From Big Medical Encyclopedia

HEYVERKHYLLSKY FEVER (synonym: gaverkhilsky fever, a streptobacillosis) — the infectious disease which is characterized by the alternating fever, intoxication, rash and polyarthritis.

The disease received the name after epidemic in 1926 in Haverhill (USA). In the form of sporadic cases meets everywhere, is more often in the countries of America.

The activator — Streptobacillus moniliformis Levaditi et al., 1925 — an aerobic, gram-positive, polymorphic stick. On dense mediums (blood or other proteinaceous) grows in a type of threads (chains), it is better — in the presence of carbon dioxide; can form a-forms (see L-forms of bacteria) with the broken or completely absent cell wall.

A source of an infection are rats, mice and other rodents are more rare, from an organism to-rykh the activator it is allocated with saliva and excrement. The sick person is not infectious. The activator is transferred to the person preferential at a sting of rodents. Infection through the milk and dairy products, meat contaminated by excrement of rodents is possible. More often the people living in dwellings where rats live are ill. Diseases of staff of laboratories and vivariums are known. Infection

results from bacteremia, owing to a cut intoxication, bronchial pneumonia, in some cases — focal infiltrates in parenchymatous bodies develops.

The pathoanatomical picture is characterized by bronchial pneumonia (see Pneumonia), focal infiltrates and heart attacks of a spleen (see) and kidneys (see).

At had within 2 — 3 years immunity remains.

Incubation interval of 3 — 10 days, more rare longer. The disease begins sharply — with a fever, the alternating fever (see), vomitings, head and muscular pains. The phenomena of bronchial pneumonia are often noted (see Pneumonia). In 1 — 3 day appear regional lymphadenitis (see), makulezno-papular korepodobny (see Measles) or petekhialny (see Petechias) rash on skin of extremities, is more rare drain on all body. On feet hemorrhages are possible, after disappearance to-rykh within several weeks pigmentation remains. Pains in left hypochondrium, the spleens caused by increase are possible. Joints of extremities are sharply painful, swell up, skin over them sometimes reddens. Duration of disease usually does not exceed 2 weeks. Sometimes in 1 week after subsiding of acute displays of a disease the recurrence proceeding with the phenomena of polyarthritis (see) is observed.

Complications in the form of an endocarditis (see), myocarditis (see), development of abscesses in intermuscular spaces are possible.

The diagnosis is established on the basis epidemiol. data (contact with rats, possible pollution of foodstuff excrement of rodents), wedge, pictures and these laboratory researches.

At a blood analysis note a leukocytosis and increase in number of the segmented leukocytes. Decrease in volume of a daily urine, an intensive hamaturia, a proteinuria, constancy of specific weight of urine within a day is possible.

Make crops of blood, pus from abscesses on a blood or ascitic agar for allocation of the activator. By means of agglutination tests (see), fixations of the complement (see Reaction of binding complement), an immunofluorescence (see) specific antibodies in blood serum find from the 10th day of a disease; antibodies in blood of had remain within

2 years and more.

Differential diagnosis is carried out about a sodoka (see), from a cut

of X. l. differs in less expressed regional lymphadenitis, more rare recurrence, existence of korepodobny or petekhialyyy rash and an endocarditis. X. l. it is also necessary to differentiate with malaria (see), rickettsioses (see), a tularemia (see), a brucellosis (see), arboviral diseases (see), a meningococcal infection (see), a pseudorheumatism (see).

Treatment consists in intramuscular introduction of antibiotics.

The forecast is usually favorable, however in zanushchenny cases lethal outcomes are possible.

Measures of prevention come down to extermination of rodents (see Deratization), to storage of products in rooms and a container, rodent-proof, to observance of the mode of safety during the work with laboratory animals (use of gloves, oversleeves, etc., receiving animals from vivariums, safe in the epizootic relation).

Bibliography: Infectious diseases,

under the editorship of M. Voykulesku, the lane from Romanians., t. 2, page 787, Bucharest, 1964; The Guide to infectious diseases, under the editorship of

A. F. Bilibin and G. P. Rudnev, page 483, M., 1967; Microbiology, ed. by B. D. Davis and. lake, p. 948, Hagerstown a. o., 1978; Tropical medicine, ed. by G. W. Hunter a. o., Philadelphia, 1976.

B. L. Cherkassky, Yu. F. Shcherbak.