Angina in alimentary toxic aleukia.

Alimentary-toxic aleukia is a mycotoxicosis that occurs when eating products made from grain that has overwintered in the field (millet, buckwheat, wheat, rye, barley, oats, rice). These cereals are affected by the fungus Fusarium sporotrihiella, which produces a mycotoxin that has both a local damaging effect, causing local aseptic inflammation of the "burn" type, and a general toxic effect on the body.

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Symptoms of angina in alimentary-toxic aleukia

The disease occurs in four periods:

1. initial or general toxic stage (headache, weakness, fever, nausea, vomiting, sweating, headache, stomatitis, glossitis, gastroenteritis, etc.);
2. the leukopenic stage is manifested by changes in the blood (a decrease in the number of leukocytes, erythrocytes, platelets, hemoglobin content; relative lymphocytosis occurs); against this background, the opportunistic microbiota of the oral cavity is activated;
3. angina-hemorrhagic stage (pinpoint hemorrhages on the skin and mucous membrane of the oral cavity, pharynx, stomach, intestines; nasal, uterine, intestinal and other bleeding; necrotic or gangrenous tonsillitis; at this stage, the fever takes on a septic character due to the emerging bacterial inflammatory phenomena in the pharynx and other lymphoid formations of the upper respiratory tract and gastrointestinal tract, accompanied by toxemia; a decrease in the platelet content and agranulocytosis are noted in the blood; in this period, the most common complications are pneumonia, phlegmon and extensive abscesses of various localizations, sepsis;
4. recovery stage, observed with timely and correct treatment; its duration in the absence of serious complications does not exceed 10-14 days.

Healing of necrotic and disappearance of hemorrhagic phenomena occurs against the background of a lytic decrease in body temperature, which indicates that the body is emerging from the state of acute toxicosis. However, some symptoms of intoxication (subfebrile temperature, weakness, malaise, etc.) may persist for a long time.

Diagnosis is made easier by establishing the fact of consumption of food products made from grain that has overwintered in the field.

Treatment of angina in alimentary-toxic aleukia

At the first symptoms of acute intoxication, it is necessary to wash the stomach using the method used for oral poisoning with various poisons and poor-quality products (probe method). Contraindications to probe gastric lavage include large diverticula and esophageal stenosis, and long periods (more than 6-8 hours) after eating products made from sprouted grains.

A thick gastric tube with a funnel is used for gastric lavage. The tube is inserted into the stomach using the generally accepted method up to the 50 cm mark. Gastric lavage consists of two stages. In the first stage, the funnel is initially positioned at the patient's knee level, slightly inclined (so as not to introduce air into the stomach) and is slowly raised, simultaneously filling it with lavage fluid (water, 2% sodium bicarbonate solution, 0.2-0.1% potassium permanganate solution) at room temperature. The funnel is raised above the patient's mouth. As the funnel rises and is constantly replenished, the liquid quickly passes into the stomach. It is impossible to allow the funnel to be completely emptied and all the liquid to pass into the stomach, since air begins to enter the tube after the liquid has completely emptied the system, which complicates the subsequent removal of the stomach contents. At the second stage, the funnel, in which they try to keep the liquid level at the mark of the narrow part, is lowered down to the level of the patient's track and wait until it is filled with the contents of the stomach, after which it is turned over over the basin and the entire procedure is repeated again until 10 to 20 liters of washing liquid pass through the stomach. The first and last portions of washing water are delivered to the laboratory for testing. After washing the stomach, the patient is given a laxative.

Further treatment is carried out in a hospital, where a gradual transition to a balanced diet is ensured, which should include milk and fermented milk products. Vitamins, calcium preparations, blood transfusions are prescribed, and intensive detoxification therapy is carried out. To prevent bacterial complications, antibiotics and sulfonamides are prescribed, and in case of bleeding, hemostatic agents of resorptive and local action are prescribed in accordance with the existing indications.

The prognosis is favorable if treatment is started in a timely manner; it worsens with the onset of sepsis or internal bleeding.