What is brucellosis Wright and what is the specific principle?

Brucellosis, also known as wave fever, is an acute or chronic infectious disease caused by brucellosis and belongs to a natural epidemic disease. The main clinical manifestations are fever, hyperhidrosis and joint pain.

catalogue

diagnose

brief introduction

Major organ invasion

Symptoms and dangers

The treatment is antibiotics.

Mongolian medicine characteristic therapy

aetiology

pathogenesis

pathological change

Epidemiological distribution

source of infection

Transmission route

susceptible population

diagnose

brief introduction

Major organ invasion

Symptoms and dangers

The treatment is antibiotics.

Mongolian medicine characteristic therapy

aetiology

pathogenesis

pathological change

epidemiology

Distribution of infection source, transmission route and susceptible population. Edit this paragraph for diagnosis.

Epidemiological data and occupation are of great value to the auxiliary diagnosis of this disease. If the disease has some special clinical manifestations, such as wave fever and orchitis, the diagnosis can be basically established. The positive results of blood, bone marrow and pus culture are the basis of diagnosis. Agglutination test (or ELISA, patch test and so on. ) should be measured monthly and weekly, and those with high titer or double titer have diagnostic value. When the agglutination test of chronic patients is negative, ELISA or anti-human globulin test should be done. In order to distinguish natural infection from artificial immunity, or to determine whether the disease is active, 2-ME test can be done.

Edit the introduction of this paragraph.

Brucella Brucella is a Gram-negative immobilized bacterium, which can survive as an intracellular parasite in many domestic animals. The main infectious agents are Brucella Malta ("Malta fever"), Brucella abortus, Brucella bovis, Brucella suis and Brucella canis. The pathogen is an infected animal (both humans and animals will get sick). Their excrement and contaminated food spread. At the beginning of the disease, it will be accompanied by moderate fever, and it will be aggravated at night when it is acute. This period is characterized by large liver, large spleen or enlarged lymph nodes. Intermittent fever with temperature fluctuation is the characteristic of Brucella and Brucella suis infection. The disease will not heal itself, nor will it become a chronic disease. For chronic diseases, many clinical symptoms may lead to multiple organs or organ systems. Tissue granuloma can be observed in infected tissues of bones or joints. Bacterial endocarditis can be life-threatening if it is not treated in time. The different stages of brucellosis patients are divided into: acute stage 1-3 months, subacute stage, chronic stage for more than 3 months, organ injury complication stage for more than 6 months, intractable stage with repeated attacks for more than 2-3 times, and late stage of various organ and tissue complications. The medication of various complicated clinical symptoms is different: male patients, female patients, married patients, unmarried patients, the elderly, children, high fever, low fever, joint pain, deformation, organ injury complications and so on. Clinically, in the late stage of brucellosis, there may be symptoms such as loss of working ability, bedridden, nervous or mental illness.

Edit the main organs invaded by this paragraph.

(1) motor system: joint muscle pain. There are joint pains such as knee joint, waist, shoulder, hip and elbow. (2) Nervous system: it can cause nerve dryness and nerve root injury, leading to neuralgia. Low back pain, hip pain, leg pain and so on. (3) Respiratory system: Some patients have interstitial pneumonia and cough. (4) Digestive system: In the acute stage, some patients suffered from severe liver damage, with symptoms of digestive tract such as yellow urine, yellow sclera, liver discomfort and loss of appetite. (5) Urogenital system: Male patients have testicular pain and slight abdominal pain due to orchitis or epididymitis. Neuralgia of spermatic cord may occur in chronic stage, leading to impotence, nocturnal emission and sexual hypofunction. Female patients may have breast pain, low back pain, slight abdominal pain, irregular menstruation, amenorrhea or excessive bleeding, excessive leucorrhea, decreased libido, premature delivery, abortion, stillbirth and so on. Nephritis, nephritis and cystitis can also occur.

Edit the symptoms and dangers of this paragraph.

After suffering from brucellosis, the first symptom is fever, and the temperature can reach 38-40 degrees. Different people have different types of fever. Some people's body temperature is not too high, fluctuating between 37-38 degrees, lasting for a long time, in a long-term low-heat state; Some people's body temperature is wavy, that is, they have a high fever for a few days, their body temperature drops for a few days, and then they start to rise again and again, so brucellosis is also called wave fever. There are also high and low body temperature, great changes in the morning and evening, dangerous illness, relaxation and fever, and so on. At present, there are many people with chronic low fever. Another feature is hyperhidrosis, especially in the early stage of onset, sweating at night, and sweating is sticky, which mostly appears in the head and chest. Patients also often have joint pain and swelling. Male patients are prone to testicular enlargement (single case), while female patients may have irregular menstruation, abortion and excessive leucorrhea. It is not obvious at the initial stage of the disease, and the symptoms of bone and joint appear one after another when the body temperature drops gradually. Pain or joint dyskinesia is more common in large joints. Such as waist, sacrum, hip, shoulder, elbow, knee and other joints. Often misdiagnosed as rheumatism. The physical examination of brucellosis patients can also see lymph node enlargement (head, armpit, groin, etc.) ), hepatosplenomegaly in some parts. Other symptoms such as fatigue, loss of appetite and mental fatigue are similar to colds. In a word, brucellosis has no obvious characteristic manifestations and various symptoms.

Edit this treatment.

Use antibiotics.

(Contraindications: active tuberculosis, rheumatic fever, malignant tumor, liver and kidney insufficiency, pregnancy, unmarried patients, etc. ) (1) Tetracycline antibiotics and streptomycin treatment: Tetracycline is 2g daily, taken orally four times, 2 1 day is 1 course of treatment, and 1-2 courses of treatment can be repeated with an interval of 5-7 days. Streptomycin is used in the first course of treatment. Adults take 1 g every day, and he gives intramuscular injections twice. (2) Treatment with rifampicin and doxycycline: adults with rifampicin were given 600-900 mg orally twice a day, and 200 mg doxycycline orally every morning for 6 weeks. (3) Sulfamethoxazole treatment: Adults take 2 tablets of compound sulfamethoxazole each time, 3 times a day for 2 weeks, and then twice a day. Three weeks is a course of treatment, which can be treated for 2-3 courses with an interval of 5-7 days. This kind of drug has a certain recurrence rate after treatment. (4) Symptomatic treatment: Besides antibiotic treatment, symptomatic treatment should also be taken. For example, people with insomnia can take sedatives, people with joint pain and headache can take painkillers, and people with high fever can take physical cooling or antipyretic drugs. There is no specific drug for chronic brucellosis. Traditional Chinese medicine is widely used in China. Because the symptoms of chronic patients are complex, different people have different manifestations. Some are mainly allergic symptoms, some are mainly endocrine disorders, and some have low immune function. Doctors should give appropriate treatment according to different situations.

Mongolian medicine characteristic therapy

Wu Bater (Mongolian)/KLOC-0 graduated from Inner Mongolia College of Mongolian Medicine and Pharmacy in July, 1983 with a bachelor's degree and a master's degree in Mongolian medicine. After staying in school to teach, he engaged in pathological research. Over the past 20 years, through the doctor's unremitting research, he has treated various types of cysticercosis, epilepsy, systemic lupus erythematosus, brucellosis, psoriasis and so on with Mongolian medicine. In 2003, Bater Qiwei Pill and other ten kinds of pure Chinese medicine prescriptions were developed, and the national drug standard number Z 15020389 was obtained, which filled the blank of domestic brucellosis drugs. At present, the demand for mass production of the drug is in short supply, and the cure rate of brucellosis patients after clinical treatment can reach over 95%, especially the prescription number Z 1. Brucellosis occurred in Inner Mongolia very early, so the Inner Mongolia government attaches great importance to this class B infectious disease. Inner Mongolia College of Mongolian Medicine was entrusted to set up a research institution specializing in the treatment of brucellosis, and a series of specific drugs for brucellosis were developed in a short time, which have continued to this day. As a member of the research group, Dr. Bater Wu dabbled in R&D, pharmacy and treatment, and developed "Yishen Shiqiwei Pill" and "Bater Qiwei Pill". These two drugs for the treatment of brucellosis were developed and invented by Dr. Wu Bater, and have been approved by the national medicine. They can solve the medical problem of male brucellosis testicular swelling (usually unilateral) within 16 days, and thus won the third prize of scientific and technological achievements of Mongolian medicine in Inner Mongolia. Professor Bater Wu made a comprehensive exposition on the etiology and diagnosis of brucellosis. The Department of Brucellosis of the 203rd Hospital of China People's Liberation Army has its own unique means to treat brucellosis. At present, there are more than a dozen drugs used by Mongolian medicine to treat brucellosis. According to the different stages of brucellosis. Various complicated clinical symptoms: (acute stage, subacute stage, chronic stage, intractable stage, late stage, male patients, female patients, married patients, unmarried patients, elderly people, children, high fever, low fever, joint pain, deformation and so on. ) Brucella 0 \ Brucella 1 \ Brucella 2 \ Brucella 3 were used respectively. The unique efficacy of Mongolian medicine The unique efficacy of Mongolian medicine lies in the wonderful compatibility method. Using pure natural herbs, minerals and livestock products from Mongolia Plateau and Qinghai-Tibet Plateau, it overcomes the shortcoming that western medicine can not enter cells to treat brucellosis, so that the wave fever of patients can be effectively controlled and the spread and recurrence of brucellosis can be completely controlled. Brucellosis patients have fatigue, weakness, hyperhidrosis, hepatosplenomegaly and other symptoms. Mongolian doctors can recover their physical fitness within 1-2 months, get rid of the shadow of laziness, sweating, fatigue and laziness, and basically resume their work and life ability by means of tonifying kidney and deficiency, supplementing qi and blood, and enhancing immunity. Through the dialectical medication of Mongolian medicine, hyperhidrosis, night sweats, fever, joint pain, hepatosplenomegaly and testicular enlargement can be quickly eliminated, so that male patients can recover their reproductive ability and completely cure brucellosis with low recurrence rate. Chronic brucellosis: Western medicine has no specific drug treatment. Our hospital has been treated with Mongolian medicine for a long time and achieved gratifying results. Because the symptoms of chronic patients are complex, different people have different manifestations. Some are mainly allergic symptoms, some are mainly endocrine disorders, and some have low immune function. Doctors should give appropriate treatment according to different situations. Harmfulness: The disease is a zoonotic disease. In the epidemic process, it can spread to people through digestive tract, respiratory tract, reproductive tract, conjunctiva and damaged skin, which seriously harms people's health and the development of animal husbandry. After people are infected with brucellosis, their condition is complicated, with symptoms such as fever, joint pain and abortion of pregnant women. Pathogen detection is slow, it is difficult to distinguish clinically and easy to be misdiagnosed. The recurrence rate is 50%, which requires long-term combined medication. Sick animals have miscarriages or empty fetuses; Cows infected with brucellosis can cause abortion, and the milk yield decreases obviously. Sick animals can't be used as breeding animals because of affecting variety improvement, and the economic loss is great. Epidemiological characteristics: the disease can occur all year round. The first peak appeared in February-April, and the second peak appeared in July-165438+1October, which was related to lactation, shearing, identification, grouping and mating. The infection rate of young cattle, sheep and pigs is low, and the infection rate gradually increases with the increase of animal age. Brucellosis in livestock is mainly infected through digestive tract, reproductive tract, skin and mucosa. Prevention and Control Measures China has taken comprehensive prevention and control measures such as perennial immunization, quarantine, isolation and culling against brucellosis in cattle, sheep and pigs. Vaccine immunization is an effective measure to control brucellosis, but the live vaccines currently used have different degrees of residual toxicity to people, so attention should be paid to self-protection during epidemic prevention. Second, we must adhere to regular quarantine, quarantine breeding animals and cows twice a year, isolate and cull positive animals eliminated from quarantine, and cultivate healthy herds; Keep calves and lambs in isolation, quarantine regularly, cull and eliminate positive animals. Third, strengthen the management of feeding links, adhere to self-propagation and self-support, do not introduce breeding animals from epidemic areas, and strictly quarantine imported animals when necessary. Fourth, we should improve the disinfection system and strictly disinfect barns, sports fields and utensils contaminated by sick animals. Fifth, increase the propaganda of disease prevention knowledge, so that the broad masses can understand and master certain disease prevention knowledge, which not only prevents brucellosis from spreading among animals, but also prevents sick animals from infecting people.

Edit the cause of this paragraph.

Brucella can be divided into six biological species, including Marta (sheep), abortion (cattle), pig, dog, forest mouse and sheep epididymis, with a total of 19 biotypes, namely, sheep (3 biotypes) and cattle (8 biotypes, bovine type 3 and bovine type 6), and the biological characteristics of Brucella are the same. In China, sheep seed bacteria are dominant, followed by cattle seed bacteria, and pig seed bacteria only exist in a few areas. In recent years, it has been found that the infection rate of dogs in 23 provinces and autonomous regions is 7.5%, and that of people in 5 provinces and autonomous regions is 6. 1%. Brucella is an inactive microsphere with negative Gram staining and no spore formation. The strain is sensitive to light, heat and common chemical disinfectants. Sunlight irradiation 10 ~ 20 minutes, 60℃ damp heat 10 ~ 20 minutes, and 3% bleaching powder clear solution can be killed in a few minutes. Brucella has strong vitality in the external environment. It can survive for weeks to months in dry soil, fur and dairy products, and for 5 days to 4 months in water. Brucella only produces endomycin, which is toxic to experimental animals.

Edit this paragraph about pathogenesis.

After Brucella enters the human body from the skin or mucous membrane, neutrophils first appear, which can partially kill the swallowed bovine bacteria, but the sheep bacteria are not easy to be killed. The surviving Brucella arrived at local lymph nodes with lymph. According to the disease resistance of human body and the number and virulence of invading bacteria, bacteria are either destroyed locally or grow and multiply in lymph nodes, forming infected lesions. When bacteria proliferate to a certain number, they will break through the lymph node barrier and invade the blood circulation. At this time, there may be a series of symptoms such as bacteremia and toxemia. After the pathogen enters the blood circulation, it is easy to form new infection lesions in the reticuloendothelial system such as liver, spleen, bone marrow and lymph nodes, and the pathogen of the posterior reticuloendothelial can enter the blood circulation many times, leading to recurrence. The fever is wavy (so this disease is also called wave fever). Brucella is mainly parasitic in macrophages. Like other chronic infectious diseases caused by parasitic intracellular bacteria, its pathogenesis is mainly delayed allergic reaction. The occurrence and development of brucellosis is very repeated. First, it is related to bacteremia, toxemia and allergic reaction. Second, the bacterium invades many organs. Third, antibacterial drugs and antibodies are not easy to enter cells. Therefore, the clinical manifestations of brucellosis are complex and it is difficult to treat. In the acute stage, the reticuloendothelial system proliferates, and in the chronic stage, granuloma composed of epithelioid cells, giant cells, plasma cells and lymphocytes can appear, which is an allergic reaction of tissues to bacteria. Similar lesions can be found in liver, spleen, lymph nodes and bone marrow. In brucellosis of sheep and pigs, suppurative granuloma is often formed, especially the latter.

Edit the lesion in this paragraph.

Hyperplasia and destructive lesions of blood vessels are also caused by allergic reactions, mainly involving small blood vessels and capillaries such as liver, spleen, brain and kidney, leading to endometritis, thromboangiitis, serous inflammation and tiny necrosis of organs. Allergic inflammation of bones, joints and nervous system is mainly manifested as arthritis, ankylosing spondylitis, osteomyelitis, neuritis, radiculitis and so on. There may be hemorrhagic catarrhal pneumonia in the lungs, cardiac lesions are less common than vascular lesions, endocarditis, myocarditis and so on. The kidney is turbid and swollen, with occasional diffuse nephritis and pyelonephritis. In addition, there are orchitis, epididymitis, endometritis and so on.

Edit this paragraph of epidemiology.

Be distributed

The disease is distributed all over the world, and WHO reports more than 500,000 cases every year. The Mediterranean region, Asia and Central and South America are high incidence areas. It is common in Inner Mongolia, Northeast China, Northwest China and other special zones, and all the epidemic areas in China 104 have reached the basic control standards. However, since the 1990s, sporadic cases have increased at a rate of 30% ~ 50%, and outbreaks have occurred in some areas.

source of infection

Sheep are the main source of infection in China, followed by cattle and pigs. After these domestic animals get this disease, they often cause miscarriage or stillbirth in the early stage, and their vaginal secretions are particularly contagious. Their fur, organs, placenta, amniotic fluid, fetal animals, milk and urine are often infected by bacteria. There are many bacteria in the milk of sick animals, which can be excreted for months to years.

Transmission route

In China, it is the main infection route for herders to receive lambs, and it is also very easy for veterinarians to deliver sick animals. In addition, skinning cattle and sheep, shearing wool, milking, cutting virus meat, slaughtering sick animals, children playing with sheep, etc. can all be infected, and germs enter the human body from the damaged skin at the contact point. Laboratory workers are often infected by bacteria on the skin and mucous membranes. Bacteria can enter the body from the digestive tract when eating raw milk, dairy products and undercooked meat of sick animals. In addition, germs can also be infected through respiratory mucosa, conjunctiva and mucous membranes of sexual organs.

susceptible population

The population is generally susceptible to Brucella, and the incidence rate of young and middle-aged men is higher than that of women because of their professional relationship. The infection rate of herdsmen in SEZ is the highest in China, mostly occurring in late spring and early summer or between summer and autumn, which is related to the lambing season of sheep. There is some immunity after illness, but reinfection is not too rare.