The
causative agent of rabies virus (Neuroryctes rabieis), released by
diseased animals with saliva, human infection occurs when the patient
bites rabid domestic or wild animals (dogs, cats, foxes, wolves), and
even birds and their saliva gets on the skin and mucous membranes, with
damage.
The incubation period ranges from 15 days to 2 months. of the bite with a possible extension to up to a year.
Symptoms. Of seizures preceded prodrome lasting 1-3 days. In this period, quite often there is pain in the area of the bite, burning, or hyperesthesia of the skin, poor sleep, depressed mood.
The disease begins with fever up to 37,2-37,5 ° C, agitation, complaints of difficulty swallowing, <shortness of breath>.
The first day of symptoms steadily increasing, developing hydrophobia (swallowing muscles twitching at the sight of the water and the sound of running water), there are general convulsions, which may be the cause of a bright light, noise, touch.
Continuously increases the reflex excitability leads to the development of general (mainly of tonic) seizures and swallowing muscles spasm, even under the influence of air flow (aerophobia).
By the end of the first day of the disease expressed manifestations of visual, auditory and tactile sensitivity is sharpened so that the slightest irritation causes seizures. At the same time, the patient may be noted the disappearance of corneal reflex (when touching the cornea with cotton patient does not blink) and the gag reflex (pressure on the tongue and pharyngeal walls touching or trowel not cause gagging).
On the 2-3rd day of illness, along with general convulsions and muscle spasms swallowing appears marked agitation. The patient is restless, gets up from the bed, crying. Speech becomes incoherent, staccato, there auditory and visual hallucinations, often threatening. Pronounced tachycardia and salivation.
Saliva is a liquid and abundant, the patient continuously spits it or it runs down his chin.
Diagnosis in typical cases of difficulty is not.
The most common form of convulsive rage, which in some cases necessary to differentiate from tetanus, which is characterized by a history of injury, frostbite, burns, illegal abortions.
In contrast to the fury of tetanus is not marked mental disturbances, agitation, salivation, hydrophobia.
In patients with tetanus persist corneal and pharyngeal reflexes, while it tries to develop their general convulsions.
Of tetanus there is increased sweating, which does not happen in rabies.
Emergency. Provide maximum patient comfort with the exception of all external stimuli (noise, bright light, concussion, the sounds of running water.) There is no specific treatment.
Hospitalization. When the diagnosis of the patient to be hospitalized in the infectious ward.
Before you go to the hospital to reduce agitation administered chlorpromazine or lytic mixture (intramuscular, intravenous rare).
With a pronounced psihomo reflex excitation single dose of chlorpromazine may be 0.15-0.2, with the need for a large number of chlorpromazine is administered intramuscularly in 2-3 places with 0.5% rastvopa Novocaine (10 ml 0, 5% solution of chlorpromazine - 5 ml of 0.5% solution of novocaine).
More stable and rapid effect on psychomotor excitation makes use of lytic mixtures containing, in addition to chlorpromazine, protivogistaminnye drugs and analgesics: 2 ml of 2.5% solution of chlorpromazine, 2 ml of 2.5% solution diprazina (pipolfen), 1 ml of 2% solution promedola 2 ml of 2.5% solution of chlorpromazine, 2 ml of a 1% solution dimedrola, 2 mL of 2% solution promedola.
Mixture is injected intramuscularly or intravenously (rarely).
In cardiovascular disease prescribed cardiovascular drugs.
Vehicles transporting patients for infectious diseases, accompanied by two nurses.
The incubation period ranges from 15 days to 2 months. of the bite with a possible extension to up to a year.
Symptoms. Of seizures preceded prodrome lasting 1-3 days. In this period, quite often there is pain in the area of the bite, burning, or hyperesthesia of the skin, poor sleep, depressed mood.
The disease begins with fever up to 37,2-37,5 ° C, agitation, complaints of difficulty swallowing, <shortness of breath>.
The first day of symptoms steadily increasing, developing hydrophobia (swallowing muscles twitching at the sight of the water and the sound of running water), there are general convulsions, which may be the cause of a bright light, noise, touch.
Continuously increases the reflex excitability leads to the development of general (mainly of tonic) seizures and swallowing muscles spasm, even under the influence of air flow (aerophobia).
By the end of the first day of the disease expressed manifestations of visual, auditory and tactile sensitivity is sharpened so that the slightest irritation causes seizures. At the same time, the patient may be noted the disappearance of corneal reflex (when touching the cornea with cotton patient does not blink) and the gag reflex (pressure on the tongue and pharyngeal walls touching or trowel not cause gagging).
On the 2-3rd day of illness, along with general convulsions and muscle spasms swallowing appears marked agitation. The patient is restless, gets up from the bed, crying. Speech becomes incoherent, staccato, there auditory and visual hallucinations, often threatening. Pronounced tachycardia and salivation.
Saliva is a liquid and abundant, the patient continuously spits it or it runs down his chin.
Diagnosis in typical cases of difficulty is not.
The most common form of convulsive rage, which in some cases necessary to differentiate from tetanus, which is characterized by a history of injury, frostbite, burns, illegal abortions.
In contrast to the fury of tetanus is not marked mental disturbances, agitation, salivation, hydrophobia.
In patients with tetanus persist corneal and pharyngeal reflexes, while it tries to develop their general convulsions.
Of tetanus there is increased sweating, which does not happen in rabies.
Emergency. Provide maximum patient comfort with the exception of all external stimuli (noise, bright light, concussion, the sounds of running water.) There is no specific treatment.
Hospitalization. When the diagnosis of the patient to be hospitalized in the infectious ward.
Before you go to the hospital to reduce agitation administered chlorpromazine or lytic mixture (intramuscular, intravenous rare).
With a pronounced psihomo reflex excitation single dose of chlorpromazine may be 0.15-0.2, with the need for a large number of chlorpromazine is administered intramuscularly in 2-3 places with 0.5% rastvopa Novocaine (10 ml 0, 5% solution of chlorpromazine - 5 ml of 0.5% solution of novocaine).
More stable and rapid effect on psychomotor excitation makes use of lytic mixtures containing, in addition to chlorpromazine, protivogistaminnye drugs and analgesics: 2 ml of 2.5% solution of chlorpromazine, 2 ml of 2.5% solution diprazina (pipolfen), 1 ml of 2% solution promedola 2 ml of 2.5% solution of chlorpromazine, 2 ml of a 1% solution dimedrola, 2 mL of 2% solution promedola.
Mixture is injected intramuscularly or intravenously (rarely).
In cardiovascular disease prescribed cardiovascular drugs.
Vehicles transporting patients for infectious diseases, accompanied by two nurses.
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