for 1-2 minutes, and when boiling - mittuvo.

Epidemiology. Dzherelo іnfektsії - an illness of a lyudin abo nosіy toxigenic stamu zbudnik. The disease is contagious from the last day of incubation to the next sanitation of the body, as it is possible in the middle of the term.

Bacteria represent a serious epidemiological threat, especially in non-immune organized groups. It is necessary to note that the number of cases of toxigenic strains of diphtheria bacteria in hundreds of times changes the number of ailments to diphtheria. In the middle of diphtheria, the number of noses can reach 10% or more of the number of healthy individuals.

From a practical point of view, they develop transiently, if toxigenic diphtheritic microorganisms are seen in the middle of the day for 1-7 days, for a short time - for 7-15 days, for a longer period of 15-30 days - for a longer period of time. There is also a greater triviality of corynebacterium diphtheria in people who are in close contact with ailments for diphtheria and in those with chronic infections of the upper mental health.

Seasonal periods of illness fall on the main winter period. The main ways of transmission of infection are drip-drip and drip-saw. You can get infected with diphtheria through objects - igrashki, bіliznu and ін. Do not switch to food transmissions with information about products (milk, cream, etc.)

Sleepiness before diphtheria is in the form of anti-toxic immunity. In this hour, the active vaccine prophylaxis of children of the youngest age is getting sick and older and the children of the senior age have lost their immunity.

Pathogenesis and pathological anatomical picture. Diphtheria is a cyclical localized form of an infectious process, which is characterized by the development of fibrinous inflammation in the muscle of external infectious diseases and toxic lesions of the heart, nerve and other systems.

At the entrance gate of the infection, wince є the pharynx, the emptying of the nose, the larynx, the appearance of the mucous membranes of the eyes, the body organs and the shkira (wound, vuha, etc.). Having penetrated into the organism of a human being, the animal settles in the area of ​​the entrance gate (mucous membrane of the oropharynx, nose, etc.), producing exotoxin. In some cases, there is a short-hour bacterium, but the role in the pathogenesis of ailments is small.

Klinichny show diphtheria injected with exotoxin, so that it can be stored in fractions. The first fraction - necrotoxin - wickedness in the muscle of the outflow tract necrosis of the epithelial ball, the increase in the penetration of the sudin, the paretic dilatation, the laxity and the stasis of the blood. As a result, there is a perspiration of blood plasma in the navkolishny tissue. When fibrinogen gets into the plasma, when it comes into contact with thromboplastin, the necrotic food is converted into fibrin, which is set on the mucous membrane of fibrin.

At the mucous membranes of the oropharynx, covered with a large ball flat epithelium, a diphtheritic firing develops from the epithelial ball and fodder. with good fabrics To that, the fibrin rolls are soldered to the flexible fabrics and to know the pracea. In slimy obolontsi, covered with single-ball cylindrical epithelium (larynx, trachea, bronchi), winery is more coarsely fired with deprivation of an epithelial ball, with many fibrinous spills it is easy to see tissues.

As a result of the development of necrotoxicity, a decrease in pain sensitivity and an increase in fabrics in the area of ​​external gates, regional lymphatic universities and pediatric cells.

Another fraction of diphtheria toxin, similar to the structure of cytochrome B, having penetrated into cells, substitutes for a dichal enzyme, such as blockade of cell dysfunction and death of the cell, summarizing the important damage to the structure of the central nervous system , nirok and ін.).

The third fraction of the toxin is hyaluronidase, which increases the permeability of the Sudin and Tissue, as well as the softening of the tissue.

The fourth fraction of the toxin is a hemolyzing factor and the development of hemorrhagic syndrome in diphtheria.

In such a rank, cleverly show diphtheria viznachayutsya mіtssevym and zalnom dієu diphtheria exotoxin on the organism of people. In genesis of toxic and hypertoxic forms of ailments more important rely on sensitization to organism.

Heart-bladder damage in the early period of accumulation of hemodynamic pyrosis (stasis, midsection, hemorrhage), and from the end of the 1st - the ear of the 2nd type of ignition-degenerative and some necrotic processes.

In the peripheral nervous system, there are signs of neuritis from the lesions to the process of myelin and schwannomas, in the context of ailments, immunopathological processes develop. It helps to promote the development of hemodynamics and destruction of clitin in the cerebral and cerebral spines of the supernatant; dystrophy of nirkovy epithelium.

In response to the injection of diphtheria toxin into the human organism, antimicrobial and antitoxic antibodies - antitoxins are violated, as at once they will not neutralize the exotoxin, which eliminates the olives from the plant. In convalescents, antitoxic immunity is formed, and there is a possibility of recurrence.

Functional problems and destructive changes in the heart-vascular and nervous systems, in the nerves and other organs, especially in case of inadequate treatment of the sick with toxic forms of diphtheria, in case of hypertoxic contraction of hemorrhagic diseases of the disease

In a large part of people diagnosed with toxigenic strains of C. diphtheriae people develop an inapparent form of ailment - bacteriosis.

Klinichna picture. The incubation period lasts from 2 to 10 days. A number of forms of ailment are developed: according to localization - diphtheria of the pharynx, nose, larynx, dichromatic paths (trachea, bronchial tubes) and rare localizations (eyes, shkiri, wounds, state of organs, vuha); by the nature of the leak - type (plural) and atypical - catarrhal, hypertoxic (fulminant) and hemorrhagic; beyond the degree of gravity - easy, average gravity i important. With urazhennі decіlkoh organs see a combined form of ailment. Importantly, diphtheria of the pharynx (90-95% of all types of ailments).

Pharyngeal diphtheria. They develop localized, widened, subtoxic and toxic forms.

The form is localized. When the form of nalloti is formed, it will grow only on the migdalens. Ailment to fix zagalny nezduzhannya, Decreased appetite, headache, minor (in older adults, more swelling) pains in case of kovtanny. The temperature rises up to 38 ° C, rises to 39 ° C, trims for a period of time up to 2-3 dib and normalizes to navigate without a trip while sparing the worms. The ailments have little improvement in regional lymph universities, often on the sides. The stench of sore, crumbling.

It grows filmy, insular and catarrhal forms of localized diphtheria of the pharynx. type filmy (sucylna) form, with a slicker of gray color, smooth with a mother-of-pearl blaze, with clear edged edges, covering the entire culyast and nabryakla mydalina. Plіvka z praceya znіmaєyatsya, exfoliate the surface, scho bleed. Osvita new nalota on the mind of the nobleman - diagnostic sign is important. The plate should not be rubbed with object slings or tones when water is burnt. At the bottom of the term, nalots become coarse, fluffy and easier to know. The smell of serotherapy lasts 3-4 days. Migdalini around the place. The meaning of the hyperemy with the cyanotic view is evident.

insular form to be characterized by the appearance of the eyes on the dysplasia in a white or siruvato-white color. Intoxication is weakly reversed, even during the day, the reaction of lymphatic universities is insignificant.

Catarrhal form. Submitted before atypical option overcoming diphtheria, in which case it is only a small hyperaemia and swelling of migdalin. Temperature and toxicity reactions can be carried out on a daily basis. In the established diagnostics, additional support is provided for the epidemiological data and bacteriological preliminaries. Localized forms of diphtheria of the pharynx without specific treatment can progress and become wider.

The diphtheria of the pharynx is widened. Growth in 15-18%. In the case of this form, it is deposited behind the dysplasia on the mucous membrane of the infantile arches, the tongue, and in some cases of the pharynx. Symptoms of an extended form can be the same, such as localized diphtheria, proteine ​​toxicity and swelling of migdalin large swells, lymph nodes great razmіrіv and more pain. Nabryak shiynoi klitkovini vіdsutnіy.

Toxic form. Often it’s gruesome to repair. The temperature in the first year rises to 40 ° C. head b_l and pain in the throat, sometimes in the abdomen, shia. In the first years in the throat, there is a hyperemia and a swelling of the migdines, a tongue, an arch, which is the front of the appearance of nallots. With a sharply swiveled embankment, the mirage of the dales stays, so that it does not get rid of the enlightenment. Pour a handful of small cobweb-like henchiefs near the jelly-like fish, it is easy to know, but at the same time it is easy to find out. On the 2-3rd day, ailments poured tovsti, a bruised-gray color, I increase the surface of the migdalin, move to the arches, a small tongue, the palate is soft and hard. The hypothermia of the pharynx changes until the end of the hour, there is a bluish vidtinok, and the bulge grows. Mova of the coatings, lips dry, cracking, the company has a specific liquorice-boring odor, dichotomy is difficult, noisy, wheezing, voice with a nasal vidtinkom. All shiin lіmphatic universities are healthy, elastic and sick. The embankment of the shiinoi klitkovini is growing. The variability and the widening of the filling of the skin cells are adequate to the toxic symptoms and lie at the basis of the development of toxic diphtheria. Nabryak shiynoi klitkovini I step reach the middle of the shoulder, II step - extend to the collarbone, III stage- below the collarbone.

Particularly in the midst of the current overload of toxic forms of diphtheria in older adults, the development of combined forms in the lesions of the oropharynx, larynx and nose is frequent. Such a form may be rapidly progressing malignant interruption and disgusting therapy.

Subtoxic form of pharyngeal diphtheria. When the form is on the basis of toxic toxicity and changes in the throat, there is a small turn, the swelling or pastiness of the small cells is insignificant. More bends on the side of the skin can only be found on one side.

Hypertoxic and hemorrhagic form. Respect for the most important manifestations of diphtheria. In case of hypertoxic form of acute flare-up, symptoms of intoxication: hyperthermia, sudomy, collapse, nonsvidomy stan. The floats are great; characteristic progressive swelling of the oropharynx and shiinoy klitkovina. Perebіg ailments bliskavichne. The fatal result occurs on the 2-3rd day of the ailment in the case of the development of infectious-toxic shock and (abo) asphyxia. In case of hemorrhagic forms, nalloti seeps out with blood, it is evident that there are many hemorrhages on the skin, bleeding from the nose, pharynx, it is clear, in the intestinal tract.

Diphtheria of the larynx, or diphtheria (true) croup. The dissection of the larynx can be isolated and combined (dichally, pharynx and / or not). Falsely from the broader process of developing diphtheria croup of localization (diphtheria of the larynx); diphtheria croup of enlargements: diphtheria of the larynx and trachea, diphtheria of the larynx, trachea and bronchial tubes - diphtheria laryngotracheobronchitis.

In the classic picture of croup, there are three stages: catarrhal, or dysphonic, stenotic and asphyxial.

Dysphonic stage to repay step by step with an adjustment of the temperature to 38 ° C, in order to avoid toxicity (lack of food, decrease in appetite), rough barking cough and hoarseness of the voice. Triva won 1-3 dib i nadal go to a friend - stenotic stage. There is a lack of energy due to the complication of the podikh, the retraction of the intercostal spaces, over- and underclavicular depressions, the jugular fossa, the spur of the pre-accessory dichotomous muscles (sternocleidomastoid, trapezoidal) The voice is hoarse or aphonic, the cough is steadily becoming soundless. The stenotic period is three times the decile years up to 2-3 dB. In the transition period from the stage of stenosis to the stage of asphyxia, one must feel more uncomfortable, feeling fear, fever, cyanosis of the lips and nasolabial tricot, reading the pulse at the entrance ("paradoxical pulse"). With the absence of free help, an asphyxia stage is present. Dikhannya is becoming frequent, superficial, arrhythmic, ale mens noisy, the retracting of the pliable muscles of the breast cage changes. The camp of the ailments is progressively degraded. Shkіrnі pokrivi dark-gray color, cyanosis is not only the nasolabial tricot, but the tip of the nose and lips, fingers and nig. The tone of the tongue is very low, the color is cold. Pulse of parts, threadlike, arterial grip falls, zinitsi expansion. It is necessary to destroy the identity, to develop by the judgment, to promote the passing of the feces and sech. Death came from asphyxia.

Timely implementation of specific therapy for the last development of all stages of diphtheria croup. After 18-24 years, after the introduction of antidifteritis of the clinical signs, show ailments and fix them to stop.

Diphtheria of the larynx in adults has a number of features. The classic symptoms of croup are the same as in children: a hoarse voice, a stenotic dichotomy, Afonya, participation in the act of dysfunction of pre-accessory muscles, however, retraction with the inhalation of a childish dilean of the breast is not very clear. In some ailments, the only symptom of a laryngeal injury is a hoarseness in the voice (nausea with low croup). About the development of dysfunctional and heart-vascular deficiencies, it is possible to allow allowances for the disease of the shkiri, cyanosis of the nasolabial tricot, weakening of the dysfunction, tachycardia and extrasystoles. Tsі symptoms serve as indications for operative treatment (tracheostomy).

Diphtheria of the nose. An ear of ailments of deeds, with minor symptoms of intoxication. The temperature of the room is adjusted or normal. From the nose, often from the same health, there are serous, and then serous-gniyny, succinct vision (Catarrhal form) wick to get wet, fixing gaps, wrinkles in front of the nose and on upper lip... Noses walk when looking around the sound through the swelling of the mucous membrane, on the nasal septum erosions, curls, scorching and bloody vision appear on the nasal septum (Catarrhal-virazkov form) abo the beating foggy deposit, usually sit on the mucous membrane (membranous form). During the process of going beyond the mucous membrane of the nose, swelling rice with an expanded abotoxic form.

Overbig nasal diphtheria is trivial, overwhelming. The presently introduced antitoxic syrovatki should be produced to a high level of wear and tear.

Differentiation of eyes, shkiri, wounds, vuh, callous state organs spontaneously grow.

Diphtheria of the eyes. Fibrinous deposits are located on the conjunctiva and can be expanded on VERY YABLUKO; the process is often one-sided. On the other hand, there is no problem with the conjunctival mice, there is little gn_ynevidokremlyuvan with the home blood. The ailing camp will collapse insignificantly.

Diphteria shkiri. It develops in case of epithelial coverage. Achievement of fibrin flavors, spite of the swelling of a bunch of mucous membranes in the mice of threshing, podryapins, wounds, perversions, eczema dylyanoks. The ignition process in females is localized on the mucous membranes of the primary organs. Diphtheria of the umbilical wound can be seen in newborns.

Clinical picture of diphtheria in chippers. Lack of mitigation of terms of vaccination and revaccination, as well as postponing of illness, unpleasant environmental and social factors, to reduce the tension of antidifferent immunity and the establishment of changes in mind. Overbig diphtheria in chipped grains make it smoother to finish, the faster it grows faster. Intoxication changes on the 2-3rd day of the ailment, insignificant swelling, the most frequent islets, insignificantly welded to the soft tissue, it can melt mimically, the pharynx is cleared up to the 3-5th day of illness. Such a key picture is meant to be creepy among quiet people, if the ailment of the vine is on aphids of excessive antidifferential immunity. When there is an increase in the visibility of the immune system, the symptoms of diphtheria do not appear as such in nonsplitting.

Folding. See specific (toxic) and nonspecific accelerated diphtheria.

Specific acceleration. It can develop in case of any form of diphtheria, but more often it is promoted in case of toxic forms of diphtheria. Before them myocarditis, mono neuritis, nephrotic syndrome are recognized.

strikes heart-vascular system in the early period of toxic and hypertoxic forms of accumulation of perspiration for all judgmental deficiency and in menshy world toxic lesions of the myocardium (syndrome of "infectious heart"). Shkіrnі pokrivi blіdі, cyanotic, pulse is weak, threadlike, arterial vise shvidko falls. Shock can develop as a cause of death.

Myocarditis can be early and early. Early myocarditis in the first stage - the ear of the second type of ailment and the opposite is important because of the progressing heart failure. Ailments adіnamіchni, skarya on pains in the abdominal area, vomiting. Pulse of parts, arrhythmic, borders of heart enlargement, systolic murmur is heard. Characteristics of a rotational rhythm disturbance (extrasystole, sinus arrhythmia, gallop rhythm). Arterial vise very low. The pechinka is zzvychay zbіlshena, sensitive.

Pizniy myocarditis, which develops on the 3-4th, may be more good.

Early and early peripheral parallelє typical accelerated diphtheria. Early parallel cranial nerves occur on the 2nd type of ailment. Most often, there is a paresis of mild day-to-day and parallax amoodation. The voice is old gugnyavim, ailments can not blow out the candle, how to burn, when the child is turned on, it wriggles through nis, the outward reflex from the soft child, when it is not in the wrong side, it sounds like Some illnesses cannot read and develop other objects. Ophthalmoplegia, ptosis, neuritis of the facial nerve are more common.

Parallel malformations are similar to polyradiculoneuritis and occur on the 4th-5th ailments. There is a decrease in tendon reflexes, myazova weakness, coordination disorder, nepevnu move.

In case of severe diseases of the shia and tulub of the ailments, it is not in the snake to sit, trim the head. There can be a variety of parallel larynx, pharynx, diaphragms, at the same time the voice and cough melt soundless, the ailments do not get out of the way, and the sludge can be drawn in. The challenge can be isolated or developed in other days. Polyradiculoneuritis is known in 1-3 m / s with new updates to the structure and functions of the language.

nephrotic syndrome It grows in the state of the century ailments and is characterized by the head rank of slaughter (there is a great number of white blood cells, galinic and granular cylinders, erythrocytes and leukocytes). The function of nirok is not damaged.

Nonspecific acceleration. For nonspecific acceleration of diphtheria, pneumonia, otitis, lymphadenitis, etc.

Forecast. In the first 2-5 days, deadly herds come in various toxic forms of diphtheria from infectious-toxic shock and asphyxia - in the form of expanded cereals; on the 2nd-3rd and 3rd of pregnancy - in the case of severe myocarditis.

The threat of a lethal result in ailments with diphtheritic polyradiculitis is enveloped in nerve damage, such as the larynx, mutilation and diaphragm (parallel dichotomy), as well as the wired system, heart (parallel).

Diagnostics. Virіshalnja nabuv staging diagnostics for clinical and epіdemiologic data. leading key symptom diphtheria - the appearance of fibrinous, thick blue-siruvate nallots, rots on the surface of the mucus membranes, or shkiri.

The bacteriological method is used to diagnose the disease. Pick up from a small amount of material, get swabs from the nose and throat, start at the elective middle (Leffler, Klauberg, etc.) І put in a thermostat at 37 ° С. -72 year - residual, for the production of biochemical toxigenic powers of zbudniks. Three serological methods of vicorisation of RNGA for detecting an increase in the titer of antibodies in the dynamism of ailments. Prospective vivchennya toxinemia.

Differential diagnosis. Diphtheria of the pharynx followed by differentiation from streptococcal angina, angina Simanovsky - Plaut - Vincent, infectious mononucleosis, anginose-bubonic form of tularemia, epidemic parotitis. Diphtheria of the larynx is derived from grated cereal, viral infections, Bark and іnshikh zhvoryuvannyah.

Differential diagnostics of toxic diphtheria should be carried out with paratonsillar abscess, infectious mononucleosis, epidemic parotitis.

Naybilsh foldably differentiates toxic diphtheria from paratonsillar abscess (paratonsillitis). In the differential diagnosis of paratonzillitis and toxic diphtheria of the pharynx, it is necessary to respect the following symptoms:

1) paratonsillitis is often accelerated chronic tonsillitisі develop in the wake of repeated angina, for which toxic diphtheria of the pharynx is most frequently repaired by the state; 2) in case of paratonsillitis, the bolovy syndrome of sharp bends from the ear itself and the growth in the world of the development of discomfort: difficulty and volume in case of contamination and dotism, trismus of jugular muzzles, due to the position of the head. Pain relief insisted on taking an abscess or on active antibiotic therapy. In case of toxic diphtheria of the pharynx, the pain syndrome of bends in the small world and only in the cob period, sometimes it is weak, without affecting the farther the thickening of the mucous membrane of the pharynx and nalotiv;

3) paratonsylitis of the power of a one-sided swelling of the pharynx, at the stage of an abscess, it means local vibration and fluctuation; in case of toxic diphtheria, the swelling is often bilateral, it is one-sided consistency and the pinkish character, it changes without its size; 4) in case of paratonsillitis, the increase in pressure does not occur in broader amounts of water beyond the intervals of the distance, with a significant increase in the amount of distance and small amount of sleep, it can be seen in the daytime. The inconsistency of the pediatric cells is meant to be rather small and not to

expanded; 5) the temperature of the body during paratonsillitis is trimmed to the abscess, or it changes in parallel with the ignition process, when antibiotics are injected, in case of toxic diphtheria of the pharynx, it goes down for 3-4 days, it does not affect the process; 6) the nature of intoxication of children: anxiety, hyperaemia, tachycardia - with paratonsillitis; adynamia, bliss, hemodynamic damage - with toxic diphtheria.

Likuvannya. The basis for the treatment of ailments for diphtheria є ethiotropic - specific and antibacterial - therapy, which is carried out in a complex with pathogenetic methods in the minds of isolation of the ailment in the infectious hospital and emergency hospital for emergency

The most important in the treatment of ailments is early early specific, but serotherapy with adequate doses of anti-toxic anti-hyperthermic disease (PDS) "Diaperm" is considered until the form and terms of ailments.

The most effective serotherapy is promoted by stretching the first to add a few years of ailment, in case of a drop of localized forms of ailment there is a sufficient amount of a one-time introduction of the PDS. Unfortunately, with hypertoxic and hemorrhagic forms, as well as with unfortunate (on the 3rd additional ailment and less) toxic forms of diphtheria, serotherapy is not very effective and ineffective.

Antidiphtheria antitoxic syrovatku should be administered consistently to the out-of-the-box rules for storing heterologous bilkovy drugs, directing them to ameliorate anaphylactic reactions.

We treat hypertoxic, hemorrhagic and toxic forms of diphtheria PDS, both of which are sensitive to heterologous results, but in cases of sensitization and toxicity, it can be injected at least in the complex

In case of localized and extended forms of diphtheria, PDS should be administered 1 time per dose of the internal tongue, with subtoxic form - two per dose with an interval of 12 years.

In case of toxic, hypertoxic and hemorrhagic forms of diphtheria, part of the additional dose of PDS should be injected intravenously in drops on the basis of glucocorticosteroid and disintoxication therapy, which is important in the minds of the mindset of intensive reanimation.

The beneficial effect of serotherapy is manifested even in the first year of the year of life, at the viglyad, the step change in fabrics, areas of nallots, їх stonshuvannya ("tanennya") and (abo) knowledge. With the development of a positive effect, polishhennya will become a sick person dobova dose PDS can be changed by adding. PDS skasovyut on zniknennya nalot_v.

The triviality of serotherapy varies from 1 to 3 in case of localized forms up to 5-7 dB, and in case of toxic, hypertoxic and hemorrhagic forms of diphtheria; in the remaining droplets, the total dose of the PDS can become 1-1.5 million AU and more. With trivial and massive serotherapy, it is not easy to develop manifestations of syrovatous ailments, which can lead to additional hyposensitizing therapy.

The order of the PDS is the positive effect of the test preparations from the donor blood - antidifter plasma and immunoglobulin, titrated for antitoxic antibodies.

One hour from serotherapy to carry out antibiotic therapy with vicorias of benilpenicillin, erithromycin, cephalosporin of the elderly, rifampicin, etc. in zalnoprinyatyh doses lasting 5-10 days.

Mistseve priznachayut rinsing antiseptic drugs in furacilin, rivanol and іn.

For deintoxication and reduced hemodynamics, native plasma, neocompensated, rheopolyglyukin, hemodez, 10% glucose products are used. At the same time, inject cocarboxylase, ascorbic acid, insulin. For toxic forms, corticosteroids are indicated (hydrocortisone at 5-10 mg / kg, prednisolone at 2-5 mg / kg of mass for dob for 5-7 days). To improve the disseminated intravascular coagulation syndrome, inject heparin. Effective plasmapheresis, hemosorption and other effective methods of detoxification.

When there is a sign of myocarditis, it is indicated to be indicated before the appointment of ATP, cocarboxylase, antioxidants, non-steroidal anti-inflammatory drugs (indomethacin and in.) And I (abo) glucocorticosteroids. In case of damage to the heart rhythm, cardiac stimulation is not effective. In case of neuritis, mlyavih parallichi in the first days, inject Vitamin B 1 , Strychnin, proserin, dibazol. Important polyradiculoneuritis with destructive effects piece ventilation lungs, hormone therapy.

We are sick of the necessary suvoriy postіlny mode of stretching 3-4 hours in case of accelerated toxic forms і 5-7 days and more - in case of development accelerated.

The peculiarity of drug entry in case of diphtheria of the larynx is explained by the need to suppress the manifestation of stenosis. The price can be reached with a good aeration ward, signs of warm pitta (tea, milk with soda), steam ingestions with additional sodium hydrocarbonate, hydrocortisone (125 mg per ingalation), injected with euphrinology, antibiotics. For a change in hypoxia, there is a stagnation of fluid lesions through a nasal catheter; Even if heat and volatile procedures do not produce a therapeutic effect, prenizolone in a dose of 2-5 mg / kg should be used to reduce stenosis. With progression of stenosis in the pre-asphyxial stage, terminova of nasopharyngeal intubation is shown, and with twisting in case of swelling of the pharyngeal tissue or larynx;

Likuvannya bakterinosiyiv. Transient transport does not require treatment. In case of an easy nosy of toxigenic strains of diphtheritic sticks, it is necessary to move the back of the body (eating, walking, ultraviolet optimization) and sanitation of the nasopharynx. Antibiotics (erithromycin, tetracycline and іn.) Are attributed to the sensitivity of microorganism to them - the zeitgeist.

Prevention. The main point in the prevention of diphtheria is to introduce immunization.

I especially respect when carried out vaccine prophylaxis of diphtheria to end up for an adequate level of immunity (90-95%), in the first place in organized groups (children, students, all infected individuals), Orupskids modern methods Immunological screening is allowed to detect seronegative individuals, which are susceptible to additional vaccination. Prototype indication before carrying out splitting against diphtheria in the area of ​​the border and prescribed in the country before vaccine preparations; We are even more important є the correct їх form with the rims of medical leads.

In the meantime, go in, turn on the hospitalization of ailments, bacteriological preliminaries of material from the nose and throat of all contacts, and the final and final disinfection.

For the hospitalization of a sick person (carrying a toxigenic stamina of an illiterate), a medical observation of the term for 7 days will be established for 7 days from the vicarious methods of emergency clinical and immunological control for all contacts. In case of susceptible to diphtheria (seronegative and not previously split), vaccination should be carried out.

It is worth noting that in toxigenic diphtheritic sticks, carry out analogous visits from isolation and treatment at home.

The laboratory criteria for the sanation of a toxigenic strain of diphtheria microbe are to serve negative results of 3-fold bacteriological examination, if not earlier than 36 years old, when the antibiotics are taken with an interval of 2 dB per nose. Nose of nontoxigenic strains of isolation is not suitable for use, so follow the clinical indications.