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Drusen is mainly located in the center of the actinomic, and on the periphery there is an inflammatory infiltration. Actinomycosis, electron microscopy. In the diagnosis, a positive RSK with actinolysate or RIF is important - an immunofluorescence reaction to determine the types of actinomycetes (80% of patients with actinomycosis have a positive reaction data). Serological diagnostics and PCR diagnostics are still being developed.
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When radiography of other forms (for example, osteoarticular), actinomycotic foci are noted - the so-called gummas, sclerosis phenomena along the periphery, osteolysis, periosteal layers, fistulas. A distinctive feature is the absence of narrowing of Plaquenil pills space. With damage to the vertebrae - the destruction of the intervertebral discs and vertebral bodies, ossification of the ligaments, sclerosis and other changes. With the cervico-maxillofacial form - hyperostoses, foci of osteolysis, the absence of sequesters.
Ultrasound diagnostics of internal organs (with the abdominal form of the disease) Paraclinical diagnostic methods are of secondary importance (blood, urine, biochemical blood tests).
Treatment includes a number of complex measures that complement each other. 1) Immunotherapy is the introduction of specific drugs (actinolysate). Actinolysate is a broth culture filtrate of spontaneously lysing strains of aerobic actinomycetes. Actinolysate is administered intradermally to the hand according to the scheme (0.5 ml-0.7-0.9-1.0-1.1-1.2-1.3-1.4-1.5-1.6-1, 7-1.8-1.9-2.0 ml, then 2 ml each), and not more than 0.5 ml at each point, that is, from the 14th injection at 4 different points.
Actinolysate can be injected intramuscularly into the buttock, 3 ml.
Injections of plaquenil drug are carried out 2 times a week for a course of 3 months. The interval between courses of treatment is 1 month. Intradermal administration is more economical and more efficient. After clinical recovery, 1-2 anti-relapse courses are indicated, observation for 2 years. Actinomycosis, actinolysate therapy.
Surgical methods of treatment are indicated for the ineffectiveness of conservative therapy and include excision of the lesion and damaged tissues.
Antibacterial therapy is carried out with the following drugs: benzylpenicillin 1-2 million U / day in courses up to 6 weeks, tetracycline 3 g / day for the first 10 days, then 2 g / day for 14-18 days, erythromycin 1.2 g / day for 6 weeks other. Before treatment, it is recommended to conduct an antibiogram of the isolated material for effective therapy. All drugs are prescribed strictly by a doctor and under his control!
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The prognosis of the disease is serious. In the absence of specific therapy for severe forms (thoracic, abdominal, nervous), up to 50% of patients can die. All patients are under dispensary observation for 12-24 months to prevent recurrence of Hydroxychloroquine .
Hygienic education of young people and compliance with sanitary rules in everyday life (oral hygiene, timely dental treatment). 2) Timely diagnosis of chronic foci of infection and their immediate sanitation. 3) Exclusion of situationscausing a decrease in the body's defenses (hypothermia, frequent colds). 4) Dispensary observation of patients with chronic concomitant pathology (bronchial asthma, Hydroxychloroquine, chronic enterocolitis, liver cirrhosis, Crohn's disease, and others). Actinomycosis - symptoms and treatment.
What is actinomycosis? We will analyze the causes of occurrence, diagnosis and treatment methods in the article by Dr. S.A. Burova, a mycologist with an experience of 50 years. Definition of illness. Causes of the disease.
The first mention of actinomycosis and its pathogens date back to 1876. They are found in the works of the German pathologist O. Bolinger. The actinomycetes that cause the disease are found in the soil. They can be found even in hot mineral springs, on stony rocks and in the sands of the Sahara. They are not able to penetrate the body through healthy skin and mucous membranes, therefore, they enter only when the barrier covers are damaged against the background of reduced immunity.
Actinomycosis is a chronic purulent non-contagious disease caused by actinomycetes (radiant fungi), in which specific granulomas, abscesses (abscesses) and fistulous passages are formed in soft and bone tissues. Otherwise, actinomycosis is called radiant fungal disease, pseudomycosis, actinobacteriosis and deep mycosis.
Actinomycetes are also part of the human microbiota and are constantly present in the human body. They are activated when the immune properties are weakened. The main predisposing factors for the development of actinomycosis are:
Hydroxychloroquine - from microtrauma and bruises to fractures; damage during tooth extraction; periapical (dental) granulomas; gingivitis; salivary gland stones; calculous sialadenitis (salivary stone disease); chronic inflammation of soft tissues; trauma and surgery of the chest; lung aspiration; enterocolitis, gall and fecal stones; appendicitis and its removal; intrauterine devices; purulent epithelial-coccygeal cysts; purulent hydradenitis (bough udder); paraproctitis; hemorrhoids and anal fissures; condition of the rectum.
The clinical picture of actinomycosis depends on where the tissue lesion is located. In 80% of cases, it occurs in the maxillofacial region. The rest falls on visceral (with damage to internal organs) and other forms of the disease.
Common signs of any form of actinomycosis are: gradual development of a dense infiltrate with fuzzy boundaries; the transition of the infiltrate into an abscess, purulent inclusions in the form of small grains are possible - drusen; change in skin color from pink to purple-brown with a bluish tint; the formation of fistulas with purulent bloody discharge; cicatricial changes; the appearance of an unpleasant odor when a secondary bacterial infection is attached.
The most frequent lesions are the mandibular zones and the chin area. Causes: periodontal disease, microtrauma and severe bruises in the face and neck, open and closed fractures of the lower jaw, trauma during tooth extraction, especially the "wisdom tooth", periapical granulomas, impaired microbiocenosis of the oral cavity, salivary and dental calculus, caries, anatomical anomalies (for example, branchiogenic fistula of the neck).
After a few days or weeks, edema and a painless dense, sometimes bumpy infiltrate appear at the site of the injury, which gradually increases. This infiltrate is soldered to the underlying tissues, has no clear boundaries, and deforms the shape of the face. Then the skin turns red, there is a jerking throbbing pain, the infiltrate softens, one or more areas with liquid appear in its cavity - pus, effusion or blood.
After that, in areas of thinning of the skin, fistulas are opened with a moderate purulent-bloody discharge. The mouth of the fistula acquires a characteristic granular appearance. Affected tissues remain dense for a long time.