Pseudotuberculosis in children or Far East scarlet fever is an infectious disease and develops when infected with a gram-negative bacillus.
The disease is quite difficult, the child's body is intoxicated, the joints and organs of the abdominal cavity, as well as the skin are affected. The musculoskeletal system is no less attacked by the infection.
It is worth noting that despite this name, the pathology has nothing to do with Koch's bacillus, which causes tuberculosis. This begs the question: why did she get such a name? The fact is that the disease in question leads to a morphological change in organs that are similar to tuberculosis. If the pathology is not treated in a timely manner, serious complications may appear.
In this article we will look at the symptoms, treatment and prevention of pseudotuberculosis in children, as well as talk about the ways of infection and possible consequences.
A bit of history
Far Eastern scarlet fever, as you already understood, is synonymous with the main theme of our material. Sometimes referred to as pseudotuberculosismesenteric lymphadenitis, but the essence remains the same after changing the names.
Specialists in the field of medicine are of the opinion that the most correct name for the pathology is yersiniosis. This is due to the fact that the causative agent of the disease is Escherichia coli from the genus Yersinia. Among the symptoms of pseudotuberculosis in children are chills, rash, intoxication and fever. We will talk about signs in more detail below.
For the first time they began to talk about such a disease in 1883, when the main pathogen was discovered. But only seventy years later, namely in 1953, they discovered the first patient who was diagnosed with Yersinia. At that time, doctors already knew the existence of gram-negative rods, which were the causative agents of pseudotuberculosis.
A lot has already been known about these anaerobes, for example, that they do not form spores and are distinguished by unpretentiousness to the environment. Bacteria multiply intensively at a temperature of twenty degrees, but there are many cases that have recorded this process at lower temperatures. They can stay in water or soil for a long time, survive after freezing. From this we can conclude that gram-negative rods are very resistant bacteria, and removing them from the body is not as easy as it might seem.
Causes of pathology
To date, it has been established that the carriers of the disease are animals. Particularly dangerous in this sense are small rodents, large hornedlivestock, poultry, horses, dogs and cats. Pigs also belong to this group, but an infected person does not pose any threat. It is worth noting that pseudotuberculosis in children and adults is transmitted by the fecal-oral route, that is, through food that was in the habitat of the bacteria.
It is quite easy to catch an infection by eating unwashed fruits and vegetables, dairy and meat products that have not undergone heat treatment, juices, compotes, dried fruits. Pathology can occur at any time of the year. At risk are children and adolescents under the age of seventeen who consume fast food in large quantities. Sometimes doctors diagnose the disease in people who eat in canteens. Pathology is detected based on the manifestation of signs and symptoms. Treatment of pseudotuberculosis in children should be timely and effective, then the prognosis is quite favorable.
Main routes of infection
In this case, the infection enters the body through the oral cavity along with drinks and food. After that, the virus goes to the intestine, clings to the lymphoid formations. Then active reproduction begins, and the pathogen enters the mesenteric nodes through the lymphatic pathways, where it begins to operate.
Is pseudotuberculosis contagious in children? As already noted, contact with an infected person is not dangerous, the virus is transmitted through animals.
The above way of infection is not always found in practice. Sometimes the pathogen immediately enters the liquid connective tissue, where it begins intensive reproduction. In this casebacteremia is detected, which lubricates the overall picture of the pathology. Through the blood, the pathogen enters all internal organs, affecting the spleen, kidneys, lungs, etc.
It must be said that part of the bacteria, when it enters the body, immediately dies, releasing endotoxin. Instead of the desired relief, the patient will receive intoxication. As a result, the following diseases and reactions often occur: arthritis, myocarditis, Quincke's edema, urticaria, etc.
Disease forms
How does pseudotuberculosis manifest itself in children? It depends on the predominant symptom and localization of the virus. In this regard, in medicine there are several main forms of the disease. Consider them in more detail:
- Gastrointestinal. Here, the pathology is very easy to confuse with ordinary poisoning, because the symptoms are quite similar. There is fever, body aches and apathy. After some time, they are supplemented by cough, pain and burning sensation in the throat, insomnia, rash with pseudotuberculosis in children. In addition, yellowness and dark urine are often observed, if treatment is not started in time, the case may end in meningitis.
- Articular. It is not difficult to guess that in this case we will talk about damage to the joints. Outwardly, this is manifested by redness, the appearance of puffiness. There are also unpleasant painful sensations.
- Septic. A rather rare form of pathology, nothing particularly stands out, only a qualified doctor can be diagnosed. Symptoms include chills, increased sweating,fever.
- Combined. This form is diagnosed if several types of pathology are detected in a child at the same time, which happens very rarely.
Symptoms of pseudotuberculosis in children
What often happens is as follows: the symptoms appear in immunocompromised babies, while those with a strong immune system hardly notice the signs. To avoid a situation where the pathology is diagnosed too late, parents need to take their child to a regular medical examination at least once every six months.
So, the main signs of pseudotuberculosis in children:
- Diarrhea with copious watery stools, painful sensations in the abdomen, associated with the rationale for inflammation in the colon. At best, they will develop into bleeding sores, and at worst, they will provoke tissue necrosis.
- Redness and swelling at the sites of infection, myalgia and arthralgia.
- Appearance of a rash strongly resembling that of scarlet fever. Spots can be absolutely any size, there are no defined boundaries.
- Peeling of the face, upper and lower extremities, hands and feet.
- Nausea and vomiting, presence of jaundice, allergic reactions, possible angioedema.
It is important to understand that complications such as gastroenteritis or enterocolitis can occur due to this pathology. Autoimmune processes provoke the appearance of other diseases: arthritis and myocarditis.
Specialists say that the incubation period continues normallyeighteen days. Around the fifth or sixth day, the first symptoms of the disease are observed, the child's temperature rises sharply to thirty-eight or forty degrees, fever begins. If pseudotuberculosis is running, then hyperthermia can last from ten to thirty days.
Course of disease
As you know, the main causes of the disease in children are playing in the sandbox and unwashed hands, along with food. In this case, the pathogen enters the body through the oral cavity, and then intensively multiplies in the lymph nodes. At risk are babies under the age of one year. Until then, babies are relatively safe through breastfeeding.
Doctors in the diagnosis should pay attention to the manifestation of the disease. If peeling of the skin of the face and neck is observed, loose stools, jaundice and an enlarged liver are found, this is pseudotuberculosis in children (photos of babies who have experienced this disease are presented in the article).
When it comes to babies, doctors often identify typical and atypical forms of pathology, which entail a blurred picture. Experts also talk about the severity and duration of the disease, which are interrelated. For example, an acute form torments a baby for thirty days, a protracted one attacks for about three months, and a chronic one for four months or more.
It is worth noting that the symptoms may vary, because each body reacts in its own way to the invasion of infection. Don't be surprised ifwith pseudotuberculosis, children will have a runny nose, cough, redness of the throat, herpes on the lips, conjunctivitis. This whole picture is complemented by loss of appetite, weakness, high fever and severe headaches. In almost all cases, a rash develops after a few days, which lasts for about a week, and then is replaced by peeling. If measures are not taken in time, a rash will appear in the groin area, folds of the limbs and sides. Some children experience nausea, vomiting, and bloating. As you understand, there are a lot of symptoms of pseudotuberculosis, so it is better to contact a specialist so that he can understand everything and offer effective therapy.
Diagnosis
The doctor always starts the first appointment with an anamnesis (gathering information) and an external examination. The first assumptions appear already at this stage, because with the naked eye you can see reddening of the skin, its peeling, etc. Usually this information is not enough to make a full diagnosis.
Then the doctor suggests that the child undergo additional studies to better understand the situation. In most cases, the doctor recommends:
- Bacteriological measures. This group includes the analysis of feces, blood, sputum and cerebrospinal fluid. Crops are done three times during the first week, and the result is prepared in about fifteen days.
- Immunological methods. Their purpose is to identify antigens to the pathogen, seen in feces or any other biological material.
- PCR diagnostics. Withit can be used to find the DNA of pathogens in the stool.
Therapy Methods
Treatment of pseudotuberculosis in children should be carried out in a hospital setting. If a particularly severe case is found, then bed rest is necessary until the fever disappears. It should be noted right away that therapy should be complex. After all, applying all the methods together gives an excellent result.
Let's consider the main ways in which pathology is de alt with:
- Taking antibiotics. Among them are Netilmicin, Cefotaxime and Gentamicin.
- Use of detoxification agents (plasma-substituting drugs, glucose-s alt solutions). Here you can add heart medicines and vitamin complexes. These drugs are aimed at eliminating the symptoms, which is one of the most important parts of the treatment.
- Taking non-steroidal anti-inflammatory drugs ("Naklofen", "Diclofenac sodium"). In the fight against the icteric form, such drugs as "Karsil", "Hepatosan", "Essentiale Forte N" showed themselves most effectively. Therefore, if a patient has a problem of this kind, the doctor will definitely prescribe these medicines.
- Special diet. You need to adjust the diet and stick to proper nutrition for three or four months, even after the symptoms disappear. It is necessary to exclude spicy, fried and fatty foods, even concentrated broth is not allowed.
Consequences
Despiteall the danger of the disease, doctors give favorable forecasts. This is possible only if you contact the doctor in a timely manner and receive high-quality treatment. You need to understand that if you do not get to a specialist in a short time, there will be serious consequences of pseudotuberculosis in children. It is strictly forbidden to engage in self-medication, because in such a situation it is very easy to aggravate the patient's condition and complicate the work of doctors. As for the timing, experts say that within three weeks the child will be able to fully recover.
Ignoring the symptoms will cause complications of various kinds:
- acute kidney failure, pneumonia;
- meningitis, damage to the lining of the brain;
- Crohn's disease, characterized by inflammation of the gastrointestinal tract;
- Reiter's syndrome, it is expressed through conjunctivitis, arthritis and urethritis;
- acute form of appendicitis requiring immediate removal of the process;
- myocarditis, polyarthritis, toxic shock, intestinal obstruction.
It is worth noting that this is an incomplete list of complications. The above effects are the most common. If you continue to ignore all the signs, there will be a relapse and subsequently death.
Because the child's body is not yet formed, it is more susceptible to attack by viruses and infections. In order to somehow protect the baby, parents need to strengthen his immunity from childhood. Then the chance of infection will be significantly reduced, and the child will be able tocarry various diseases.
Prevention
A few days after infection, the first signs and symptoms appear. Prevention of pseudotuberculosis in children is aimed at preventing the disease. After all, it is easier to follow certain rules in advance than to deal with pathology later.
There are certain preventive measures that must be followed:
- rodent control, limit contact with animals;
- compliance with the rules of personal hygiene, special attention should be paid to washing hands before and after eating;
- water supply must be controlled so that all sanitary standards are met, and do not eat food that has not been heat-treated. Before eating, if you are in doubt about the product, it is better to pour boiling water over it. Thus, all unnecessary substances will disappear, and you can start eating without fear of infection.
The disease in question is considered quite dangerous and difficult to diagnose due to the abundance of symptoms similar to those of other pathologies. In our material, we talked about the symptoms and treatment of pseudotuberculosis in children, and also studied the rules for prevention and possible complications. The disease in rare cases is fatal if not treated promptly and the symptoms are ignored. For this reason, you should immediately contact a specialist when the first signs of the disease are detected.
