GIRUDINOZ

From Big Medical Encyclopedia

GIRUDINOZ (hirudine + - osis) — the disease caused by influence of bloodsuckers and which is followed by bleedings, headaches, anemia. The bloodsuckers attacking the person can get into various cavities of an organism which are reported with the environment and also to stick to integuments; depending on it distinguish G. internal and outside.

Geographical distribution

Numerous species of bloodsuckers are eurysynusic in tropical and subtropical zones where they are the real scourge for the population. Hirudo japonica (Japan) gets into a nasopharynx and a conjunctival sac, Limnatis granulosa (India) — into the nasal courses, L. nilotica (Africa, the Canary islands, Southern Europe, Asia Minor) — into a throat, a gullet, a trachea, the nasal courses, a conjunctival sac, a vagina, Haemopis sanguisuga (North Africa) — is preferential in a nasal cavity, H.paludum (Sri Lanka, Malaysia) — in a nasal cavity and a throat, H. javanica (island of Java), H. fallax, H. morsitans, H. vagans (the islands of Sumatra, New Guinea, Celebes, Borneo, the countries of Southeast Asia, Chile, Trinidad) cause internal G., bloodsuckers of the sort Philoemon (South Australia) parasitize at the person, the bloodsucker of Limnatis turkestanica (the USSR — Ashgabat, Samarkand, Bukhara, Tashkent, Mount Karatau, the area between Qurghonteppa and Baldzhuan) causes internal G., the medical bloodsucker (Hirudo medicinalis) living in Europe, North Africa, North America is capable to stick to skin, a mucous membrane of an oral cavity and other bodies. Outside G. on the lake of Sri Lanka is connected with mass attack of bloodsuckers of Haemadipsa zeylanica in the period of rains; people catch at circulation on a wet grass.

An etiology

Bloodsuckers — a class of annlides (Annelida) with a secondary small false kolchatost of a body, an oral sucker and a prisasyvatelny disk on the back end. Live in water; are very mobile. Eat blood of preferential vertebral; have very capacious stomach with blind outgrowths owing to what exhaust up to 15 ml of blood during a krovososaniye. Therefore bloodsuckers are long since applied as means of suction of blood. The bloodsuckers belonging to blood-sicking cause more often (this. Hirudinidae) and pharyngeal (this. Herpobdellidae) to parasites.

Infection with bloodsuckers comes at drink of water from natural reservoirs where parasites live. And drink of water from ware or a handful allows to see a bloodsucker. Drink of water prone from standing reservoirs, aryk, creeks, peatbogs, reed lakes or drink promotes possible swallowing bloodsuckers at night. Besides, bloodsuckers attack the person during the bathing or circulation barefoot on a wet grass, wetlands.

Being implemented into a human body, parasites can settle in nasal cavities, a pharynx, in a nasopharynx, a throat, a trachea, a gullet, in an urethra, a vagina, in a conjunctiva of an eye.

In a bloodsucker a long time pathogenic microorganisms can keep life activity. So, the causative agent of a typhoid survives in an organism of a bloodsucker up to 30 days, a paratyphoid In — up to 90 days. And though there are no experimental proofs of possible transfer by a bloodsucker of pathogenic microbes to the person, these data speak about need of a close attention to protivoepid, to the mode in nurseries of medical bloodsuckers.

A pathogeny

Sticking to a mucous membrane or to skin, bloodsuckers allocate a secret of cervical or head glands — hirudine (see), being strong anticoagulant. Besides, the secret of cervical glands contains the histamine-like substance expanding capillaries. It also involves a pneumorrhagia or bleeding, especially persons with disturbances of coagulant system have blood.

The clinical picture

the Characteristic symptom of presence of a parasite in a nasopharynx or a nasal cavity is not explainable bleeding from a nose and a mouth. The pneumorrhagia or throat bleeding can be observed at localization of a parasite in a trachea. Vulval bleeding and a hamaturia are observed at localization of a bloodsucker in urinogenital bodies. Coloring of contents of a stomach in brown color, and a calla in dark because of impurity of blood are observed in the first days of suction of a bloodsucker to a mucous membrane of a stomach. Long stay of a bloodsucker in an organism can cause a big loss of blood, anemia, headaches. Suction of a bloodsucker to a glottis or to a wall of a trachea is the most dangerous. In extremely exceptional cases in process of a nasasyvaniye of blood and increase in sizes the bloodsucker can close a gleam of a trachea and cause asphyxia, and at a delay with the emergency medical intervention and death.

The diagnosis

Outside G. is quite just diagnosed by ad oculos. Internal G.'s diagnosis is based on the leading sign (symptom) — bleeding or a blood spitting. Certainly, other reasons of bleeding shall be excluded.

Differential diagnosis: at implementation of a bloodsucker in a nasal cavity or G.'s nasopharynx it can be accepted for polyposes; It is necessary to differentiate of a bladder, a vagina with a tumor, G. of a stomach and intestines — with intestinal bleedings of other etiology (a tumor, an ulcer).

Treatment

Removal of bloodsuckers from cavities is difficult since they are quite strongly fixed on a mucous membrane. Use of strong solution of sodium chloride (rinsing), tampons with iodine go allows to remove with alcohol parasites. Presence of sharply increased bloodsucker (nasosavsheysya blood) in a trachea or a glottis demands immediate surgical intervention. During removal of a parasite from skin and proceeding sometimes at this bleeding apply a compressing bandage and even brackets. At the developed anemia and in cases of disturbance of a blood coagulation use of transfusion of fresh blood is shown, the desensibilizing means are reasonable.

Forecast at the early diagnosis of G. favorable.

Prevention

internal G.'s Prevention — at drink of water from natural sources to use ware, checking before drink of ad oculos whether there are no parasites in it. Outside G.'s prevention is reached by protection, first of all legs, from attack of bloodsuckers. For this purpose stockings, socks, a bottom of trousers impregnate with solution of dimethyl phthalate or indalony, cover footwear with liquid soap. Residents of Sri Lanka, e.g., bandage legs a gauze, seasoning with turnover of bandage with sodium chloride.

See also Bloodsuckers .


Bibliography: The multivolume guide to microbiology, clinic and epidemiology of infectious diseases, under the editorship of H. N. Zhukova-Verezhnikov, t. 9, page 825, M., 1968; Pavlovsky E. N. Guide to parasitology of the person, t. 1, page 440, M. — L., 1946; Manson’s tropical diseases, ed. by Ch. Wilcocks a. Ph. E. C. Manson-Bahr, Baltimore, 1972.

F. F.Talyzin.

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