Anthrax — an acute inflammation of several nearby located hair a follicle with education in skin of the extensive center of a necrosis. After an otkhozhdeniye of necrotic masses on the place of an anthrax the deep ulcer in some cases reaching muscles is formed. The exhausted patients, diabetics and people of advanced age can have a malignant course of an anthrax and be complicated by sepsis or bleeding. In treatment antibiotic treatment, local application of anti-septic tanks, some types of physical therapy is shown. When forming the necrotic center surgical treatment is carried out.
The anthrax received the name thanks to dark color formed at it is purulent - necrotic masses. "carbo" in translation from Greek means "coal". An anthrax meets at various age, but is the most frequent at young people. At the same time men are ill approximately by 1,5 times more often than women. About 40% of cases of an anthrax fall on summertime of year.
Causes of an anthrax
The causative agent of an anthrax in most cases is staphylococcus, the staphylococcal and streptococcal infection sometimes mixed. In some cases the anthrax can be caused by colibacillus, neklostridialny anaerobe bacterias, Proteus or enterokokka. Favorable conditions for infection hair a follicle are created at the increased sweating, increase in secretion of sebaceous glands, pollution of skin by dust particles of sand, cement, lime, coal, etc. The activator can get through microinjuries and attritions on skin. Developing of an anthrax is promoted by decrease in resilience of an organism, exchange violations at diabetes and obesity, exhaustion of an organism and a serious illness.
As a rule, an anthrax happens single. They are more often localized on the back surface of a neck, on a face, between shovels, on buttocks and a waist, skin of extremities is surprised much less often. At the beginning of the development the anthrax consists of several dense hillocks infiltrates representing the separate inflamed hair follicles.
In process of increase of an inflammation these hillocks merge and the uniform semi-spherical infiltrate raised over skin level is formed. It can reach the size of a children's palm. Skin in the center of infiltrate has cyanotic coloring and hot to the touch. Tension of skin in the field of infiltrate gradually increases that is followed by morbidity strengthening. It is a stage of maturing of an anthrax which takes on average 8-12 days. It often is followed by temperature increase of a body (sometimes to 40 degrees), the general weakness, a loss of appetite, a headache, nausea and vomiting can be observed.
Maturing of an anthrax comes to an end with formation on its surface of several . Being opened, pustula form openings through which there is an allocation of necrotic masses and pus. Separated has green color and can be with blood impurity. Gradually more and more fabrics of an anthrax are exposed to a necrosis and on the place of infiltrate the deep ulcer is formed. In certain cases it can reach muscles. The stage of suppuration and a necrosis lasts 14-20 days. Development of an anthrax comes to an end with gradual healing of the formed defect of skin. On its place the rough hem soldered to surrounding fabrics is formed.
The complications arising at an anthrax are connected with spread of an infection to depth of fabrics, on the course of vessels and its hit in blood. Usually they develop at the weakened patients or in the absence of adequate treatment.
Spread of an infection to depth of soft fabrics can lead to formation of abscess of soft fabrics or developing of phlegmon, infection of a bone leads to development of osteomyelitis. Upon transition of an infection to venous vessels phlebitis and thrombophlebitis develops. Bleeding from the struck vessels is possible. When involving lymphatic vessels and knots there can be serous and purulent lymphadenitis, limfangit, periadenit also an adenoflegmon. Accession of an erysipelatous inflammation is in certain cases observed.
The anthrax located on a face is most dangerous. The infection from them can pass to brain covers with development of purulent meningitis. At hit of causative agents of an anthrax sepsis which can lead to a lethal outcome develops in blood and their rating on an organism. At bystry emergence of such serious complications as sepsis, meningitis or bleeding, speak about the malignant course of an anthrax.
Diagnosis of an anthrax
The specific clinical picture and appearance of an anthrax, as a rule, do not cause in the dermatologist any difficulties in his diagnostics. However the important diagnostic point is differential diagnosis of a usual anthrax from an anthrax at anthrax of which emergence of a black scab in the field of a pustula is characteristic. Crops of the separated anthrax allow to exclude existence of a sibireyazvenny stick and to define sensitivity of the allocated microflora (usually stafilokokk) to antibiotics.
Treatment of an anthrax
Small anthrax without the expressed intoxication and violation of the general health is subject to out-patient treatment. If treatment is begun in a stage of maturing of an anthrax, then it is carried out by conservative methods and can end with its return development about a rassasyvaniye of inflammatory infiltrate. To the patient appoint antibiotics of a broad spectrum of activity for intake: ampicillin, gentamycin, , etc. In parallel make an anthrax obkalyvaniye antibiotics. Apply analgetics to removal of morbidity. The surface of an anthrax is processed by 70% ethyl alcohol, then apply an aseptic bandage. Application of a sintomitsinovy or streptomitsinovy emulsion is possible.
Transition of an anthrax to a necrotic stage is the indication to surgical treatment. It is carried out against the background of antibiotic treatment. Operation is performed under local anesthesia. Opening of an anthrax includes a wide section, removal of all nekrotizirovanny and impractical fabrics. After operation enter a tampon with proteolytic enzymes and hypertensive solution of chloride of sodium into a wound. In the postoperative period for final rejection of nekrotizirovanny masses and clarification of a postoperative wound carry out daily shift of bandages with hypertensive solution and proteolytic enzymes. In certain cases there is a need for additional landmark nekrektomiya. Bolshaya Square and depth of defeat of fabrics at an anthrax leads to the fact that the postoperative wound heals with formation of a noticeable and rough hem.
From physiotherapeutic methods of treatment in a stage of maturing of an anthrax and in the postoperative period apply local Ural federal district and UVCh-therapy. If necessary for stimulation of protective forces of an organism carry out ultra-violet radiation of blood (UFOK) and the intravenous laser radiation of blood (ILRB). Indications to treatment in a hospital are: the expressed intoxication, the big size of an anthrax, its localization on a face, presence at the patient of noncompensated diabetes and other serious illness.