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Opisthorchiasis: symptoms and treatment in adults, photos, signs, prevention

The population living in the basins of large rivers (the Urals, the Volga, the Irtysh and others) is often diagnosed with a special type of helminthiasis - opisthorchiasis. However, you can become the owner of the helminth and in a trip to Thailand, Ukraine, Kazakhstan. This is due to the fact that the source of infection is in freshwater fish.

Opisthorchiasis is quite a dangerous disease, with a long course leading to serious consequences, up to the development of cancer. That is why it is necessary to diagnose the presence of helminthiasis as early as possible and start antiparasitic treatment.

Content

Opisthorchiasis - what is it?

Opisthorchiasis - what is it

Opisthorchiasis is a severely parasitic lesion of the body caused by flatworms (feline fluke) of the genus Opisthorchidae. Worms-flukes enter the body of a human or carnivore (cats, dogs, foxes, etc.) by eating insufficiently processed fish (see photo).

Helminth parasitizes the biliary system (gallbladder, hepatic passages, bile ducts). Already after 2 weeks the parasite begins to lay off up to 1000 larvae per day.

The damaging effect of worms-flukes on the human body:

  • Attaching to the walls of the bile ducts with two suckers, the worms cause mechanical damage to the epithelial layer and provoke the development of inflammation.
  • With a massive invasion, desquamation of the epithelium and unregulated cell division can lead to the development of cancer pathology.
  • The waste products of opistorhas have a toxic effect not only on the gastrointestinal tract, but also the brain and the heart.
  • Large populations of parasites block the flow of bile and spread to the adjacent sections of the gastrointestinal tract - the stomach, pancreatic duct, 12 duodenal ulcer. All this leads to indigestion.

Opisthorchiasis gives polymorphic symptoms, the detection of helminth often occurs already in the chronic stage of the disease. Without appropriate therapy, flatworms live in a person under 25 years of age. Even an effective treatment of opisthorchiasis does not completely eliminate the damage done to the body.

Ways of transmission of opisthorchiasis

Ways of transmission of opisthorchiasis

Initially, the helminth larvae from the water contaminated with the feces of a sick animal fall into the mollusks (at this stage the parasite is not infectious to humans) and then into freshwater fish.

Mass infection is recorded among cyprinids: roach, bream, rudd, minnow, verkha, gudgeon, sabrefish, ide, white-eyed and others.

However, cases of infection with opisthorchiasis from pike, ruff, burbot, perch and other predatory fish that have the same habitat with the carp family are recorded.

Ways of infection:

  1. The use of infested fish, prepared with non-compliance with the rules of processing;
  2. Taste the taste of minced fish (this "sin" many housewives);
  3. Close communication with pets (this applies mainly to children) when feces with parasite eggs fall on human hands.

It is definitely not possible to become infected with opisthorchosis when bathing in a reservoir contaminated with opisthorch larvae. Having penetrated the skin, the larvae die quickly and can only cause itching and a short-term rise in temperature.

Also, opisthorchiasis is not transmitted from person to person, subject to compliance with basic standards of hygiene. The larvae of the parasite in the soil die within a few hours. But the freezing of infested fish in the refrigerator does not prevent human infection.

Symptoms of opisthorchiasis in adults, photo

Symptoms of opisthorchiasis in adults

opisthorchosis photo

The duration of the incubation period of opisthorchiasis depends on the number of larvae, an average of 2-4 weeks. Further, depending on the state of immunity, there are suddenly signs of acute parasitic damage. Acute opisthorchiasis in adults can occur in the following scenarios:

  • Easy flow - lasts 1-2 weeks, the patient complains of fever up to 38 ºС, weakness, fatigue, headache.
  • Moderate course - urticaria-like urticaria rash (toxic effect on the vascular bed), muscle and joint pain, vomiting, diarrhea, temperature up to 39ºС appear in the infected. Decreased appetite, possibly losing weight. Symptoms last 2-3 weeks.
  • Severe - against the background of an extremely serious condition of the patient due to severe intoxication, inhibition or psychomotor agitation, signs of damage to certain parts of the gastrointestinal tract, insomnia are observed. Perhaps the development of acute epidermal necrosis (Lyell's syndrome), acute myocarditis, Stephen-Johnson syndrome, angioedema.

Forms of acute opisthorchiasis:

  • Hepatocholangitis - associated with extensive damage to the gallbladder and liver. The patient complains of spastic pain, localized in the right hypochondrium and imitating hepatic colic. Signs of stagnation of bile are recorded: yellowness of the skin and sclera.
  • Pancreatoid-like - signs of pancreatitis often accompany bile duct damage. Shingles, flatulence, dyspepsia occur.
  • Gastroenterocolitic - symptoms of opisthorchiasis are dominated by signs of inflammatory and ulcerative lesions of the duodenum 12 and, often, of the stomach. In this case, intoxication is often weakly expressed.
  • Typhoid - on the forefront in the symptomatic picture of skin rashes, hyperthermia, sometimes there is a cough.

The inhabitants of the distressed regions of Western Siberia, which are unfavorable in terms of the epidemiology of opisthorchiasis, often proceed in a latent form, without giving any vivid symptoms.

Chronic opisthorchiasis

Chronic opisthorchiasis

symptoms in an adult

Gradually, pronounced symptoms of opisthorchiasis subside, and the disease goes into a chronic stage: on the background of normalization of temperature, symptoms of biliary duct dyskinesia, cholecystitis, hepatitis, and pancreatitis periodically occur.

Often, patients are diagnosed with gastroduodenitis or stomach ulcers. And only the data of laboratory and instrumental studies allow us to identify helminthiasis .

For chronic opisthorchiasis toxic damage to other organs is also characteristic:

  • central nervous system - persistent headache, twitching of the eyelids, hand tremor, irritability and depressive state;
  • heart - heartache, arrhythmia, signs of myocardial dystrophy appear on the ECG;
  • adrenal exhaustion - asthenic-vegetative syndrome.

Lack of treatment is fraught with the development of cirrhosis or liver cancer, pancreatic oncology, and peritonitis.

Analyzes and diagnosis of opisthorchiasis

The diagnosis of "opisthorchiasis" at an early stage of the development of the disease is rather difficult: helminth eggs in the fecal masses and bile are detected after 4-6 weeks. after infection. Diagnostic methods that detect the presence of flatworms in the body:

  • Blood test with the definition of leukocyte formula - eosinophillosis (indicates the presence of any worms and the development of sensitization to a foreign protein);
  • Biochemistry - an increase in liver enzymes (ALT, AST), changes in protein indicators;
  • Feces on the eggs of the worm - is carried out repeatedly (eggs are allocated sporadically), up to 100 eggs per 1 g - a mild degree, over 30 thousand - a massive invasion;
  • Immunological analysis - blood for opisthorchiasis detects antibodies to the opistorchis protein;
  • PCR - detection of helminth DNA in faeces;
  • Instrumental studies confirming opisthorchiasis;
  • Abdominal ultrasound, CT, MRI - detection of damage to the liver and biliary tract;
  • Duodenal sounding - detection of opistorchis eggs in the collected bile;
  • Retrograde pancreatic cholangiography and percutaneous cholangiography - endoscopic techniques reveal clusters of helminths.

Treatment of opisthorchiasis in adults, drugs

Medical tactics for opisthorchiasis involves the gradual use of various drugs. Antiparasitic treatment is preceded by a preparatory stage: the body should be prepared for a course of toxic drugs that destroy opistrohis.

Also required and rehabilitation course after antiparasitic treatment.

Preparatory Course

With the start of treatment of opisthorchiasis, symptoms are eliminated in the first place, as well as developing pathological processes:

  • Providing bile outflow - choleretic (Cholensim, Holosas, Tsikvalon, Galstena), traditional antispasmodics (No-shpa, Buscopan, best - Duspatalin), cholespasmolytics (Platyfillin, Atropine);
  • Digestion restoration - enzymes (Mezim forte, Pancreatin, Creon), prokinetics (Motilium, Motilak);
  • Elimination of cholestasis - Heptral, Ursofalk, Urososan;
  • Elimination of sensitization - antiallergic agents (Tavegil, Suprastin), for severe allergic manifestations, corticosteroids are advisable (Dexamethasone);
  • Detoxification of the organism - sorbents (activated coal, Prolisorb, Enterosgel, Lactofiltrum), hepatoprotectors (Kars), infusion therapy;
  • Leveling inflammation - antibiotics (Amoxicillin, Ampicillin), Metronidazole, the course - no more than 10-14 days.

The course of drug preparation takes 10-20 days.

Degelmentization

Destruction of flatworms is done by taking a course of toxic anthelminthic drugs: Albendazole, Hloksila, Praziquantel (the best). The treatment regimen for opisthorchiasis in adults - the dosage of drugs, the frequency of administration per day, and the duration of the course - is determined individually.

With caution, helminthic chemotherapy drugs are prescribed for the elderly and for patients with severe heart, kidney and liver damage. These medicines are contraindicated for pregnant women (1 trimester), nursing mothers and children under 4 years old.

Against the background of degelmentization, there are pains in the right hypochondrium, headache, nausea, weakness and dyspepsia increase. Sometimes in the first 2-3 weeks of antihelminthic treatment, there is a worsening of liver tests, and a skin rash may appear.

Blind duodenal sounding with xylitol or mineral water is carried out on day 2 of degelmentization in order to excrete the decay products of worms into the intestines. Strengthening the flow of bile is achieved by the use of electrical stimulation and a pulsed magnetic field.

The use of home remedies (popular - garlic with celandine) at the stage of degelmentization and the replacement of antihelminthic drugs prescribed by a doctor are not allowed!

Self-treatment can lead to deterioration and definitely will not kill all parasites.

Rehabilitation stage

Drug therapy restores the normal functioning of the damaged gastrointestinal tract. For 3-4 months, antispasmodics, hepatoprotectors, choleretic drugs are used.

It is at this stage that the treatment of opisthorchiasis with folk remedies is permissible: decoction of St. John's wort, plantain, calendula, devyasila.

  • A successful cure for opisthorchiasis is ascertained with negative studies of feces and duodenal contents after 1, 3 and 6 months after the end of the treatment course. In each of these terms, the study is conducted three times.

Prevention of opisthorchiasis

In order to avoid infection with opisthorchosis, the following recommendations for the preparation and consumption of freshwater fish should be strictly observed:

  • It is strictly forbidden to eat poorly processed fish, and, especially, to taste the raw product.
  • Abandon salted freshwater fish, sliced ​​fish.
  • Thorough dishwashing (cutting board, knife) in contact with raw fish.
  • Effective freezing: -28 ºС - 32 hours, -35 ºС - 14 hours, -40 ºС - 7 hours.
  • Fish cooking: chunks - 20 min., Fish semi-finished products (dumplings) - 5 min. From the beginning of the boil.
  • Frying: whole fish - 15-20 min., Large pieces and minced meat cutlets - 20 min., Fish pies - in the oven for 1 hour.
  • Salting in a strong salt solution: large - 40 days, fish up to 25 cm in size - 21 days, small fish - 10 days.
  • Ambassador before drying (for 10 kg of product you need 2 kg of salt): 2 weeks. salting and drying at will, 3 days salting and drying 3 weeks.
  • Smoking: hot + 70-80ºС - 2-2.5 hours, cold type of smoking - pickling 2 weeks or freezing.

Due to possible contamination from animals, contact with wildlife (foxes, foxes) should be avoided. Home pets (cats, dogs) should be fed only well-boiled fish.

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