What Is Salmonellosis?
Salmonellosis, also called paratyphoid, is a common disease of young foxes and birds. Young fox infected
figure 1
Salmonellosis
- Salmonellosis, also known as paratyphoid, is a general term for diseases caused by Salmonella bacteria in various animals. Symptoms of sepsis and enteritis are often seen at the clinic, which can also cause abortion of pregnant females.
- Name
- Salmonellosis
- Alias
- paratyphoid
- resistance
- Stronger
- Include
- Swine, horse, bovine salmonellosis
- Symptom
- Fever, chin, weight loss
Basic overview of salmonellosis
- Salmonellosis, also called paratyphoid, is a common disease of young foxes and birds. Young fox infected
- figure 1
A brief introduction to salmonellosis
- Multiple diseases caused by infection of various animals by different serotypes in Salmonella
- figure 2
Introduction to Salmonellosis
- The bacterium is a short bacterium, one to three micrometers long, 0.5 to 0.6 micrometers wide, blunt at both ends, does not form capsules and spores, has flagella, is mobile, and is a Gram-negative bacteria. [2]
- This bacterium can grow in an alternative medium and is aerobic and anaerobic. Change in broth
- image 3
- Salmonella can ferment glucose, monolactulose, mannitol, sorbitol, maltose, and acid and gas. Can not ferment lactose and sucrose, so it can be distinguished from other intestinal bacteria.
- The bacterium is highly resistant, dying after one hour at sixty degrees Celsius, twenty minutes at seventy degrees Celsius, and five minutes at seventy-five degrees Celsius. (image 3)
- It has strong resistance to low temperature. It can survive 115 days on agar medium at -10 degrees Celsius. Can survive 2-3 months in dry SARS, can be stored in dry excreta for four years, in 0.1% liter mercury bath, 0.2% formaldehyde solution, 3% carbolic acid solution 15- Can be killed in 20 minutes. In bacon with 29% salt, it can survive for four to eight months at 6-12 degrees Celsius.
Salmonellosis disease symptoms
- The incubation period for natural infection is eight to twenty days, with an average of fourteen days; the incubation period for artificial infection is two
- Figure 4
- The acutely passed diseased fox showed antifeeding, first excited and then depressed, and the body temperature rose to forty-one to forty-two degrees Celsius, which fluctuated slightly throughout the disease period. Only before death, the body temperature decreased, and most of the diseased foxes were lying Lying in the small room, arching waist when walking, tears in his eyes, the cage moved slowly. Diarrhea, vomiting, and death in a coma. It usually takes five to ten hours or prolongs to two to three days to die. (Figure 4)
- Sub-acute diseased foxes are mainly characterized by a high degree of gastrointestinal disorders, body temperature rising to forty to forty-one degrees Celsius, depressed spirit, superficial breathing frequency, and loss of appetite. Diseased foxes are dull and dull with fur, the eye sockets are sunken, and sometimes purulent conjunctivitis occurs. A few cases have a mucous nasal leak or cough. The sick fox quickly lost weight, diarrhea, and vomiting in some cases. The stool becomes liquid or watery, mixed with a large amount of gelatinous mucus, and some are mixed with blood. The limbs are weak and weak, especially the hind limbs are often mop-like. Hind limb paralysis occurs in the later stages of the disease. In highly depleted cases, death occurs between seven and fourteen days. Mucosa and skin jaundice often occur, especially the disease caused by S. choleraesuis.
- Chronic illness, digestive dysfunction, loss of appetite, diarrhea, mixed mucus in stool, gradual weight loss, anemia, collapsed eyes, and sometimes purulent conjunctivitis. Sick foxes mostly lie in the small room, rarely exercise, walking instability, slow movement. In the case of high failure, death occurs after three to four weeks.
The main species of salmonellosis
- It mainly includes swine salmonellosis, marmonella, bovine salmonellosis, sheep salmonellosis, avian salmonellosis, and so on.
Salmonellosis in pigs
Basic definition of salmonellosis
- Salmonellosis causes bowel changes. (Figure 5)
- Swine salmonellosis, also known as paratyphoid piglet, is a type of piglet caused by Salmonella bacteria
- Figure 5
Salmonellosis bacterial subject
- There are mainly porcine scavenger variants of Salmonella cholerae, Salmonella typhimurium, Salmonella typhimurium, and Salmonella Dublin, Salmonella enteritidis, which are a group of serologically related Gram-negative, mobile, facultative anaerobic Bacillus, without capsule, does not form spores, grows well on normal media, and colonies are colorless on MacConkey media. The bacteria in this genus are resistant to dryness, decay, sunlight and other factors, and can survive for weeks, months, or even years under external conditions.
- Bacteria can be killed by general disinfectants (phenols, chlorine and iodine).
Salmonellosis epidemic characteristics
- Epidemic characteristics This disease mainly occurs in weaned piglets under 4 months of age. Adult and suckling pigs rarely develop disease. Bacteria can infect healthy pigs through the digestive tract through the feces of infected or infected pigs, contaminated water sources, and feed. Rodents can also spread the disease.
- The disease can occur all year round, and it is more likely to occur in rainy and wet seasons. It is generally distributed or endemic in pigs. Environmental pollution, humidity, crowded sheds, accumulation of manure, untimely supply of feed and drinking water, and other stress factors can easily promote the occurrence of the disease.
Clinical symptoms of salmonellosis
- It mainly occurs in piglets younger than 4 months. Routine drinks are rarely seen in raw suckling piglets. Sick pigs showed restlessness, loss of appetite, and increased body temperature. At the onset of large herds, a few dead pigs became purple in the tail and abdominal extremities. On the 3rd or 4th day of the onset of septic salmonellosis, yellow watery feces appeared. At the time of the outbreak, the morbidity was low (usually less than 10%), but mortality was high.
- Colitis-type salmonellosis: characterized by diarrhea. The initial symptoms are yellow watery diarrhea without blood or mucus. Within a few days, most of the same group developed symptoms. A typical diarrhea is a white beeswax-like diarrhea that can recur 2 to 3 times within a few weeks. Sometimes the stool is bloody. Sick pigs have fever, reduced feeding, and dehydration corresponding to the severity and duration of diarrhea. Mortality of sick pigs is generally low. Pure-breeding herds can sometimes have abnormally high mortality rates.
Pathological changes in salmonellosis
- Ear, hoof, tail and ventral skin cyanosis. The spleen is swollen, dark blue, with firmness like rubber, and the section is blue-red. The mesenteric lymph nodes are swollen, and other lymph nodes are enlarged to varying degrees. The lymph nodes are soft and red, similar to marble. The liver and kidney are also swollen, congested, and bleeding to varying degrees. Sometimes, the liver parenchyma can be seen with bran-like, extremely fine grayish yellow necrotic spots. Mucosa and serosa of the whole body have bleeding spots of varying degrees. Gastrointestinal mucosa shows acute catarrhal inflammation.
- Colitis type salmonellosis: characteristic lesions are local or diffuse necrotic colitis and cecumitis. The cecum and colon sometimes spread to the posterior part of the ileum, the intestinal wall thickens, and the mucosa is covered with a layer of diffuse, necrotic, saprophytic substance, peeling off and seeing a red ulcer at the bottom and irregular edges. In a few cases, the mucosa around the follicle is necrotic, slightly protruding from the surface, with fibrin exudate accumulation [4] , forming a vaguely visible ring. Lymph nodes, especially ileocytic nodes, are highly swollen and moist. Partial lymph node cheeseiness. Liver and spleen are not swollen, only terminal congestion.
Diagnosis of Paratyphoid Swine in Salmonellosis
- As a primary disease, weaned piglets that mainly occur within 4 months of age are generally sporadic and poorly managed.
- Image 6
Differential diagnosis of salmonellosis
- Paratyphoid swine is similar to enteric swine fever. It is very easy to be misdiagnosed clinically. However, intestinal swine fever can occur in pigs of various ages. The focus of necrotic enteritis starts from lymphoid follicles and develops outward [4] , thus forming a concentric layered button-like ulcer protruding from the mucosal surface, brown or It is dark, the center is low, and some are exfoliated. The paralysis of the pig paratyphoid fever has a rough surface, different sizes, and uneven edges. The two can be distinguished accordingly.
Preventive measures for salmonellosis
Salmonellosis method
- 1. Strengthen feeding management to eliminate the cause of disease.
- 2. For pigs with frequent occurrence of this disease, antibiotics can be added to the feed, but the emergence of drug-resistant strains in the area should be noted. When resistance to a certain drug is found, another drug should be used instead.
- 3. Vaccination to prevent salmonellosis.
- 4, found the disease, immediately isolate and disinfect.
Salmonellosis treatment in sick pigs
- It should be carried out as early as possible on the basis of isolation and disinfection and improved feeding management. Its efficacy depends not only on the strength of the drug used against bacteria, but also on the time, dose and duration of treatment. Also note that there is a longer course of treatment. It takes a long time to repair necrotizing enteritis. If the drug is stopped halfway, it often causes relapse and death. Commonly used drugs are: chloramphenicol, kanamycin, panterine, sulfa drugs and quinolone drugs.
Salmonellosis
- Also known as paratyphoid equine, it is caused by Salmonella abortus or Salmonella typhi
- Figure 7
Salmonellosis in cattle
- The pathogens are mostly Salmonella typhimurium or Salmonella Dublin. Home-fed young calves are more susceptible than adult cattle and are often endemic. The sick calves have fever, fasting, weakness, and foul-smelling liquid stools, often mixed with bloodshot and mucus. Those with high mortality can reach 50 to 70%, usually 5 to 10%; undead or joint swelling occurs. Postoperative examination revealed hemorrhagic gastroenteritis and septicemia, and necrotic lesions in the liver and spleen. It rarely occurs in adulthood or only spreads, but it may turn to endotoxin later in life. The lesions were mostly acute hemorrhagic enteritis. Pregnant cattle often have abortions.
Salmonellosis
- Ovinesalmonellosis [6] is mainly caused by Salmonella typhimurium, Salmonella abortus, Dublin
- Figure 8
- Epidemiology: This disease can occur all year round, and can be infected by livestock and poultry of all ages. Gastrointestinal infections are the main cause, and mating and other ways can also infect them; various adverse factors can promote the occurrence of this disease.
- Symptoms: The incubation period varies, depending on the age of the animal, stress factors, and pathways of invasion.
- Mandibular paratyphoid fever is more common in lambs of 15-20 days of age. At the beginning of the disease, the spirit is depressed, the body temperature rises to 40-40 ° C, bows his back, and he loses appetite or refuses to eat. He was weak, emaciated, unable to lie on the ground, and died within 1-5 days. Most sick lambs have abdominal pain and diarrhea, a large number of gray-yellow pasty stools are eliminated, and symptoms of dehydration quickly appear. Eyes sink, and physical strength weakens. Some sick lambs have symptoms such as forced breathing, mucus nasal discharge, and cough.
- Abortion paratyphoid abortion is more common in the last two months of pregnancy. Before the abortion of the sick sheep, the body temperature rose to 40-41 ° C, anorexia and depression, some sheep had symptoms of diarrhea, and vaginal secretions flowed out. Live lambs produced by sick sheep are relatively weak, do not eat milk, and may have diarrhea, and usually die within 1-7 days. Sick sheep are associated with enteritis, gastroenteritis and sepsis.
- Pathological changes: diarrhea-type sheep can see the weight loss of sick sheep. The stomach and intestine [6] are empty, the mucosa is congested, and the internal dissolved matter is thin. Mesenteric lymph nodes are enlarged and congested, the spleen is congested, and there are small bleeding points in the cortex of the kidneys and the epicardium.
- Abortion sheep have stillbirth or primiparous lambs die within a few days, showing sepsis. Tissue edema, congestion, hepatosplenomegaly, gray necrosis. Placental edema and bleeding. Ewes have acute hysteritis, swelling of the uterus with miscarriages or stillbirths, necrotic tissue, exudates, and retained placenta.
- Diagnosis: A preliminary diagnosis can be made based on epidemiological, symptomatic, and pathological changes, and laboratory diagnosis is required to confirm the diagnosis.
- Prevention and control: strengthen breeding management, do a good job of disinfection, and eliminate sources of infection.
- With oxytetracycline or neomycin, lambs are administered orally three times daily at 30-50 mg / Kg body weight; adult sheep are injected twice daily with 10-30 mg / Kg body weight or intravenously.
Salmonellosis in poultry
- Avian Salmonellosis (Salmonellosisavium)-Avian Salmonella is a general term that refers to a large group of acute or chronic diseases of poultry caused by any one or more members of the genus Salmonella. Salmonella
- Figure 9
- Chicken white pheasant is an infectious disease of chickens caused by Salmonella solani. The disease is characterized by [7] young infants who often present with acute sepsis, with high morbidity and mortality. After infection in adult chickens, they are mostly chronic or recessive carriers, which can be excreted with feces. Ovarian infection can seriously affect hatchability And chick survival rate.
Salmonellosis etiology
- Chicken white pheasant refers to poultry infections caused by Salmonella solani. Salmonella galliformis is highly host-adaptive. This bacterium is a slender bacillus (0.3 0.5um × 1 2.5um) with slightly rounded ends. It is well-colored for general aniline dyes and Gram-negative. Bacteria often exist alone and rarely have more than two long chains. Filaments and large bacteria were occasionally seen in the smear. This bacterium cannot move, does not liquefy gelatin, does not produce pigments, has no spores, no capsules, and is facultative anaerobic. Try to avoid the use of selective media when separating cultures, as some strains are particularly sensitive. Salmonella grows well in media such as nutrient broth or agar plates. It grows on common agar and MacConkey culture medium, forming round, smooth, colorless, translucent, dew-like small colonies. It has a certain resistance in the external environment and can be killed by commonly used disinfectants.
Salmonellosis epidemiology
- Chickens of various breeds are susceptible to this disease, and the incidence and mortality of chickens within 2 to 3 weeks of age are the highest and are epidemic. As the age increases, so does the chicken's resistance. Adult chicken infections are often chronic or recessive.
- Turkeys are susceptible to this disease but second to chickens. Ducks, goslings, guinea fowls, pheasants, quails, sparrows, European warbler and pigeons have also been reported to be naturally affected. Hibiscus birds, red doves, canaries and crows are not susceptible.
- Chicken farms that have always had this disease have an incidence of around 20% to 40%, but newly introduced chicken farms have a significantly higher incidence, sometimes as high as 100%, and the case fatality rate is higher than that of old disease farms. The disease can be transmitted vertically or horizontally through eggs.
Clinical symptoms of salmonellosis
- The symptoms and progression of this disease in chicks and adult chickens are significantly different.
- Chicks and chicks have similar symptoms. The incubation period is 4 to 5 days.
- Figure 10
- In middle chickens (bred chickens), the disease mostly occurs in chickens between 40 and 80 days, and the disease occurs more frequently in ground-fed chickens than in online and brooding brooders. From the breed point of view, brown feather laying hens have a high breed. In addition, the incidence of stress in the breeding chickens is mostly affected by stress factors. For example, the flock density is too high, the environmental sanitation conditions are poor, extensive feeding management, abrupt climate change, sudden changes in feed or low quality. Sudden occurrence of this disease, the appetite and spirit of the whole flock of chickens are acceptable. It is often seen that chickens with poor spirit, appetite and diarrhea are constantly appearing in the flocks, and often die suddenly. The peak of death is not seen, but chickens die every day in varying numbers. The course of the disease is long, can be delayed for 20 to 30 days, and the mortality rate can reach 10% to 20%.
- Adult chickens are often chronically infected or recessive. Generally, no obvious clinical symptoms are seen. When the flock is relatively infected, it can obviously affect the egg production, the egg production peak is not high, the maintenance time is short, and the death rate is increased. Some chickens show crest atrophy, and some chickens develop well at the start of production. Later, they show that the crest gradually becomes smaller and becomes cyanotic. Sick chickens sometimes burp. A closer inspection of the flocks reveals that some chickens are oligoactive or do not lay eggs at all. Very few sick chickens showed a debilitating mental state, drooping cephalic fins, diarrhea, draining white dung, and stopping spawning. Some infected chickens cause peritonitis due to yolk sacitis, and the peritoneal hyperplasia appears as a "vertical abdomen" phenomenon, and sometimes adult chickens can present with acute disease.
Pathological changes of salmonellosis
- Chicks: Chicks that are short in age and die soon after the onset of disease have no obvious lesions. Liver enlargement, congestion, or striped bleeding. Congestion of other organs. The yolk sac does not change much. Those with prolonged disease have malabsorption of yolk, whose contents are yellow like oily or cheese-like; there are necrotic lesions or nodules in the heart muscle, lungs, liver, cecum, large intestine and muscle and stomach. In some cases, there are epicardial inflammation, liver or papillary bleeding and necrosis, gallbladder enlargement, spleen sometimes enlarged, renal congestion or anemia, ureter filled with urate and dilatation, cheese-like matter in the cecum to block the intestinal cavity, and sometimes even Mixed with blood, thickened intestinal wall, often with peritonitis. Among the above-mentioned organ lesions, liver lesions are the most common, followed by lung, heart, muscle stomach, and cecum lesions. A few days old died of hemorrhagic pneumonia. Slightly older patients showed gray-yellow nodules and gray liver changes.
- Adult chickens: Chronically infected hens. The most common lesions are egg deformity, discoloration, texture change, and egg-shaped cysts with peritonitis accompanied by acute or chronic pericarditis. The injured eggs are often fat or cheese-like, the yolk membrane is thickened, the degenerated eggs may still be attached to the ovary, and there are often pedicles (handles) of varying length and thickness connected to the ovary. The shed eggs are hidden in the abdominal cavity. Inside the fatty tissue. Some eggs fall into the abdominal cavity retrograde from the fallopian tube, and some are blocked in the fallopian tube, causing extensive peritonitis and adhesion of abdominal organs. Ascites can be found, especially in big chickens. The heart changes slightly, but often with pericarditis, the severity of which is related to the duration of the disease. The lighter see the pericardial membrane with poor transparency and contain slightly mixed pericardial fluid. In severe cases, the pericardium becomes thick and opaque, and gradually adheres, and the pericardial fluid increases significantly. Sometimes, amber cheese-like capsules are found in abdominal fat or on the stomach and intestinal wall.
- Lesions in adult roosters are often confined to the testes and vas deferens. The testicles are extremely atrophic, with small abscesses. The lumen of the vas deferens is enlarged and filled with dense homogenous exudate.
Salmonellosis diagnosis
- The diagnosis of chicken white pheasant is mainly based on the characteristics of the disease in chickens of different ages and the main pathological changes of sick and dead chickens. It is not difficult to make a precise diagnosis. However, only after Salmonella spp. Is isolated and identified can the exact diagnosis of S. poultry be made.
Prevention of Salmonellosis
- For the prevention and control of chicken and white pheasants, the breeder usually adds antibacterial drugs to feed or drinking water from the day when the chicks start to eat. Generally, satisfactory results can be achieved.
- There are many types of medicines added to feed and drinking water. People have used penicillin, streptomycin, oxytetracycline, tetracycline, chloramphenicol, gentamicin, and norfloxacin. From years of prevention and control practices, isolation of bacteria, and drug sensitivity test results, the following drugs are
- Figure 11
- Chicken diarrhea also works well. Penicillin, streptomycin, and oxytetracycline are almost ineffective against Salmonella poultry. (Figure 11)
- Prevention with drugs should prevent the use of a drug for a long time, let alone blindly increase the dose of the drug to achieve prevention and control purposes. It should be considered that effective drugs can be used alternately and in rotation within a certain period of time, the dosage of the drugs should be reasonable, and there must be a certain course of treatment. During the administration of the above medicine, the feeding time of Zetridine can be longer (even 7 days, and then 5 to 7 days after stopping the medicine), and other medicines can only be administered for 4 to 5 days to achieve the prevention purpose.
- In recent years, microbial preparations have begun to be used in animal husbandry. Some biological preparations have good effects in the prevention and treatment of livestock and poultry diarrhea. They are safe, non-toxic, have no side effects, bacteria do not produce resistance, and are inexpensive. Commonly used are bacterial growth promotion, hormonal growth, lactic acid bacteria and so on. Antibiotics should be contraindicated while using these drugs and 4 to 5 days before and after. According to a large number of experiments, the effect of this biological agent on the prevention and treatment of chicken bladder disease is equivalent to or better than the level of drug prevention in most cases. The use of such preparations must ensure normal brooding conditions and better veterinary hygiene management measures. It is also related to the health of the flock. In use, it should be started from small group tests, carried out in accordance with the prescribed dose and method, and used in production after obtaining experience.
- The treatment of cultivating chicken white rickets should highlight an early word. Once an increased number of dead chickens are found in the flock, the whole group will be administered immediately after diagnosis. Drugs such as enrofloxacin or chloramphenicol can be administered for 5 days and then separated by 2 Feed 3d and 5d again, the purpose is to effectively control new cases and prevent the spread of the epidemic. At the same time, strengthening breeding management and eliminating the effects of adverse factors on the flock can greatly shorten the course of disease and minimize losses.
- In terms of control measures, some people have used dead bacteria or live bacteria vaccines to control the occurrence of the disease, but no good results have been obtained. Therefore, the principle of preventing the occurrence of this disease is to prevent the introduction of pathogens and eliminate the carriers and chronic patient. At the same time, strict sanitation, disinfection and quarantine systems must be implemented. The comprehensive prevention measures are as follows:
- 1. Select healthy breeders, breed eggs, establish healthy flocks, insist on self-reproduction, and carefully from outside
- Figure 12
- 2. During hatching, use quaternary amine disinfectant spray to sterilize the eggs before hatching, wipe them dry, and then incubate. Eggs from unsafe flocks must not enter the hatchery. The incubator and all utensils should be disinfected with formaldehyde before each incubation. Pay attention to quarantine and quarantine of imported chickens. [8]
- 3. Strengthen the hygiene management of brooding, pay attention to the regular cleaning and disinfection of the chicken house and all utensils. The brooding room and sports field are kept clean and dry. The feed trough and drinking fountains are cleaned once a day to prevent contamination by chicken manure. The temperature of the brooding room is kept constant. Use high-temperature brooding, and pay attention to ventilation to avoid overcrowding. The feed must be properly mixed to ensure that it is rich in vitamin A. Feed the chicken without hatched waste eggs. Prevent chicks from pecking. If sick chicks are found, they should be quickly quarantined and disinfected. In addition, birds or other animals must be prevented from spreading pathogens within the poultry farm.
- 4. Drug prevention. After the chicks come out of the shell, use formalin 14ml / m3 and potassium permanganate 7g / m3 for fumigation in the hatcher for 15 minutes. Use 0.01% potassium permanganate solution as drinking water for 1-2 days. During the age-susceptible age of chicken paeony, using 0.02% furazolidone as drinking water, or mixing furazolidone at 0.02% or adding sulfonamides at 0.5% in chick powder is beneficial to control the occurrence of chicken paeony. [8]
Diagnosis of salmonellosis
- Based on epidemiological and pathological anatomy changes, a preliminary diagnosis can be made. The final diagnosis is to carry out a bacterial examination. The bacterial culture can be isolated from the organs and blood of dead animals for biological tests. Fur animal salmonellosis can be quickly bacteriologically examined before birth. Blood was collected by aseptic method, inoculated into three to four sticks, slanted in agar medium or broth, and cultured in an incubator at 37-38 degrees Celsius. After 6-8 hours, the bacteria grew and the culture An agglutination reaction with known Salmonella positive sera can confirm the diagnosis.
- Figure 13
Control measures for salmonellosis
- In order to maintain heart function, 20% camphor oil can be injected subcutaneously, and the fox is 0.5-1 ml. [9] Treated with chloramphenicol, neomycin and levomycin, 5-10 mg for young foxes and 20-30 mg for adult foxes. Do not feed them in the feed for 7-10 consecutive days. (Figure 13)
- Strengthening feeding management during pregnancy and lactation has an important effect on improving the resistance of foxes to salmonellosis, especially during weaning
- Figure 14
- Promote veterinary hygiene, and do not allow feeding of foxes with salmonella-contaminated feed. Suspect feed should be harmless before feeding. Found this disease, immediately isolate and treat cage utensils strictly disinfect. The cured fox still needs to be kept in isolation until the skin is removed. (Figure 14)
Salmonellosis- related diseases
- Pulmonary heart disease, E. coli infection, listeriosis,
- Brucellosis, viral hemorrhagic fever, bacterial food poisoning,
- Salmonellosis, Pseudomonas infection, Herpes simplex virus infection,
- Mycoplasma infection, Staphylococcus infection, Streptococcus infection, Chlamydia infection,
- Klebsiella infection, adenovirus infection, atypical mycobacterium disease,
- Atypical mycobacterial disease, middle ear cancer, vasomotor rhinitis,
- Acute myocardial infarction, stroke, primary pulmonary hypertension,
- Erosive hydatidiform mole, secretory otitis media, congenital posterior nostril atresia,
- Sinus cyst, nasal septum perforation, laryngeal obstruction, streptococcal pharyngitis,
- Chronic pharyngitis, noise deafness, epistaxis, sir preauricular fistula,
- embolism, obstructive sleep apnea syndrome, adenoid hypertrophy,
- Viral myocarditis, viral meningitis, viral herpes,
- Allergic asthma, allergic conjunctivitis, rickets, hyperthyroidism,
- Parkinson's disease, senile cataract, pancreatitis, renal failure,
- Retinal detachment, phlebitis, osteomyelitis, urethral stricture.