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Ascariasis in adults and children - symptoms and treatment, prevention

The maximum prevalence of the disease is observed in winter, and the minimum - in spring and summer. Children from 2 to 10 years of age are more susceptible to ascariasis, but isolated cases can be registered even in adults.

The greatest prevalence in children is explained by their high activity, lack of hygiene skills and the lack of immunity to this invasion.

Content

What is Ascariasis?

Part of the removed intestine with ascaris

Part of the removed intestine with ascaris, photo

Ascariasis - helminthiasis (a disease caused by parasitic worms) of a person characterized by a fecal-oral mechanism of infection, i.e. parasites enter through the mouth, and are excreted in the stool.

To transfer these worms, various environmental items are needed that are contaminated with helminth eggs - vegetables, soil, berries, etc. At the beginning, eggs get into the intestines of a person, from where they penetrate into the lungs with blood, ripening and acquiring pathogenic properties.

At the second stage, the worms penetrate again into the intestine and other organs of the digestive system and are already beginning to damage them.

Human ascariasis occurs in stages. For the acute stage is characterized by the appearance of allergic symptoms indicating the reaction of the immune system. They include:

  • itchy skin;
  • urticarial rashes (pimples);
  • increased blood eosinophils;
  • the appearance of infiltrates in the lungs, which independently pass through after some time (therefore, they are called volatile).

The late stage is characterized by damage to the digestive system, which occurs chronically. Less commonly, various neurological disorders can occur when roundworms are populated in the brain.

Etiology and pathogenesis, photo

Female and male roundworm, photo

Female and male roundworm, photo

The cause of ascariasis is the parasites Ascaris lumbricoides. They live in the small intestine, in which they receive everything necessary for their sustenance (these worms feed on the contents of the intestine and on the surface layers of the mucous membrane). The length of the female is longer than the length of the male ( 25-40 cm and 15-25 cm, respectively).

A fertilized female is capable of producing about 200 thousand immature eggs per day. However, they do not develop in the intestine, because require the presence of oxygen. Development occurs in the environment when a larva is formed from an egg.

Therefore, ascariasis infection is possible only through contaminated items that are in daily use. If only females live in the intestines, and sexually mature males are absent, then the eggs are unfertilized and, accordingly, non-invasive for humans. Externally, they can be distinguished by a rounded shape (fertilized eggs are oval).

The source of the invasion is a sick person who releases helminth eggs with feces into the external environment. In this form, they do not pose a danger, therefore the household transmission route is not typical for this helminthiasis . Eggs develop in the environment in autumn, spring and especially summer time. In the soil, they can remain viable for several years.

The life cycle of roundworm is quite complicated:

1. Infection occurs through the ingestion of invasive forms (fertilized) eggs. Usually this contributes to the consumption of raw unwashed vegetables and fruits, as well as drinking unboiled water.

To acquire invasive properties, all of these products must be contaminated with eggs contained in human feces. Therefore, the highest prevalence of ascariasis is observed in those regions where human feces are used as kidney fertilizers (according to sanitary and hygienic norms, this method is prohibited).

infection route-ascariasis

2. In the intestine, the eggs lose their protective sheath, which helps them penetrate the mucous membrane. Then they enter the intestinal veins, which carry blood to the portal vein, and then through the liver to the inferior vena cava.

3. From the inferior vena cava, the eggs enter the right atrium, and then into the right ventricle, from which they enter the pulmonary system (the pulmonary circulation). They migrate through the system of pulmonary capillaries, leading to the appearance at this stage of coughing and wheezing, detected by auscultation.

In the lungs, the larvae become elongated and enlarged. They are easily entered into the trachea and bronchi. And with expectoration, expectorated, get into the pharynx, esophagus and intestines. In these organs, transformation occurs from larvae to mature individuals.

The entire migration process takes about 2 weeks. From the moment of infection until the release of eggs with feces passes from 60 to 80 days. Pulmonary symptoms appear 40 days after invasion.

The intestinal stage of ascariasis lasts about a year. Adults can live in the small intestine from six months to 2 years. Their accumulation in large quantities causes intestinal obstruction, which may be partial or complete. In the latter case, surgery is required for life reasons.

Mature individuals can easily migrate to the liver and biliary tract, as well as to the pancreas. It is extremely rare to see ascaris in the brain and kidneys, but the effects of this condition are very serious.

In addition to the mechanical effects on the affected organs, these helminths have a number of other pathogenic properties:

  • High immunogenicity of waste products and substances released during the molting of the larvae causes an increased allergenic mood of the body;
  • Inflammatory processes in the intestinal wall lead to increased secretion of enzymes (alkaline phosphatase, enterokinase, and others);
  • The formation of peptide hormones, secretin and gastrin, is disturbed, which provokes digestive disorders. This leads to hypovitaminosis, impaired absorption of proteins and fats, and lactase deficiency;
  • Immunosuppression, leading to a decrease in the effectiveness of vaccination;
  • Provocation of toxic-allergic reactions and neuro-reflex reactions, which are accompanied by a violation of intestinal eubiosis (dysbacteriosis develops, aggravating the human condition);
  • Perforation of the intestinal wall of mature worms, causing the development of peritonitis.

Symptoms of ascariasis in adults and children

Symptoms of Ascariasis in Adults

The symptoms of ascariasis in adults and children are not specific, since the disease is disguised as various pathologies. The incubation period is from 1 to 2 days.

In the clinical picture, there are two phases (stages):

  1. The early phase associated with the migration of ascarid larvae;
  2. Intestinal phase, corresponding to the chronic stage.

The early phase in 20% of cases may be asymptomatic or even asymptomatic. This leads to a late diagnosis of the disease. In 80% of cases, there are manifestations of toxic-allergic syndrome.

These include:

  • Skin itchy rashes in the form of spots and pimples;
  • Puffiness of the eyelids;
  • Respiratory symptoms (cough and sore throat).

As a rule, allergic manifestations are observed in children over 4 years of age. In younger children, the respiratory system is dominant.

At this stage, characteristic volatile infiltrates in the lungs appear, which were first described in 1932 by Leffler. Their appearance occurs on the 3-7th day from the moment of infection with ascaris. Clinically, this is expressed in the appearance of cough with sputum, which sometimes becomes asthmatic, i.e. with bouts of choking.

weakness in ascariasis in adults

weakness and indisposition - symptoms of ascariasis in adults (photo)

The general condition usually does not suffer, but certain symptoms may be observed:

  • weakness;
  • malaise;
  • chest pain;
  • fever is not higher than 38 ° C.

Eosinophilic infiltrates resolve themselves within a week. However, after the disappearance of some lesions appear others, which persist up to 10 days. Auscultation in this stage is often heard hard breathing, in 12% of cases moist rales can be detected.

Penetration of the ascarid larvae causes disruption in the work of the autonomic nervous system. This leads to symptoms such as:

  • increased fatigue;
  • headache;
  • excessive sweating;
  • sleep disorders;
  • marble color palms;
  • pale skin and blue under the eyes;
  • lability of the nervous system (irritability and tearfulness).

In 30% of patients in the larval stage, signs of dyspeptic syndrome appear:

  • nausea;
  • abdominal pains localized in the epigastrium;
  • reduced appetite;
  • presence of white or yellowish plaque on the tongue.
Symptoms of ascariasis in children, photos

Symptoms of ascariasis in children, photos

Late intestinal phase corresponds to the chronic stage. Its main symptoms in children under 3 years of age are:

  • abdominal pain of a different nature and location;
  • Refusal to eat and worry the child during its reception;
  • diarrhea with mucus up to 3 times a day.

At the age of 4 to 9 years, symptoms of the intestinal phase include:

  • abdominal pain localized around the navel;
  • swelling of it;
  • increased rumbling;
  • nausea;
  • emetic urge;
  • addiction to constipation.

Less specific signs of the intestinal phase are:

  • change in appetite (decrease or increase);
  • salivation;
  • alternating diarrhea with constipation;
  • pale skin;
  • physical developmental delay;
  • headaches;
  • irritability;
  • disturbed sleep;
  • reduced physical and mental performance.

Certain hematological abnormalities are characteristic of ascariasis:

  • decreased hemoglobin;
  • reducing the number of red blood cells;
  • a significant increase in eosinophils;
  • tendency to decrease of leukocytes in the blood;
  • ESR acceleration.

MORE: How to find out if a person has worms?

Diagnosis of Ascariasis

Specific diagnosis - analysis for ascariasis. However, it is informative only in the intestinal stage, and the disease already exists from 6 to 12 months, which is accompanied by various complications.

For specific diagnostics, feces are being examined for the identification of helminth eggs. But even in the presence of the disease, the results can be negative, because:

  • eggs do not stand out constantly;
  • only males are present in the intestines;
  • in the intestines there are only females who have stopped ovulation.

The detection of ascaris in the larval phase is an exceptional rarity. To do this, apply:

  • general clinical analysis of blood (eosinophilia and accelerated ESR);
  • X-ray examination of the lungs (detection of volatile infiltrates);
  • study of the level of antibodies to ascarids in the blood (the test will be positive within 2-3 weeks after infection).

Treatment of ascariasis in adults and children

Treatment of Ascaridosis in Adults

Treatment of ascariasis in adults and children is carried out with a diagnosed infection, as well as for the purpose of prevention. For this, pharmacological agents from different chemical classes are used. However, Albendazole is currently the most effective and popular.

It affects sexually mature individuals, including those that are resistant to other drugs. A single dose of Albendazole equal to 400 mg helps to achieve a cure in 100% of cases.

The drug is well tolerated, but some side effects may be reported:

  • stomach ache;
  • vomiting and nausea;
  • headaches;
  • fever;
  • fatigue;
  • allergic reactions;
  • decreased platelet and / or leukocyte counts.

As a rule, they are associated with additional sensitization observed during the death of the parasites. Cleansing enema and heavy drinking helps to reduce their expression. Pirantel and Mebendazole can be used for therapeutic purposes against helminths, which are quite effective.

After the degelmentization, it is necessary to restore the intestinal microflora, since in children with ascariasis dysbacteriosis is observed.

The optimal therapeutic combination is probiotic (directly restores the intestinal microflora) and enzyme preparation (restores the normal functioning of the gastrointestinal tract). The last doctor cancels gradually.

In the acute stage, it is necessary to prescribe antihistamine drugs that suppress the severity of allergic reactions. At the same time, vitamin complexes and high-grade protein nutrition are recommended.

A control study of feces is performed 2-4 weeks after the end of anthelmintic therapy.

More: Modern methods of treatment of parasites by bioresonance therapy.

Consequences and complications of ascariasis

Consequences of ascariasis

Adverse effects and complications of ascariasis include:

  1. Intestinal obstruction;
  2. Peritonitis associated with intestinal perforation;
  3. Ascariasis hepatitis;
  4. Ascariasis of the biliary tract;
  5. Fatal suffocation;
  6. Exacerbation of pancreatitis, cholecystitis and peptic ulcer disease;
  7. Appendicitis when crawling ascaris into the appendix;
  8. Congenital ascariasis in contact with worms through the placenta.

However, timely diagnosis and treatment contribute to a favorable prognosis. It is considered serious in a young child who has developed organ lesions.

In some cases, surgery may be necessary to eliminate intestinal obstruction or suturing the perforation.

Prevention of Ascariasis

The complex of preventive measures for ascariasis consists of the following measures:

  • identification and treatment of infected children;
  • protection of soil from contamination by faeces;
  • acquaintance of people with ways and sources of infection, and also measures of the prevention of an invasion.

Which doctors should be consulted if you suspect?

If ascariasis is suspected, you should contact an infectious diseases specialist. A narrower specialist dealing with this problem is a parasitologist.

In cases where there is neither one nor the other doctor, you can contact the therapist or family doctor.

Interesting
daria juice
2017-11-30 06:20:13
They picked up this nonsense together with my daughter (well, it would seem, okay, children, but I didn’t keep track of it, it's a shame I still don’t want anyone to face such a "nuisance" ..

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