From Big Medical Encyclopedia

TO SODOK (sodocu; synonym disease of a sting of rats) — the infectious disease which is characterized by the alternating fever, inflammatory reaction in the place of implementation of the activator, damage of lymph nodes, polymorphic rash.

The disease meets more often in the countries of Asia, Africa and Latin America; in the USSR isolated cases are registered.

The activator C. — a sperilla (Spirillum minor Carter 1888, treats bacteria) — shtoporoobrazny curved thread with curls. It is mobile, it is well painted by all main dyes, it is unstable in the environment.

The main source of an infection — rats, infectiousness to-rykh sometimes reaches 50% and more. Mice, polecats, proteins, caress, etc. can also be a source of an infection. The sick person is not infectious for people around. At animals the activator C. is in fabrics, blood and on a mucous membrane of a mouth. Infection of the person occurs at a sting of a rodent and hit of the activator on a wound surface more often, and also through the foodstuff contaminated by excrements of rodents. S. also the persons adjoining to animals — hunters, workers of vivariums, the staff of laboratories, etc. are ill.

In the place of implementation of the activator C. there is moderately expressed primary affect — a hyperemia, puffiness, hemorrhages (see Affect primary). On limf, to ways the activator gets into regional limf, nodes where breeds, collects, then gets to blood and with its current is brought in various bodies (lungs, kidneys, a spleen). Pathoanatomical changes at S. of a malospetsifichna. In lungs, kidneys, a spleen the centers of infiltration (see), heart attacks are possible (see. Heart attack ), sites necrosis (see).

Immunity it is not studied. Repeated cases of a disease are not described.

The incubation interval fluctuates from 2 days to 2 months, 10 — 14 days are more often. The disease begins suddenly with temperature increase to 39 — 40 °, a fever. Patients note the general weakness, a headache, an ache in all body, a joint pain. In the field of a sting painful infiltrate of dark red color appears, to-ry it can ulcerate and nekrotizirovatsya. Are characteristic limfangiita (see) and regional lymphadenites (see). There is recurrence of fever: after 2 — 5-day remission temperature increases for 2 — 4 days again. Similar attacks can be 2 — 3, up to 10 — 20 more rare. During attacks of fever polymorphic rash develops. Increase in a spleen is noted, polyarthritis (see). The disease sometimes gets a long current — about one year and more. The periods of an apireksiya at the same time are extended; the cachexia develops. Perhaps atypical disease which is not followed by the phenomena of intoxication; there are no rash, arthritises, changes in area of a sting.

At S. are possible complications — anemia (see), more rare glomerulonephritis (see), bronchial pneumonia (see Pneumonia), an endocarditis (see) and myocarditis (see), defeat of a nervous system — anesthesia (see), paralyzes (see Paralyses, paresis), and also mental disorders.

Diagnosis is established on the basis epidemiol. data (contact with rats or other animals), wedge, pictures and results lab. researches. In blood — a leukocytosis with moderate neutrophylic shift, an eosinopenia, hypochromia anemia, acceleration of ROE. For identification of the activator carry out crops of blood, pus, joint liquid on a blood or ascitic agar, put a biological test. In an agglutination test (see), reactions of binding complement (see), immunofluorescence (see) with 8 — the 10th day of a disease reveal specific antibodies.

Differential diagnosis is carried out with malaria (see), sepsis (see), heyverkhilljeky fever (see), a tularemia (see), a brucellosis (see), rickettsioses (see), a meningococcal infection (see), a pseudorheumatism (see).

For treatments apply antibiotics of a broad spectrum of activity.

Forecast usually favorable, however in the absence of treatment lethal outcomes are possible.

Measures prevention come down to extermination of rodents, respect for safety during the work about a lab. animals (providing vivariums with animals from safe nurseries in the epizootic relation, use of dense gloves, oversleeves, etc.).

Bibliography: Mikhaylova L. M. To clinic and treatment to a sodok, in book: Aktu-aln. vopr. tropichesk. medical, under the editorship of. K. M. Lobana, page 162, M., 1976; Rudnev of G. P. Antropozoonoza, page 155, M., 1970; Gunning J. J. Rat-bite fevers, in book: Trop. med., ed. by G. W. Hunter and. lake, p. 246, Philadelphia, 1976.

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