Werner-His disease

Werner-His disease - the acute rickettsial disease characterised by the subitaneous beginning, a garapata disease, strong onychalgias, an abundant makulo-papular exanthema.

Aetiology. The originator - Rochalimea quintana (R. quintana). It is characterised by properties, characteristic and for other Rickettsias (pl Rickettsiae), for laboratory animals a little pathogenic.

Epidemiology. Disease is described in 1915 During the First World War has had been ill over 1 million, the case rate and during the Second World War became perceptible. Now it is not registered. An infection contamination source - the sick human. The transmitting agent - the body louse, infestation of the human descends at a puncture of the infected louse (Rickettsias (pl Rickettsiae) contain in a saliva and in excrements). At some patients of a Rickettsia (pl Rickettsiae) can remain in blood long time (300-400 days).

Pathogenesis. It is studied insufficiently.

Symptoms and flow. An incubation interval of 7-17 days. Disease begins subitaneously, with a fever the body temperature, further a fever of a returnable type (without etiotropic treatment of 3-8 attacks) raises. Delicacy, a strong headache, onychalgias, a loin, a back, in eyeballs disturbs. At survey the hyperemia of the person is taped, the injection of pots of scleras, is not present primary affect and a regional lymphadenitis. Early there is an abundant makulo-papular eruption - at first on a trunk, then on extremities. Separate maculae can merge in erythematic fields.

At inspection of cardiovascular system the tachycardia, BP depression, from a respiratory organs without the special changes becomes perceptible. The liver and a lien (about 3-4 days) is early enlarged. Disease proceeds in the form of attacks duration about 5 days. At half of patients one attack, at the others to brake in limens from 3 to 8 (before introduction in antibioticotherapia practice) was observed only. The general duration of disease was usually equaled 5-6 weeks. At a blood analysis the leukocytosis is more often became perceptible. Disease proceeded congenially, lethal cases were not.

The diagnosis and the differential diagnosis. For diagnostics great value epidemiological preconditions (have a pediculosis, appearance of cases of a Werner-His disease) and characteristic clinical semiology (a garapata disease, onychalgias, an exanthema). Weil-Felix reaction with all Proteuses (OX19, OX2, OXk) the negative. Specific diagnosticums now is not issued.