Description
Sap (synonyms of the disease: single-maled disease) is an acute infectious disease from a group of bacterial zoonoses, is caused by a sap stick, with a predominantly contact mechanism of infection, proceeds in acute and chronic form with the formation of specific granulomas, is characterized by fever, septicopyemia, skin, mucous membranes and internal bodies.
The causative agent of sapa - Pseudomonas maliei - belongs to the genus Corynebacterium, the family Brucellaceae.
The source of infection are sick horses, less often donkeys, mules
The incubation period with acute form of sap lasts 2-6 days, less often - up to 2-3 weeks. The disease begins acutely. The body temperature with chill rises to 38-40 ð C.
Temperature curve of septic character with large daily fluctuations. Patients complain of a headache, tenderness of muscles and joints. In the area of the entrance gate of infection, a papule is formed, surrounded by a zone of redness. Subsequently, the papule turns into a hemorrhagic pustule, and 2-3 days into an ulcer with dug edges and a "greasy" bottom. Often develops regional lymphadenitis, lymphangitis. On the 4th-8th day, the body temperature rises again, multiple skin papules appear on the skin of the nasal mucosa, mouth cavity, and conjunctiva, and then they become hemorrhagic vesicles, pustules, and ulcers. From the nose, mucopurulent or supra (hemorrhagic) fluid is secreted. Abscesses in the muscles (especially the gastrocnemius), fistulas with the release of greenish ductile manure, purulent arthritis develop. In the case of lung damage, pain in the chest, cough with discharge of mucopurulent or purulent sputum, cyanosis of the lips, dyspnea. Develops draining pleuropneumonia. Heart sounds are deaf, tachycardia, blood pressure is reduced, it is possible the development of collapse. The spleen is markedly enlarged, the liver is not always enlarged. On the part of the blood neutrophilic leukocytosis is revealed, the ESR is increased. After 1-4 weeks, death occurs.
Chronic sap is characterized by a slow development of signs of the disease with alternating remissions and exacerbations. Flows like a chroniocepsis. The disease lasts from several months to 2-3 years and in half the cases leads to death. Chronic sap can occur in the form of cutaneous, pulmonary and nasal forms. With a frequent cutaneous form on the skin appear hemorrhagic purulent pustules, ulcers that merge, forming extensive ulcerous surfaces with a purulent secret, followed by scarring. In the muscles and internal organs abscesses are formed.
The pulmonary form of chronic gland is characterized by a feverish condition, the appearance of draining, creeping pneumonia, often pleuropneumonia with the formation of multiple abscesses, bronchiectasises with the development of pneumosclerosis. In the case of the primary nasal form of gland on the nasal mucosa, pustules appear, deep ulcers that spread to the mucous membrane of the pharynx, larynx, and trachea. Discharge from the nose - mucopurulent-bloody.
Complications - multiple abscesses in different tissues and organs, deep phlegmon, pneumonia, pneumosclerosis, bronchiectasis, common amyloidosis, purulent meningitis, cachexia.
The prognosis in patients with acute sap if the treatment was not performed is always unfavorable, in case of chronic form the lethality reaches 50%
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