Malleus

Last Updated: 2021-11-19

Author(s): Anzengruber, Navarini

  • Rayer 1837.
  • Loeffler u. Schütz 1882.

Rotz, Hautrotz, glanders.

Notifiable infectious disease caused by the gram-positive bacterium Pseudomonas mallei.

  • Very rare in the western world.
  • People in contact with horses (stable boys, farmers, veterinarians) are particularly at risk.
  • Pathogen
    • Pseudomonas mallei (= Actinobacillus mallei, Bacillus mallei), gram-negative bacterium.
  • Incubation period
    • 2 days - 3 weeks.
  • Transmission usually occurs through "the snot" (the nasal secretion) of diseased animals.

Types of progression:

  • Primary nasal rhinitis: Entry site at the nasal mucosa. Clinically, a pustule or ulceration is seen. In some cases, bloody secretion may occur. Due to the accompanying swelling, nasal breathing is severely impaired.
  • Akuter Hautrotz (dermatitis malleosa): A pustule appears in the area of the inoculation site, which ulcerates in the course. There is the development of lymphangitis and lymphadenitis and macular exanthema, partly with vesicles, partly with ulcerated lesions (red ulcers).
  • Reduced general condition.
  • Acute fulminant form: Foudroyant cephalgias, myalgias, nausea and vomiting.
  • Chronic form: Poorly healing ulcerations with myalgias and arthralgias. The skin lesions remain localised. Often neither primary effect nor lymph node swelling are visible.
  • Anamnesis: travel history.
  • Clinical appearance.
  • Detection of pathogens by means of bact. smear (ulcer, pus or from abscess), blood culture.
  • Agglutination and complement fixation test are not positive from the start.

Without treatment, the course is usually lethal.

  • Must be reported!
  • Systemic antibiotic therapy according to resistogram.
  • If this is not available:
  • Sulfadiazine i.v. 120 mg/kg bw daily for 2-3weeks .
  • Systemic antibiotic therapy according to antibiogram is required, if necessary also over long periods.

Topical therapy

  • Antiseptic externals.
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