Malinica, określana również jako pian, bouba, frambezja bądź jagodzica, jest przewlekłą chorobą zakaźną dotyczącą przede wszystkim dzieci i wywołaną przez Treponema pallidum ssp. pertenue. Schorzenie charakteryzuje się powstawaniem pojedynczych lub mnogich zmian pierwotnych ("malinica pierwotna"), a następnie mnogich, rozsianych zmian skórnych. Wczesne zmiany skórne są zakaźne i mogą być obecne przez wiele miesięcy. Nawroty zmian skórnych są częste w pierwszych pięciu latach choroby. Zmiany późne mają charakter niszczący i obejmują skórę, kości i stawy.
1. MALINICA (SYN. BOUBA, PIAN, FRAMBEZJA, JAGODZICA) - OBRAZ KLINICZNY
Choroba przenosi się przez bezpośredni kontakt ze zmianami zakaźnymi, często podczas zabawy lub spania w jednym łóżku z zakażoną osobą. Naturalnemu zakażeniu sprzyjają uszkodzenia skóry po ukąszeniu owadów, otarcia naskórka oraz zadrapania.
Po 3-4 tygodniowym okresie utajenia dochodzi do powstania pierwotnej zmiany skórnej - pojedynczej grudki, występującej zazwyczaj na kończynie dolnej. Grudka następnie stopniowo powiększa się i nabiera charakteru brodawczakowatego, przypominającego malinę (stąd nazwa). Następnie dochodzi do powiększenia regionalnych węzłów chłonnych. Zmiana pierwotna w przebiegu schorzenia ulega zwykle wygojeniu w ciągu 6 miesięcy.
Uważa się, że rozsiew choroby następuje już w jej wczesnych stadiach. Wysypce w malinicy wtórnej, mającej charakter plamkowy, grudkowy lub brodawczakowaty, towarzyszy uogólnione powiększenie węzłów chłonnych. Wysypka wtórna może podlegać nadkażeniu bakteryjnemu.
Obecność bolesnych brodawczaków na podeszwach stóp powoduje chód podobny do kraba; chorobę określa się wówczas mianem "malinicy krabiej". Innymi objawami malinicy są nocne bóle kostne i zapalenie okostnej palców. Do późnych objawów malinicy należą kilaki skóry i kości długich, szczególnie nóg. Występuje ponadto nadmierne rogowacenie skóry podeszw i dłoni, zapalenie kości, okostnej, pojawienie się zwłókniałych guzków w okolicach okołostawowych oraz obecność wysięków stawowych.
Późne zmiany w przebiegu malinicy są zwykle mnogie i mają charakter niszczący. Zniszczenie kości nosa, szczęk, podniebienia i gardła jest określane mianem gangosa i przypomina zmiany spotykane w trądzie i leiszmaniozie.
Po 3-4 tygodniowym okresie utajenia dochodzi do powstania pierwotnej zmiany skórnej - pojedynczej grudki, występującej zazwyczaj na kończynie dolnej. Grudka następnie stopniowo powiększa się i nabiera charakteru brodawczakowatego, przypominającego malinę (stąd nazwa). Następnie dochodzi do powiększenia regionalnych węzłów chłonnych. Zmiana pierwotna w przebiegu schorzenia ulega zwykle wygojeniu w ciągu 6 miesięcy.
Uważa się, że rozsiew choroby następuje już w jej wczesnych stadiach. Wysypce w malinicy wtórnej, mającej charakter plamkowy, grudkowy lub brodawczakowaty, towarzyszy uogólnione powiększenie węzłów chłonnych. Wysypka wtórna może podlegać nadkażeniu bakteryjnemu.
Obecność bolesnych brodawczaków na podeszwach stóp powoduje chód podobny do kraba; chorobę określa się wówczas mianem "malinicy krabiej". Innymi objawami malinicy są nocne bóle kostne i zapalenie okostnej palców. Do późnych objawów malinicy należą kilaki skóry i kości długich, szczególnie nóg. Występuje ponadto nadmierne rogowacenie skóry podeszw i dłoni, zapalenie kości, okostnej, pojawienie się zwłókniałych guzków w okolicach okołostawowych oraz obecność wysięków stawowych.
Późne zmiany w przebiegu malinicy są zwykle mnogie i mają charakter niszczący. Zniszczenie kości nosa, szczęk, podniebienia i gardła jest określane mianem gangosa i przypomina zmiany spotykane w trądzie i leiszmaniozie.
2. MALINICA (SYN. BOUBA, PIAN, FRAMBEZJA, JAGODZICA) - ROZPOZNANIE
Rozpoznanie malinicy (jak i pozostałych krętkowic endemicznych) stawia się na podstawie cech klinicznych oraz badania mikroskopowego w ciemnym polu widzenia i badań serologicznych (jeśli możliwe jest ich wykonanie). Testy wykonywane w kile mają zastosowanie również w krętkowicach endemicznych - nie ma testu pozwalającego odróżnić poszczególne krętkowice.
3. MALINICA (SYN. BOUBA, PIAN, FRAMBEZJA, JAGODZICA) - LECZENIE
Zalecanym leczeniem chorych oraz osób z kontaktu jest podanie penicyliny benzatynowej G w dawce 1,2 mln jednostek domięśniowo u dorosłych (i 600 tys. jednostek u dzieci poniżej 10 roku życia). Nie ma dowodów na powstawanie oporności na penicylinę, choć donoszono o nawrotach choroby u osób leczonych w Papui-Nowej Gwinei. Istnieją nieliczne dane na temat skuteczności tetracyklin w malinicy. Przyjmuje się, że doksycyklina, tetracyklina i erytromycyna mogą zastępować penicylinę u osób uczulonych na ten antybiotyk. Po podaniu antybiotyku u chorego może wystąpić reakcja Jarischa-Herxheimera.
KATEGORIA: CHOROBY ZAKAŹNE, MEDYCYNA TROPIKALNA, PEDIATRIA, DERMATOLOGIA
TAGI: Malinic, also known as foam, bouba, yaws or yaws, is a chronic infectious disease primarily on children and Treponema pallidum induced ssp. Pertenue. The disease is characterized by the formation of single or multiple primary lesions ("Malinic primary") and multiple scattered lesions. Early lesions are infectious and may be present for several months. Recurrence of skin lesions are common in the first five years of illness. Changes late are devastating and include the skin, bones and joints. 1 Malinic (SYN. Bouba, PIAN, yaws, yaws) - CLINICAL disease transmitted through direct contact with infectious changes, often while playing or sleeping in the same bed with an infected person. Conducive to natural infection of skin damage after insect bites, abrasions and scratches. After a 3-4 week period of latency comes to the creation of the primary lesion - single papules, usually occurring in the lower limb. Papule gradually enlarges and becoming papillary, raspberry-like (hence the name). Then become enlarged regional lymph nodes. The change in the course of the primary disease is generally healed within 6 months. It is believed that the spreading of the disease is present already in the early stages. Rash in secondary yaws, having the nature spot, follicular or papillary, accompanied by lymphadenopathy. The rash may be subject to secondary bacterial nadkażeniu. The presence of painful papillomas on the soles of the feet will walk like a crab; the disease is defined as "crab yaws". Other symptoms are night yaws bone pain and inflammation of the periosteum fingers. By the late symptoms of yaws are kilaki skin and long bones, especially the legs. Furthermore, there is hyperkeratosis of the skin soles and hands, inflammation of the bones, periosteum, the appearance of fibrotic nodules in the area of periarticular and articular presence of exudates. Late changes in the course of yaws are usually multiple and are devastating. The destruction of the nasal bones, jaw, palate and throat is called gangosa and resembles the changes seen in leprosy and leishmaniasis. 2 Malinic (SYN. Bouba, PIAN, yaws, yaws) - DIAGNOSIS The diagnosis of yaws (as well as other endemic trypanosomiasis) puts on the basis of clinical and microscopic examination darkfield and serological tests (if it is possible their performance). Tests performed in syphilis also apply krętkowicach endemic - there is no test to distinguish individual treponematoses. 3 Malinic (SYN. Bouba, PIAN, yaws, yaws) - The recommended treatment of patients and people with contacts is to give benzathine penicillin G at 1.2 million units intramuscularly in adults (and 600 thousand. Units in children under 10 years of age) . There is no evidence for the emergence of resistance to penicillin, although relapses of the disease have been reported in patients treated in Papua New Guinea. There are limited data on the efficacy of tetracyclines in yaws. It is assumed that doxycycline, tetracycline and erythromycin may be substituted for penicillin in people who are allergic to the antibiotic. Following administration of an antibiotic in a patient may experience Jarisch-Herxheimer. CATEGORY: INFECTIOUS DISEASES, TROPICAL MEDICINE, PEDIATRICS, DERMATOLOGY Malinic, auch als Schaum, Bouba, giert oder giert, ist eine chronische Infektionskrankheit, vor allem auf Kinder und Treponema pallidum induziert ssp. Pertenue. Die Krankheit wird durch die Bildung von einzelnen oder mehreren primären Läsionen ("Malinic primären") und mehrere verstreute Läsionen charakterisiert. Frühen Läsionen sind ansteckend und können vorhanden sein für mehrere Monate. Wiederauftreten der Hautveränderungen sind in den ersten fünf Jahren der Erkrankung häufig. Änderungen spät sind verheerend und beinhalten die Haut, Knochen und Gelenke. 1 Malinic (SYN Bouba Pian, giert, giert.) - Klinische Krankheit durch direkten Kontakt mit infektiösem Änderungen übertragen, die oft beim Spielen oder Schlafen im selben Bett mit einer infizierten Person. Förderlich für die natürliche Infektion von Hautschäden nach Insektenstichen, Abschürfungen und Kratzern. Nach einer 3-4 wöchigen Wartezeit kommt, um die Schaffung der primären Läsion - Einzel Papeln, in der Regel im unteren Extremitäten auftreten. Papel allmählich vergrößert und immer papillären, himbeerartigen (daher der Name). Dann werden erweitert regionalen Lymphknoten. Die Veränderung im Verlauf der Primärerkrankung wird allgemein innerhalb von 6 Monaten geheilt. Es wird angenommen, dass die Ausbreitung der Krankheit bereits in der Anfangsphase vorhanden ist. Hautausschlag in der Sekundarstufe giert, mit der Natur vor Ort, follikuläre oder papilläre, begleitet von Lymphknotenschwellungen. Der Hautausschlag kann vorbehaltlich sekundäre bakterielle nadkażeniu sein. Die Anwesenheit von schmerzhaften Papillome auf den Sohlen der Füße wie eine Krabbe gehen; Die Erkrankung wird als "crab giert" definiert. Andere Symptome sind Nacht giert Knochenschmerzen und Entzündungen der Knochenhaut Fingern. In den späten Symptome giert sind kilaki Haut und lange Knochen, vor allem die Beine. Darüber hinaus gibt es Hyperkeratose der Haut Sohlen und Händen, Entzündungen der Knochen, Knochenhaut, das Auftreten von fibrotischen Knötchen im Bereich der gelenknahen und Gelenk Gegenwart von Exsudaten. Späte Änderungen im Zuge der giert sind in der Regel mehrere und sind verheerend. Die Zerstörung der Nasenknochen, Kiefer-, Gaumen-und Rachen wird Gangosa genannt und ähnelt den Veränderungen in der Lepra und Leishmaniose gesehen. 2 Malinic (SYN Bouba Pian, giert, giert.) - Diagnose Die Diagnose der giert (wie auch andere endemische Trypanosomiasis) stellt auf der Basis von klinischen und mikroskopischen Untersuchung Dunkelfeld und serologischen Tests (wenn es möglich ist, ihre Leistung). Tests in der Syphilis durchgeführt gelten auch krętkowicach endemisch - es gibt keinen Test, um einzelne Treponematosen unterscheiden. 3 Malinic (SYN Bouba Pian, giert, giert.) - Die empfohlene Behandlung von Patienten und Menschen mit Kontakten zu Benzathinpenicillin G bei 1,2 Millionen Einheiten intramuskulär bei Erwachsenen (und 600 Tausend Stück auf Kinder unter 10 Jahren.) Geben . Es gibt keinen Beweis für die Entstehung von Resistenzen gegen Penicillin, obwohl Rückfälle der Erkrankung bei Patienten in Papua-Neuguinea behandelt wurden. Es gibt nur begrenzte Daten über die Wirksamkeit von Tetracyclinen in giert. Es wird angenommen, dass Doxycyclin, Tetracyclin und Erythromycin für Penicillin in Menschen, die allergisch gegen das Antibiotikum sind, substituiert sein. Nach der Verabreichung eines Antibiotikums bei einem Patienten kann es zu Jarisch-Herxheimer. KATEGORIE: Infektionskrankheiten, Tropenmedizin, Kinderheilkunde, Dermatologie Malinic, également connu comme mousse, bouba, le pian ou le pian est une maladie infectieuse chronique principalement sur les enfants et Treponema pallidum ssp. Pertenue induite. La maladie est caractérisée par la formation de lésions uniques ou multiples primaires («primaires Malinic") des lésions disséminées et multiples. Les lésions précoces sont infectieux et peuvent être présents pendant plusieurs mois. Récurrence des lésions cutanées sont fréquentes au cours des cinq premières années de la maladie. Les changements sont en retard dévastateur et notamment la peau, les os et les articulations. 1 Malinic (SYN Bouba, PIAN, le pian, pian.) - Maladie clinique transmis par contact direct avec les changements infectieuses, souvent pendant la lecture ou de dormir dans le même lit avec une personne infectée. Propices à l'infection naturelle des lésions de la peau après les piqûres d'insectes, écorchures et égratignures. Après une période de 3-4 semaines de latence s'agit de la création de la lésion primaire - papules simples, se produisant habituellement dans la branche inférieure. Papule agrandit progressivement et devenir papillaire, framboise-like (d'où le nom). Alors devenez ganglions lymphatiques régionaux élargis. Le changement dans le cours de la maladie primaire est généralement guéri dans les 6 mois. On pense que la propagation de la maladie est déjà présente dans les premiers stades. Éruption dans le pian secondaires, ayant la place de la nature, folliculaire ou papillaire, accompagné par une lymphadénopathie. L'éruption peut être soumis à nadkażeniu bactérienne secondaire. La présence de papillomes douloureuses sur la plante des pieds marcheront comme un crabe; la maladie est définie comme "le pian de crabe". D'autres symptômes sont pian de nuit des douleurs osseuses et l'inflammation des doigts périoste. Par les symptômes fin du pian sont la peau et les os longs kilaki, en particulier les jambes. En outre, il est hyperkératose de la plante de la peau et des mains, l'inflammation des os, le périoste, l'apparition de nodules fibreux dans la zone de présence et périarticulaire articulaire d'exsudats. Changements de dernière minute dans le cadre du pian sont généralement multiples et sont dévastatrices. La destruction de l'os du nez, de la mâchoire, du palais et de la gorge est appelé gangosa et ressemble aux changements observés dans la lèpre et la leishmaniose. 2 Malinic (SYN Bouba, PIAN, le pian, pian.) - DIAGNOSTIC Le diagnostic du pian (ainsi que d'autres trypanosomiase endémique) met sur la base d'un fond noir de l'examen clinique et microscopique et des tests sérologiques (si il est possible de leur performance). Les tests effectués dans la syphilis s'appliquent également krętkowicach endémique - il n'existe aucun test pour distinguer tréponématoses individuels. 3 Malinic (SYN Bouba, PIAN, le pian, pian.) - Le traitement recommandé des patients et des personnes contacts est de donner la pénicilline G benzathine à 1,2 millions d'unités par voie intramusculaire chez l'adulte (et 600 mille unités chez les enfants de moins de 10 ans.) . Il n'y a aucune preuve de l'émergence de la résistance à la pénicilline, mais les rechutes de la maladie ont été rapportés chez des patients traités en Papouasie-Nouvelle-Guinée. Il existe des données limitées sur l'efficacité des tétracyclines dans le pian. Il est supposé que la doxycycline, la tétracycline et l'érythromycine peut être substitué à la pénicilline chez les personnes qui sont allergiques à l'antibiotique. Après l'administration d'un antibiotique dans un patient peut ressentir de Herxheimer. CATÉGORIE: MALADIES INFECTIEUSES, la médecine tropicale, la pédiatrie, la dermatologie Malinic, также известный как пена, Bouba, фрамбезией или фрамбезией, является хроническим инфекционным заболеванием, прежде всего, на детей и бледной трепонемы индуцированной подвид. Pertenue. Заболевание характеризуется образованием единичных или множественных первичных поражений ("Malinic первичных") и нескольких разбросанных поражениях. Ранние повреждения заразны и могут присутствовать в течение нескольких месяцев. Рецидив поражений кожи распространены в первые пять лет болезни. Изменения поздно являются разрушительными и включают кожу, кости и суставы. 1 Malinic (SYN Буба, PIAN, фрамбезия, фрамбезия.) - Клиническое заболевание передается через прямой контакт с инфекционными изменений, часто во время игры или спать в одной постели с инфицированным человеком. Способствует естественной инфекции повреждения кожи после укусов насекомых, ссадин и царапин. После 3-4 недельного периода латентности приходит к созданию первичного очага - одиночные папулы, как правило, происходит в нижней конечности. Папулы постепенно увеличивается и становится папиллярный, малина-как (отсюда и название). Тогда стали увеличенные региональные лимфоузлы. Изменение в процессе первичной болезни, как правило, зажила в течение 6 месяцев. Считается, что распространение болезни присутствует уже на ранних стадиях. Сыпь в средних фрамбезией, имея Природа фолликулярная или папиллярная сопровождении лимфаденопатией. Сыпь может быть предметом вторичной бактериальной nadkażeniu. Наличие болезненных папиллом на подошвах ног будет ходить, как краб; болезнь определяется как "краб" фрамбезией. Другие симптомы ночные фрамбезия боли в костях и воспаление надкостницы пальцев. К концу симптомов фрамбезией являются kilaki кожи и длинные кости, особенно ноги. Кроме того, есть гиперкератоз подошв кожи и рук, воспаление костей, надкостницы, появление фиброзных узелков в области околосуставных и суставных наличии экссудата. Поздние изменения в ходе фрамбезией обычно многочисленны и являются разрушительными. Разрушение костей носа, челюсти, неба и горла называется gangosa и напоминает динамику видели в проказе и лейшманиоза. 2 Malinic (SYN Буба, PIAN, фрамбезия фрамбезия.) - ДИАГНОЗ Диагноз фрамбезией (а также других эндемичных трипаносомоз) ставит на основе клинической и микроскопической темнопольным и серологических тестов (если это возможно их производительность). Испытания, проведенные в сифилиса применяются также krętkowicach эндемичных - нет тест различить отдельные трепонематозах. 3 Malinic (SYN Буба, PIAN, фрамбезия фрамбезия.) - Рекомендуется лечение больных и людей с контактами, чтобы дать бензатин пенициллин G в 1,2 млн единиц внутримышечно в взрослых (и 600000 единиц в детей в возрасте до 10 лет.) . Там нет никаких доказательств для возникновения устойчивости к пенициллину, хотя рецидивы заболевания были зарегистрированы в пациентов в Папуа-Новой Гвинее. Есть ограниченные данные об эффективности тетрациклинов в фрамбезией. Предполагается, что доксициклин, тетрациклин и эритромицин может быть заменен на пенициллин у людей, страдающих аллергией к антибиотику. После введения антибиотика у пациента могут возникнуть Jarisch-Herxheimer. КАТЕГОРИИ: инфекционные заболевания, тропической медицины, педиатрии, дерматологии Malinic, también conocida como la espuma, Bouba, pian pian o, es una enfermedad infecciosa crónica, principalmente en los niños y Treponema pallidum inducida ssp. Pertenue. La enfermedad se caracteriza por la formación de lesiones primarias individuales o múltiples ("malinic primarios") lesiones múltiples y dispersas. Las primeras lesiones son contagiosas y pueden estar presentes durante varios meses. La recurrencia de las lesiones de la piel son comunes en los primeros cinco años de enfermedad. Los cambios finales son devastadoras e incluyen la piel, los huesos y las articulaciones. 1 Malinic (SYN Bouba, PIAN, pian, pian.) - La enfermedad clínica se transmite a través del contacto directo con los cambios infecciosos, a menudo durante la reproducción o dormir en la misma cama con una persona infectada. Llevan a la infección natural de daños en la piel después de picaduras de insectos, abrasiones y rasguños. Después de un periodo de 3-4 semanas de latencia trata de la creación de la lesión primaria - pápulas individuales, generalmente se produce en el miembro inferior. Pápula va creciendo y convirtiéndose en papilar, frambuesa-como (de ahí el nombre). Luego se agrandan los ganglios linfáticos regionales. El cambio en el curso de la enfermedad primaria generalmente se curó dentro de los 6 meses. Se cree que la propagación de la enfermedad ya está presente en las primeras etapas. Erupción en el pian secundarias, teniendo el paraje natural, folicular o papilar, acompañada de linfadenopatía. La erupción puede ser objeto de nadkażeniu bacteriana secundaria. La presencia de papilomas dolorosas en las plantas de los pies caminarán como un cangrejo; la enfermedad se define como "el pian de cangrejo". Otros síntomas son la frambesia noche dolor de huesos y la inflamación de los dedos periostio. A finales de los síntomas de pian son piel y huesos largos kilaki, especialmente las piernas. Además, hay hiperqueratosis de las suelas de piel y manos, la inflamación de los huesos, el periostio, la aparición de nódulos fibróticos en el área de la presencia periarticular y articular de exudados. Cambios de última hora en el curso del pian suelen ser múltiples y son devastadores. La destrucción de los huesos nasales, mandíbula, paladar y la garganta se llama gangosa y se asemeja a los cambios observados en la lepra y la leishmaniasis. 2 Malinic (SYN Bouba, PIAN, pian pian.) - DIAGNÓSTICO El diagnóstico del pian (así como otras tripanosomiasis endémica) pone sobre la base de campo oscuro examen clínico y microscópico y pruebas serológicas (si es posible su desempeño). Las pruebas realizadas en la sífilis también se aplican krętkowicach endémica - no existe una prueba para distinguir treponematosis individuales. 3 Malinic (SYN Bouba, PIAN, pian pian.) - El tratamiento recomendado de los pacientes y las personas con los contactos es dar benzatina penicilina G en 1,2 millones de unidades por vía intramuscular en adultos (y 600 mil unidades en niños menores de 10 años de edad.) . No hay evidencia de la aparición de la resistencia a la penicilina, a pesar de las recaídas de la enfermedad han sido reportados en pacientes tratados en Papua Nueva Guinea. Existen datos limitados sobre la eficacia de las tetraciclinas en el pian. Se supone que la doxiciclina, tetraciclina y la eritromicina puede ser sustituido por la penicilina en las personas que son alérgicas a los antibióticos. Después de la administración de un antibiótico en el paciente puede experimentar Jarisch-Herxheimer. CATEGORÍA: ENFERMEDADES INFECCIOSAS, MEDICINA TROPICAL, pediatría, dermatología a english to spanish translation a
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