Ergot poisoning (ergotism): symptoms and signs of disease
Ergot poisoning — a disease known since ancient times. The number of deaths during outbreaks was comparable to the mortality from plague and smallpox. The first mention of the disease can be found in the writings of chroniclers of the tenth century. Description of Sigebert Zablotskogo who lived in the Western Lorraine, just gives an idea of the symptoms of ergotism: "a hidden fire" covers the limb of the patient and gradually kills him. Other manifestations of the disease called "witch's cramps". These included the following symptoms: confusion, psychomotor agitation, tonic convulsions, hallucinations. To combat the disease was established a special award, named in honor of St. Anthony.
Gradually thanks to the work of scientists has been established cause of the disease. The culprit was ergot — a fungus that affects cereals. When ingested spores of the fungus on the plant is the development of the sclerotium. It is called ergot, or otherwise "uterine horns". The composition of the fungus includes alkaloids which possess high toxicity.
The establishment of thorough control over the cleaning of grain from ergot allowed to leave this pathology in the past. However, minor outbreaks sometimes happen in our days. Therefore, will not be superfluous to know about the first signs of this disease.
Clinical forms of the disease
The contents of ergotoksina, ergometrine, ergotamine, tyramine and histamine causes the toxic effect of ergot on the body. The mechanism of action is the following:
- Alkaloids affect the metabolism of dopamine and serotonin.
- Spasm of smooth muscles leads to a redistribution of blood, there is a centralization of blood circulation (a condition in which first blood is provided by vital organs).
- The concentration of substances acting on the nervous structures, increases.
The toxic substances included in the composition of the fungus Claviceps, resistant to high temperatures, so after baking the bread of their poisonous properties are preserved.
The disease manifests with symptoms of General intoxication. The patient noted a pronounced weakness, fatigue, decreased performance. In some cases, there may be complaints of excessive sweating.
Further development of the disease may follow one of three directions:
|Convulsive (convulsive)||The patient complains of dizziness, paresthesia. Observed seizures (often tonic). These symptoms can join additional complaints of dyspeptic disorders: pain in the stomach, nausea and vomiting, disturbances of a chair. The emergence of various disorders of consciousness, the appearance of hallucinations, sharp dance moves tells about the difficult course of illness. Disease duration is usually 3 to 6 weeks.|
|Gangrenous||Basically, the defeat affects the neurovascular bundles. The patient complains of pain in the extremities. Objectively it is possible to reveal hyperemia initially and, later, necrotic changes on the big toes of the hands and legs, feet, nose, ears, chest, face. The accumulation of serous exudate occurs with detachment of the epidermis. The contents of the bladder ensues, evolving necrosis. First, in the area of the affected areas revealed marked soreness, but over time, the sensitivity decreases to complete disappearance. Clinically on the development of gangrenous changes says:
Gangrene develops in 3-7 days from onset of the disease.
Regardless of the form of the disease, when ergot poisoning often develop ischemic changes in the brain and tissues of the internal organs.
A diagnosis of ergotism can be installed based on the following data:
- eating infected bread or medication based on ergot in history;
- characteristic of ergot poisoning symptoms.
Quality control of bread must be carried out by using organoleptic and fluorescent methods.
The main goal of therapy is rapid clearance of the organism from toxic substances. To this end, the patient is lavage of the stomach, are enema.
Common areas of treatment
- To suppress the toxic effect of alkaloids applied CaCl.
- The binding of toxic substances in the intestine promotes the use of solution of tannin.
- Drugs to improve microcirculation.
- Drugs to relieve spasm of blood vessels.
- With the development of hallucinations — drugs benzodiazepinovogo series.
- Anticonvulsant medications.
- Drugs, stabilizing the work of the parathyroid glands.
To predict disease outcome independing on the severity of the symptoms of ergotism and the speed of their development. Severe course of the disease, its rapid development threaten a high risk of death. If the symptoms develop slowly, with time begun treatment, the probability of healing.
The main methods of prophylaxis considered:
- cleaning grain prior to the time of maturation of the fungus;
- cleaning of cereals;
- control for further processing;
- receiving medication based on ergot should be carried out solely under the supervision of a physician.
The use of ergot preparations in clinical practice
Ergot alkaloids are an important source of medicinal drugs.
Broad use of ergotamine and ergometrine found in obstetric and gynecologic practice. The introduction of these drugs practiced in atonic condition of uterus, hemorrhage, incomplete abortion.
Thanks to the anesthetic, sedative and antispasmodic action of ergotamine he used in migraine. Often used in conjunction with caffeine. It is known that the latter is able to increase the effects of ergotamine.
Dihydroergotamine and dihydroergotoxine used for the treatment of neuroses, hypertension, used in the treatment of cerebrovascular disorders.
Parlodel is widely used to suppress lactation after childbirth (if contraindications to feeding), the recovery of ovarian function. The drug used in the treatment of menstrual disorders, appointed by the galactorrhea, which was induced by admission of neuroleptic drugs, oral contraceptives.
In endocrinological practice used to treat illness Itsenko-Kushinga.
Ergot poisoning is a dangerous disease that is extremely rare, but still can be found in the modern world. Often the disease is common among cattle. This is due to the consumption of hay, struck "uterine horns." The content of more than 0.5% ergot in the hay leads to the development of signs of disease. Just like humans, animals have the disease can manifest itself in gangrenous or convulsive forms. Additionally, it may develop reproductive disorders.
The fight against ergotism in the first place should include preventive measures. The valid contents of the ergot in the bread of 0.05%. Even with a slight excess may develop some symptoms of the disease.
The first signs of the disease should be a cause for immediate treatment for medical help. Treatment is reduced mainly to symptomatic measures.