Herbal Treatment for Tularemia in Ayurveda

Abstract

Tularemia is a highly infectious systemic disorder. It is characterized by focal suppurative and granulomatous inflammatory reactions in many sites of the body. The causative agent is a tiny gram negative bacteria called pleomorphic coccobacilli. Basically the organisms cause a disease of animals, occasionally transmitted to man by direct contact with the infected animals or arthropod vectors. The animal reservoir comprises a wide variety of wild and domestic animals as well as birds and ticks. But the most common mode of transmission is rabbits and squirrels. In this article we will discuss every detail related to Tularemia and how it can be managed using Ayurvedic formulations.

Introduction

The cases which are reported, ninety percent of them are due to the direct contact of humans with the infected animal. From this data it is easy to determine which part of the population is mostly affected. Most commonly affected population is butchers, hunters, farmers, cooks and housewives. The organism is said to penetrate the unbroken skin and so present a risk for medical and paramedical staff too. In rare cases the infection can also spread from the bite of an infected animal like deer, fly or variety of ticks. The most common fly responsible for spreading infection is Chrysops discalis. But beside that invasiveness and the effectiveness of the organism, man-to-man transmission has not been recorded.

Types of tularemia

Generally the bacteria enters through the portal like through gastrointestinal or through eyes. So types are being described depending on the portal entry. The clinical pattern of the disease which are distinguished are:

1. Ulceroglandular tularemia
2. Glandular tularemia
3. Oculoglandular tularemia
4. Typhoidal tularemia
5. Pneumonic tularemia

In all the types the disease usually begins within two to five days following implantation of the organisms. However, the incubation period may vary from one to 21 days.

Symptoms depending on the type of tularemia Ulceroglandular tularemia

1. Over half of the cases of tularemia are of the ulceroglandular pattern. A local ulceration develops at the site of the original portal of entry on the skin or mucous membrane surface.
2. The primary lesion is generally located on the hands, arms or face but may also be situated in conjunctiva or in the oropharynx.
3. The papula rapidly enlarges to 1to 2 cm in diameter, becomes pustular and eventually ruptures to cause an extremely painful ulcer.
4. This is followed by regional or generalized lymphadenopathy
5. The latter presumably reflects the bacteremia that is usually present during the first week of disease.
6. The symptoms patients commonly experience are fever, chills, headache, nausea and vomiting, muscular aches and pains. Generalized enlargement of lymph nodes is also present.
7. Lymph Nodes have extreme firmness, are tense, which is the result of edema.

Oropharyngeal tularemia

When the disease is contracted by the ingestion of contaminated food and water, the local ulceration may appear anywhere in the oropharynx.

Glandular tularemia

In many cases no localized skin or mucosal lesions can be seen and the disease takes the form of a regional or generalized adenopathy alone. This pattern is termed as glandular tularemia. When the adenopathy is distributed throughout the body, it’s almost invariably accompanied by marked enlargement of the spleen and liver. The lesions in this diffuse form of the disease are similar to those described in the regional nodes.

Oculoglandular tularemia

The oculoglandular tularemia form of disease differs only in the initial portal of entry, which involves the conjunctival surfaces with the production of tiny papules that eventually become pustular and ulcerate. When these pustules occur on bulbar conjunctiva, they can perforate the eyeball to produce extensive type of infection in the anterior and sometimes posterior chambers of the eye.

There are very rare chances of complete destruction of eye structure and involvement of anterior chamber as well as posterior chamber can also be seen.If the optic gets involved then an extensive spread of infection is present and it can result in the complete destruction of eye structure. In almost all the cases the regional nodes undergo the characteristic gross and microscopic changes described. The oculoglandular variant of the disease may also be accompanied by generalised adenopathy and spleen enlargement.

Typhoidal tularemia

Rarely, the disease assumes a typhoidal pattern manifested chiefly by acute septicemia without a localizing skin lesion and frequently without striking peripheral adenopathy. In this pattern the patients are acutely ill with extreme high fever, drenching sweats, headaches, prostration and sometimes shock, all reflecting the overwhelming bacteremia and toxemia. This form of disease may be extremely difficult to identify without a careful history of contract or exposure and appropriate diagnostic tests.

Pneumonic tularemia

1. Pneumonia may develop in the course of any of the above mentioned patterns of tularemia. Secondly to hematogenous dissemination of organisms. The pneumonic involvement is generally related to hilus of the lungs and grossly appears as a small area of yellow white consolidations in which central foci of necrosis can sometimes be seen. When the disease is more florid, large portions of a lobe or entire lobes may become solidified.
2. If seen histologically then the lesions in case of pneumonic tularemia differ from usually bacterial pneumonia. There is presence of some characteristic tularemia nodules that sometimes strikingly simulate tuberculosis.
3. In contrast to many other infections the pulmonic involvement in this disease is almost invariably accompanied by necrosis of alveolar walls and lung substance, so that complete resolution is not possible and scarring and fibrosis are virtually inevitable residuals. As serious or seropurulent pleuritis is present in about half the cases of pulmonary infection.

Course of Disease

The course of disease is one of fairly striking chronicity and patients are frequently sick for as long as one or two months. Occasionally relapses occur along with re-exacerbation of lymphadenopathy which may progress to the stage forming new draining sinuses. In the usual case, the actual phase begins to subside about two to three weeks after the onset of fever or sooner if appropriately treated, and the convalescence, although prolonged, is uneventful.

Diagnosis of Tularemia

1. The diagnosis frequently can be suspected only by the clinical manifestations. Agglutinins can be demonstrated in the blood, usually following the second week of illness.
2. Along with blood tests chest X-ray can also be performed for the signs of pneumonia.
3. Bacterial culture can be done. The organism can usually be cultured from areas of necrosis, sputum (when pneumonia is present).
4. A diagnostic skin test similar to the tuberculin test is also available. It is called foshay’s test.

Treatment of tularemia

Generally the treatment involves usage of antibiotics. Antibiotics include streptomycin, gentamicin, doxycycline and ciprofloxacin. The duration of treatment is around 10-21 days depending on the stage of illness and the medication used.

Herbal Formulations by Planet Ayurveda

Planet Ayurveda is a leading Ayurvedic firm which deals with the manufacturing of herbal formulations. These formulations are prepared using potent herbs which are really effective in managing many conditions related to immune system disturbances and its working. The formulations prepared by Planet Ayurveda do not contain any kind of adulterants, dyes, additives, fillers etc. These medications are really potent to manage various conditions related to bacterial brone conditions that involve inflammation especially and are very fruitful hence giving positive noticeable results. The medication or formulations offered by Planet Ayurveda for the management of all types of tularemia are as follows:

1. Boswellia Curcumin
2. Giloy Capsules
3. Praanrakshak Churna
4. Bronco Plan Syrup
5. Sanjivani Vati
6. Manjishtha Capsules

Products Description

1. Boswellia Curcumin

Boswellia Curcumin is filled with anti-inflammatory properties as it contains two very effective herbs which are Shallaki (Boswellia serrata) and Curcumin (Curcuma longa). These both are really good as the best agents for reducing inflammatory conditions. Both of them are helpful in inflammation of the mucosal layers, which is the result of bacterial invasion. Even in oculoglandular tularemia the formulation has very good results. They work by improving circulation and also contain analgesic properties that help in treating pain in the affected area.

Dosage: Two capsules twice a day after meals with lukewarm water.

2. Giloy Capsules

Giloy capsules are prepared with standardised extract of guduchi (Tinospora cordifolia). These capsules are really very helpful as an immune system modulator. Guduchi, which is a synonym of giloy means it protects the body and improves various metabolism working in it. Giloy basically has an anti inflammatory and anti secretory effect on the respiratory system which means it reduces mucus production and thus relieves breathlessness. Hence the formulation is very effective in pneumonic tularemia. It also has an antipyretic effect which means it is really helpful in relieving fever.

Dosage: One capsule twice a day after meals with lukewarm water.

3. Praanrakshak Churna

Praanrakshak churna is formulated for the management of respiratory symptoms like excitonation, cough, breathlessness and many more. It also helps in healing the inflammation in the respiratory tract. The formulation is having very significant results in relieving symptoms related to pneumonic tularemia. It helps in rejuvenation of fibrosed fibrosed tissue, reduces the stiffness in the tissue and also helpful in preventing consolidations.

Dosage: One tsp twice a day after meals with lukewarm water.

4. Bronco Plan Syrup

Bronco plan is a liquid formulation which is prepared with extract of very potent and effective herbs like Tulsi (Ocimum sanctum), Madhuyashti (Glycyrrhiza glabra), Pippali (Piper longum), Maricha (Piper nigrum), Kakarshring (Pistacia integerrima) etc. these all herbs has a very good effect on managing symptoms related to whole respiratory system including faregyl symptoms too. The formulation also helps in reducing the effects of pneumonia induced due to tularemia.

Dosage: Two tsp twice a day after meals.

5. Sanjivani Vati

Sanjivani vati is popularly known to infuse life. It is best for ama digestion and also helps in burning the accumulated toxins. This is also a classical formulation and contains many herbs like sonth (Zingiber officinale), vidanga (Piper retrofractum), giloy (Tinospora cordifolia), triphala etc. These all combinedly strengthens the immune system and relieves fever generally associated with tularemia. The formulation helps a lot in relieving cough too and hence is very useful in almost all kinds of tularemia.

Dosage: Two tablets twice a day after meals along with lukewarm water.

6. Manjishtha Capsules

These capsules are made using standardized extract of manjishtha (Rubia cordifolia). It enhances the blood circulation and also improves the quality of blood by removing toxins from it. It has an antioxidant property and supports a healthy immune system. Manjishtha is a very good and effective herb which can act very well in healing ulcers present on skin or anywhere in the body.

Dosage: Two capsules twice a day after meals with lukewarm water.

Conclusion

Tularemia, as mentioned before is a condition which is a highly infectious systemic disorder and is characterized by focal suppurative and granulomatous inflammatory reactions in many sites of the body. The causative agent for tularemia is a tiny gram negative bacteria called pleomorphic coccobacilli. Such conditions are hard to ignore but can be well managed. The ayurvedic herbs mentioned above are very effective in its management and are totally organic. They do not contain any kind of additives and also do not have any side effects. In case of any query related to tularemia kindly visit www.PlanetAyurveda.com