Rymarenko N. New aspects of pathogenesis and therapy of acute infectious diseases of bacterial etiology in children

The dissertation presents theoretical basis and practical solution of the important problem of child infectology - the improvement of treatment effectiveness of acute germ diseases with abenteric localization of inflammatory process in children occurring with the development of endotoxemia of intestinal origin. The results of clinical, bacteriological, immunological examination are presented, including the level of endotoxin and its receptors, antiendotoxin antibodies in 257 children suffering from quinsy, scarlet fever, meningitis and HIV-infected patients with oropharyngeal lesions of microbial etiology. It was found that severe forms of acute infectious diseases with extraintestinal localization of the inflammatory process in children occur with the development of endotoxemia of intestinal origin, which is an integral factor in the pathogenesis of these diseases and affects the destabilization of the cellular and humoral immune systems. Negative effect of the course of quinsy, scarlet fever and meningitis on the biocenosis of the oropharynx and large intestine is established as they create the preconditions for increased penetration of ET from the intestine to the systemic blood flow. For the first time the relationship between endotoxin-dependent disorder of cellular activation and C-reactive protein with the development of severe forms of bacterial quincy, scarlet fever and purulent meningitis and with the development of infectious toxicosis in children was shown. For the first time the depressive character of the infringement of humoral antiendotoxin immunity with the development of the endotoxemia of intestinal origin in flow of acute bacterial quinsy, scarlet fever and purulent meningitis. The effective therapy was developed that includes enterosorption and immunoglobulins for prosthomere impurity that prevents endotoxinemia and supports the reduction of duration of intoxic syndrome, manifestation of the local inflammatory process and laboratory signs of inflammation.