Cách điều trị bệnh sốt mò hiệu quả

Bệnh sốt mò có thể diễn biến nặng ngay từ tuần đầu của bệnh với các bệnh viêm phổi, suy hô hấp. Vì vậy cần biết cách điều trị bệnh cho phù hợp để tránh những biến chứng của căn bệnh.

Điều trị bệnh sốt mò kịp thời sẽ phòng tránh được tối đa các biến chứng nguy hiểm của bệnh.

Tìm hiểu chung về sốt mò

Bệnh sốt mò còn được gọi là sốt triền sông Nhật Bản, sốt bụi rậm hay sốt phát ban rừng. Nguyên nhân gây bệnh bắt nguồn từ loại vi khuẩn có tên Orientalis tsutsugamushi, thuộc họ Rickettsia.

Ấu trùng bọ ve mò đã bị nhiễm mầm bệnh chính là vật trung gian truyền sốt mò. Ấu trùng mò mang vi khuẩn đốt cắn con người, truyền bệnh qua nước bọt là phương thức lây nhiễm duy nhất. Bệnh không lây lan từ người sang người.

Cách điều trị bệnh sốt mò hiệu quả 1

Ấu trùng bọ ve mò đã bị nhiễm mầm bệnh chính là vật trung gian truyền sốt mò.

Biểu hiện đặc trưng của sốt mò là người bệnh bị sốt cao liên tục (trên 38-40 độ C), kiểm tra trên cơ thể phát hiện vết loét do mò đốt điển hình ở vị trí da mỏng mềm. Triệu chứng kèm theo có thể là nhức đầu chóng mặt dữ dội, phát ban và nổi hạch sưng đau.

Đôi khi, bệnh sốt mò không xuất hiện nốt loét (thể ẩn) nên dễ bị chẩn đoán nhầm với các bệnh sốt rét, sốt xuất huyết,… Việc chẩn đoán phân biệt là rất quan trọng nhằm đưa ra phương hướng chữa bệnh chính xác, đòi hỏi phải thăm khám cẩn thận và làm một số xét nghiệm cần thiết.

Nếu bệnh nhẹ có thể tự khỏi sau vài tuần. Tuy nhiên đa phần bệnh sốt mò đều cần phải được điều trị sớm và tích cực bằng kháng sinh đặc hiệu mới có thể khỏi và hạn chế được biến chứng nguy hiểm của sốt mò.

Sốt mò có lây không?

Đường truyền bệnh

Sốt mò là bệnh lây truyền sang người từ côn trùng trung gian – ấu trùng mò. Như vậy, con mò không chỉ là vật chủ mà còn là trung gian truyền bệnh. Tuy nhiên người bị nhiễm bệnh khi bị ấu trùng mò đốt thì không có khả năng truyền bệnh sang người khác.

Cách điều trị bệnh sốt mò hiệu quả 2

Sốt mò là bệnh lây truyền sang người từ côn trùng trung gian.

Điều kiện lây truyền sang người

Mò và ấu trùng ưa sống ở vùng đất xốp, ẩm mát nơi các khe hang, ven bờ sông suối, nơi râm mát có bụi cây và cây thấp có quả hạt để chờ thú nhỏ hoặc những loài gặm nhấm lui tới. Người có thể bị đốt trong các trường hợp sau:

  • Sinh hoạt lao động trong ổ dịch.
  • Phát rẫy làm nương.
  • Bộ đội đi dã ngoại.
  • Ngồi, nằm nghỉ, trên bãi cỏ, để mũ nón buộc võng vào gốc cây.

Các biện pháp chẩn đoán bệnh Sốt mò

Chẩn đoán phân biệt

Bệnh do xoắn khuẩn: cũng có sốt, sung huyết, mắt đỏ, đau cơ, nổi ban và hạch to nhưng không có vết loét đặc trưng, thường có xuất huyết dưới da.

Thương hàn: cũng có sốt kéo dài, li bì, mạch nhiệt phân ly nhưng ban rất thưa, bụng thường chướng, có óc ách hố chậu phải và không có vết loét đặc trưng.

Sốt Dengue: sốt thường kéo dài trung bình 6 – 7 ngày, nhưng ở sốt Dengue cổ điển dát sẩn dày hơn, đau cơ khớp rõ hơn còn ở sốt xuất huyết Dengue thì ban xuất huyết hay xuất hiện khi hết sốt, không có vết loét đặc trưng.

Sốt rét:tuy sốt rét tiên phát có sốt liên tục nhưng sau đó cũng chuyển vào cơn sốt chu kỳ với 3 giai đoạn rét – nóng – vã mồ hôi, không có vết loét đặc trưng, xét nghiệm máu tìm ký sinh trùng sốt rét dương tính.

Các biện pháp điều trị bệnh Sốt mò

Điều trị sốt mò bao gồm điều trị đặc hiệu và điều trị triệu chứng.

Điều trị đặc hiệu:

Liệu pháp kháng sinh:

Sulfamid dùng cùng Rickettsia nhưng chỉ dùng cho thể nhẹ. Tuy nhiên, hiện nay bác sĩ ít kê đơn cho dùng vì trong sốt mò có viêm nội mạc mạch máu. Thuốc dễ gây phù nề, tắc mạch và nếu điều trị sulfamid dễ gây tổn thương cầu thận, ống thận.

Kháng sinh thông dụng và có hiệu quả nhất với sốt mò là clorocid và tetracyclin. Do hai thuốc này chỉ có tác dụng kìm khuẩn chứ không diệt được vi khuẩn nên Rickettsia vẫn sống và tồn tại trong hạch bạch huyết, ở hệ võng nội mô trong nhiều ngày, nhiều tháng và dễ tái phát bệnh.

Cách điều trị bệnh sốt mò hiệu quả 3

Kháng sinh thông dụng và có hiệu quả nhất với sốt mò là clorocid và tetracyclin.

Liều lượng và cách dùng:

Clorocid hoặc tetracyclin:

  • Ngày đầu: 2g/ngày (cho người khoảng 50kg), dùng liều cao 2g khởi đầu có xu hướng cắt sốt nhanh hơn.
  • Những ngày còn lại dung liều 1g/ngày, cho tới khi cắt sốt 2-3 ngày;
  • Tổng liều: 6-7g.

Việc uống liều cao cũng không làm giảm khả năng sinh kháng thể và không ảnh hưởng tới kết quả của các phản ứng huyết thanh cũng như gây tai biến gì cho người bệnh.

Ciprofloxacin và azithromycin cũng có công dụng tốt trong điều trị bệnh sốt mò.

Có thể dùng doxycycline viên 100mg x 2 viên/ngày cho người lớn, dùng 7 đến 15 ngày.

Khi can thiệp sớm (trong 3 ngày đầu), sau 6 ngày ngưng thuốc nên chỉ định điều trị đợt 2 trong 3-4 ngày, để ngăn chặn tái phát.

Liệu pháp kháng sinh phối hợp với corticoid:

Một số trường hợp người bệnh sau khi dùng kháng sinh vài ngày nhưng nhiệt độ vẫn không thuyên giảm thì có thể dùng phối hợp với cortancyl (nếu không có chống chỉ định) với liều trung bình ngắn ngày như sau: cortancyl viên 5mg x 4 viên/ngày, dùng trong 2-3 ngày sẽ hạ nhiệt độ nhanh hơn.

Điều trị triệu chứng:

Bổ sung nước – điện giải: ở bệnh nhân sốt mò thường có tình trạng sốt cao kéo dài và ăn uống kém nên dễ có hiện tượng mất nước và các chất điện giải. Do vậy cần cho bệnh nhân uống đủ nước và truyền dịch.

Trợ tim mạch: người sốt mò thường biến chứng sang viêm cơ tim, viêm nội mạc mạch máu nên cần dùng các thuốc trợ tim mạch như: ouabain, spartein, coramin.

Nâng cao sức đề kháng của cơ thể: bổ sung vitamin, ăn uống đủ chất.

An thần, hạ sốt (khi sốt cao).

Điều trị bội nhiễm nếu có.

Nguồn: Tham khảo

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