In rare severe cases, marked rezchayshaya headache, loss of consciousness, delusions, agitation, rigidity neck, Kernig and Brudzinskogo symptoms, increased reflexes, swallowing disorders, speech. There are fibrillar twitching of facial muscles, tremor of limbs, ankle clonus, dyspnea, dysuria, etc. All this can be characterized as meningo-encephalitis typhous. In most patients, even mild forms characterized by changes in the cardiovascular system in the form of lowering blood pressure voiceless heart sounds, rapid pulse, frequent – extrasystole. Sometimes defined by expanding the boundaries of the heart, muscle noise at all auscultatory points. In patients with typhus decreased appetite, coated tongue is dry and dirty-gray bloom, often cracked, with protruding shaking, sometimes, "stumbling" on the teeth, bends (sign language – sign Govorova-Godelier). Often there constipation, and by the end of the disease is often observed without diarrhea pathological impurities.
The spleen and liver are usually enlarged with a 3-4th day of illness, they have a soft texture, increase their first determined percussion, then the 5-6th day of the liver and spleen disease begin to appear of the hypochondrium. Quite often, throughout the disease observed in patients with dry cough (diffuse bronchitis). In difficult cases, a leaking urine retention with dilation of the bladder (ishuira paradoxa). Blood picture at and peripheral nervous system is very relaxed, skin rash rather scanty, and often neobilnaya limited rozeoleznaya elements. Hectic period with milder forms of truncated to 06/08/10 days, the number of white blood cell count is often normal, sometimes marked leukopenia, but in all cases characterized by neutrophilia with a shift to the left. Typhus can be repeated in these cases due to reinfection develops only; for disease very similar to the primary typhus, and in most cases it is the identity. Mortality rates for typhus, due to effective adjuvant therapy, can be reduced to almost zero, especially when the use of tetracycline antibiotics. Complications.
Brucellosis often takes a long, recurrent course, delayed until 1-2-3 years and, in rare cases, more. There are several classifications of brucellosis, based on which it is practically important to distinguish following forms: 1) The acute form of generalization or primary phase of infection without focal lesions, the duration of 2-3 months. The main symptoms of this form of fever, chills, sweating, lack of typhoid status hypotension, bradycardia often, poliadenopatiya, an increase in the spleen and liver. In the blood was leukopenia with limfomonotsitozom. Reaction Wright Heddlsona – Kaytmchzovoy and Burne vnutrnkozhnaya test positive with the 12-15th day disease.
2) a latent form, or phase, during which time no complaints and objective data, talking about the disease can be identified. 3) Subchronic form or phase of the localization of recurrent generalization. In patients with newly repeated symptoms of an acute process with the development of various focal lesions – especially on the part of the musculoskeletal system. Liver and spleen were enlarged and sealed. In the hemogram indicated leukopenia, neutropenia, lymphocytosis, normal ESR. The duration of this form of the disease is 2-3 months. 4) Chronic form: a) with relapsed and b) with persistent localized lesions. There are marked pain, the presence of persistent focal lesions may relapse, the temperature is normal or low-grade, accompanied by a slight chilling and sweating.
Enlarged spleen and liver is relatively rare. The total duration of the disease can be 2-5 years. Diagnosis. Recognition of brucellosis is based on epidemiological data, the analysis of clinical symptoms that develop in a strict sequence, is taken into account the shape and phase of illness, and the results laboratory studies. Important methods of diagnosis of brucellosis in humans are currently the following laboratory studies 1) The bacteriological examination of blood Pull the pathogen (blood culture, obtaining mielokultury). Because of the need to have special conditions and the duration of the laboratory bacteriological studies (3-4 weeks), this method is not widely applied.
diabetes with no symptoms of type II diabetes often do not manifest and can be detected by routine inspection by the biochemical analysis of blood and urine. diabetes mellitus Yes, a hereditary disease, both types of diabetes mellitus in a certain way can be inherited, transferred or rather a predisposition to the disease, and is independent from external influences, manifest diabetes in particular person or not. drugs or other diseases cause diabetes mellitus This is called secondary (sekundarnym diabetes), diabetes can be symptoms of another disease. Diabetes can cause Some drugs, such as corticosteroids (adrenal hormones) used in the treatment of rheumatic diseases, asthma: nonspecific intestinal inflammation (Crohn's disease, koloproktita), skin disease (severe forms of eczema) or some inflammation of the kidneys (glomerulonephritis). Cause of secondary diabetes may be other drugs – diuretics (diuretics), containing thiazides, used to treat hypertension and heart failure.
Diabetes mellitus may occur as a symptom of disease of the pancreas (after inflammation, and hemochromatosis), under certain hormonal disorders and severe malnutrition. Some 'Quiescent') diabetes mellitus. It is detected only by laboratory analysis of so-called glucose tolerance test, the patient drinks a solution of glucose (sugar) – 75 g in 100 ml of water – and the level of sugar in Blood found out how quickly his body is able to process this sugar. Patients with impaired glucose tolerance, it is likely that in 10-15 years they have actually develop diabetes. This disease is not to be treated, requires medical supervision only. doctor makes a diagnosis of diabetes if the patient has symptoms typical of diabetes (thirst, urination strong, hunger or weight loss), enough research on blood sugar. If the level is elevated, it is diabetes. If the patient has typical symptoms of diabetes, but there are only a suspicion of diabetes, glucose tolerance test is performed, the principle of which is described above.