helminthiases

Helminthiasis - diseases caused lodged in the body of parasitic worms - worms and their larvae.

Alveococcosis. Etiology, pathogenesis. Pathogen-larval stage alveococcus. Infection occurs after hexacanth hit in the mouth after contact with contaminated skins of foxes, foxes, dogs, stagnant water: ponds and by eating wild berries collected in endeichnoy areas. Clusters of larvae (usually liver) infiltrate and grow into the tissue, break blood supply to organs, causing degeneration and atrophy of tissue, have toxic and allergenic influence.

Symptoms within. The disease develops slowly and remains asymptomatic for a long time. Noted a progressive enlargement of the liver, there are weight and pressure in the right upper quadrant, dull aching pain. A few years later the liver becomes lumpy and very dense. May develop jaundice. Often increases spleen. Chance of ascites. In the decay of nodes increased body temperature, sweating observed, leukocytosis, eosinophilia, increased ESR. Characterized albuminosis, hypergammaglobulinemia. Necrotic and germination of the inferior vena cava can lead to profuse bleeding. Metastases in the lungs can cause symptoms of pneumonia, bronchitis, coughing up blood. Brain metastasis simulates clinical brain tumor.

The diagnosis is based on clinical data. Put serological tests with alveokokkovym antigen. For more accurate localization of the used X-ray and ultrasound scan of the liver, ventroscopy, CT. Trial puncture is strictly prohibited due to the risk of contamination of other bodies. Differentiate from tumors, echinococcosis and cirrhosis.

Surgical treatment and symptomatic.

Forecast serious.

Prevention see. Echinococcosis.

Hookworm (hookworm and necatoriasis). Etiology, pathogenesis. Pathogens - American hookworm and hookworm, parasites in the intestines of thin person, often in the duodenum. Infection occurs through the active implementation of the larvae through the skin or by ingestion of contaminated ie vegetables, fruit, water. Larvae make migration for large and small circulation, lasting 7-10 days. In the small intestine, the larvae transform into mature individuals, and after 4-6 weeks begin to lay eggs. Lifespan Ancylostoma from several months to 20 years. During the migration of the larvae cause toksikoallergicheskie phenomenon. Adult worms -gematofagi. By fixing them to the mucosa tissue injure intestine, leading to the formation hemorrhages, erosions, induce bleeding anemisation support allergy condition, dyskinesia, gastrointestinal tract, and dyspepsia.

Symptoms within. Shortly after infection occurs itching and burning sensation, rash urticaria, wheeze phenomenon, fever, eosinophilia. In the later stage appear nausea, salivation, vomiting, abdominal pain, bowel function disorders (constipation or diarrhea), bloating. Sometimes psevdoyazvenny syndrome (pain hungry apigastralnoy area, hidden bleeding). Characteristically ginohromnoy development of iron deficiency anemia; its severity depends on the intensity of infection, malnutrition, the individual characteristics of the organism. At low intensity infestation can subclinical, appearing eoeinofiliey.

Diagnosis is confirmed by detection of eggs in feces and sometimes in the duodenal contents.

Treatment. In severe anemia (hemoglobin below 67 g / l) used iron supplements, transfusion of red cells. Deworming is carried out naftamonom, kombantrinom or levamisole. Naftamon administered on an empty stomach for 2-5 days. Single dose for adults is 5 g In order to eliminate the bitter taste and nausea medication is better to give 50 ml of warm sugar syrup. Kombantrin (pyrantel) administered in a daily dose of 10 mg / kg in two divided doses after meals and levamisole (dekaris) at a daily dose of 2.5 mg / kg in a single step. Treatment with these drugs lasts 3 days. The efficiency of about 80%.

Forecast favorable in most cases.

Prevention. The foci of hookworm diseases should not walk barefoot and lying on the ground without bedding. Careful washing and scalding with boiling water fruits, vegetables, berries before using them for food, you can not drink unboiled water.

Ascariasis. Etiology, pathogenesis. Vozbuditel- Ascaris, a parasite in the adult stage in the small intestine. The lifespan of Ascaris about a year. In the migration phase (first 6-8 weeks after infection), the larvae of Ascaris have mechanical and sensitizing effect, causing hemorrhage, eosinophilic infiltrates in the tissues of various organs. The intestinal phase (after 8 weeks. After the defeat) adult roundworm common cause toksikoallergicheskie nervnoreflektornye and reactions of the body and a variety of local mechanical stress.

Symptoms within. Migration phase often occurs under the guise of acute respiratory infections, bronchitis; may be volatile eosinophilic infiltrates in the lungs. The intestinal phase distinguish gastrointestinal form (salivation, nausea, decreased appetite, cramping pain around the navel, sometimes stool disorders and gastric secretion); hypotonic (decreased blood pressure, weakness) and neurological (dizziness, headache, fatigue, sleep disturbance, vegetative-vascular disorders) form.

complications; askaridoznaya ileus, a characteristic feature of which is the allocation of Ascaris with vomit and palpation of the moving "tumor" - tangle of worms; askaridozny appendicitis; ruptured peritonitis; ascariasis liver with development of jaundice, purulent angioholitah, liver abscess, subphrenic abscess; ascariasis pancreas with symptoms of acute pancreatitis; zapolzaniya ascarids in the respiratory tract with the development of asphyxia.

Diagnosis of early phase of ascariasis is based on the detection of nematode larvae in sputum and blood antibodies, late intestinal phase - of Ascaris eggs in faeces.

Treatment. In the migration phase of ascariasis appoint diphenhydramine on 0.025-0.05 g 3 times per day, calcium chloride, calcium gluconate. For the expulsion of juvenile and adult ascarids used piperazine, levamisole, kombantrin; in the hospital, oxygen. Piperazine administered after a meal 2 times a day with an interval between doses of 2-3 hours for 2 consecutive days at a dose of 1.5-2 g per reception (3-4 g / day). Efficiency increases when taking piperazine after dinner before going to bed. Levamisole (dekaris) administered after a meal at a dose of 150mg once. Kombantrin (pyrantel) after eating once recommended rate of 10 mg / kg. Oxygen Treatment is carried out on an empty stomach or 3-4 hours after breakfast, consecutive 2-3 days. Oxygen is introduced into the stomach through a thin tube in an amount of 1500 ml per session. After the introduction of oxygen the patient must lie down for 2 hours.

The forecast in the absence of complications requiring surgical intervention, favorable.

Prevention. Mass screening and treatment of all infested ascariasis. Protection of soil gardens, orchards, berry contamination by fecal matter. Thorough washing and scalding with boiling water vegetables and fruits. personal hygiene measures.

Hymenolepiasis. Etiology, pathogenesis. Pathogen - dwarf tapeworm. Infection occurs by ingestion of parasite eggs, got on his hands in contact with the patient and with contaminated feces, household goods (chamber pots, toilet seat and so on.) And toilet walls. Local effects of larval and adult forms on the intestinal mucosa is expressed in the destruction of the villi, proliferative inflammation (sometimes with ulceration.) Mucosa with copious mucus. There and toxic-allergic effect.

Symptoms within. Loss of appetite, nausea, abdominal pain, diarrhea or constipation, dizziness, headache, irritability, fatigue, restless sleep. Sometimes, marked weight loss, mild anemia, eosinophilia. Hymenolepiasis may be asymptomatic.

Diagnosis is based on detection of the dwarf tapeworm eggs in faeces.

Treatment. To apply fenasal deworming. Treatment cycles carried out at intervals of 4-7 days. A month after the main course is carried out a cycle of anti-treatment. In between cycles deworming spend restorative treatment (vitamins, calcium glycerophosphate). In the period of treatment is necessary to comply with hygiene rules (disinfection of pots, toilet seats, linen, personal hygiene). Fenasal administered in a daily dose of 3.2 3.2 Carry treatment cycle for 4 days with an interval between them of the day 4 (Scheme 1) or 7.5 cycles of 2 days every 5 days (Figure 2). According to Scheme 1 fenasal administered in 4 divided doses every 2 consecutive hours for 4 days. During the treatment of the reception, the food in 8.13 and 18h, reception fenasala -. In 10,12,14 and 16 hours In Scheme 2 fenasal administered at once on an empty stomach for 1.5-2 hour before meals for 2 consecutive days. On the eve and day of treatment patients receive besshlakovuyu diet. In the early days of the first two cycles of the day after taking fenasala prescribe a laxative, and at night - a cleansing enema. During treatment and 3-4 days after the end of the patient should take a shower and change clothes every day. All persons lechivshiesya from hymenolepiasis, more precious in the absence of eggs in the feces remain in the dispensary for a year.

Forecast serious because of the possibility autosuperinvazii.

Prevention. Observance of body hygiene, clothing, housing, public hygiene. Testing for worms all members of the family of the patient and the simultaneous treatment of all John based.

Diphyllobothriasis. Etiology, pathogenesis. Pathogen - a tapeworm. The duration of his life is tens of years. Human infection occurs by eating fresh, enough salted eggs and raw fish (pike, perch, cisco, grayling, etc.). Tapeworm, attaching themselves to the intestinal mucosa by their bothria, it hurts. Large clusters of parasites can clog the intestinal lumen. helminth exchange products sensitized body. Absorption broad tapeworm of vitamin B ^ directly from the digestive tract leading to vitamin deficiencies in the ^ and the development of anemia.

Symptoms within. Characterized by nausea, unstable chair, selection during defecation strobila scraps. Patients sometimes complain of weakness, dizziness, pain in the abdomen. Occasionally anemia pernicious type of anemia is close to Addison - Birmera.

The diagnosis is established when detecting tapeworm eggs and scraps strobila in feces.

Treatment. In severe anemia gelmintizatsii to prescribe vitamin B ^ 300-500 mg / m 2-3 times a week for a month, iron supplements, gemostimulin, hematogen. For deworming used fenasal extract of male fern, decoction of pumpkin seeds.

Forecast favorable in the absence of complications.

Prevention. You can not eat raw, undercooked or poorly salted fish and provyalennuyu, as well as "live" schuchyu caviar.

Clonorchiasis -gelmintoz liver and pancreas, caused by trematode fluke-Chinese. It occurs in people living in the Amur basin. The pathogenesis, clinical features, diagnosis, treatment and prevention are the same as when opistorhoze.

Metagonimoz - bot, called Small trematodes. Pathogen parasitize the small intestine of man, dogs, cats, pigs. Human infection occurs in the use of raw fish. In the intestine of metagonimusa metacercariae hatch into larvae, which are thicker mucosa after 2 weeks reach sexual maturity and go into the lumen of the gut. As a result, the mechanical impact and toksikoallergicheskih develop enteritis.

Symptoms within. Abdominal pain, excessive salivation, persistent diarrhea. Sometimes subclinical.

Diagnosis is based on the detection of eggs in the feces metagonimusa.

Treatment. The extract of male fern once or twice with an interval of 2-3 weeks at a dose of 3 g (adults) and naftamon a daily dose of 2.5-5 g (as in hookworm).

Prevention see. Diphyllobothriasis.

Nanofietoz - intestinal helminth infections occurring among the population of the Far East. Pathogen - nanofietus, parasite in the intestine of humans, dogs, cats, mink, badger. Infection occurs by eating raw fish. Worms provide mechanical and toxic-allergic effect on the intestinal tissue.

Symptoms within. The pain and rumbling in the stomach, diarrhea, constipation, excessive salivation and nausea at night.

Diagnosis is based on detection nanofietusov eggs (egg-like difillobotrid) in the stool.

Treatment. Male fern extract at a dose of 3-3.5 g

Prevention, see. Diphyllobothriasis.

Opisthorchiasis. Etiology, pathogenesis. Pathogen - cat fluke, or Siberian, which is a parasite in the bile ducts of the liver, gallbladder and pancreatic ducts man, cats, dogs, etc. In humans, the parasite lives 20-40 years.. Infection occurs by eating raw (thawed, frozen), slightly salted and insufficiently fried carp fish species (ide, rudd, dace, etc..). Opistorhisov injure the mucous membranes of the pancreatic and bile ducts, creating outflow obstruction, bile, promote development of extensions and cystic tumors of the liver. Have toxic and neuro-reflex effects. In the early stage there is a pronounced allergy of the body (blood eosinophil-leukemoid reaction).

Symptoms within. The incubation period is about 2 weeks. In the early period may be fever, muscle aches and joint pain, vomiting, diarrhea, pain and enlargement of the liver, rarely the spleen, leukocytosis, and high eosinophilia, allergic skin rash. In the chronic stage of the most frequent complaints of pain in the epigastric region, right upper quadrant radiating to the back and the left upper quadrant. Sometimes there twinges type-cystic bile colic. Frequent dizziness, various dyspeptic symptoms. Identify resistance of the muscles in the right upper quadrant, enlargement of the liver, sometimes ikterichnost sclera, increased gallbladder, pancreatitis symptoms. The most frequently at opistorhoze evolving phenomenon angiohopita, cholecystitis, biliary dyskinesia, chronic hepatitis and pancreatitis, rarely-gastroduodenita symptoms, enterocolitis. In some cases, there is a picture of holangiticheskogo cirrhosis. Opisthorchiasis may be asymptomatic.

Diagnosis is based on detection in stool and duodenal contents helminth eggs.

Treatment. Assign hloksila (geksahlorparaksilol), during treatment and for 2 days after treatment, limit the use of fats and alcohol is prohibited. The drug is better to give milk. Laxative is not appointed. hloksilom treatment lasts 5 days, the daily dose (60 mg / kg) given in three divided doses after breakfast, lunch and dinner. The total dose per cycle of treatment 0.3 g / kg. The day after the end of treatment should be carried out hloksilom duodenal intubation. Later prescribe cholagogue and antiseptic means (holosas, hologon, allohol et al.), And 1-2 times a week - without biliary tract drainage probe, Monthly spend duodenal intubation. The conclusion of the results of the treatment can only be done with long-term monitoring of patients (4-6 months after treatment). In asymptomatic opistorhoze use mebendazole (Vermoxum) po0,1 g, 2 times a day for 3 days.

Forecast serious in connection with the development of serious complications.

Prevention. Clarification of the population the danger of eating raw, frozen and thawed (steak), slightly salted and insufficiently fried fish.

Strongyloidiasis. I etiology, pathogenesis.

Pathogen - ugritsa intestinal, parasitizing the intestine wall (preferably the duodenum), sometimes in the ducts of the liver and pancreas during migration - in the bronchi and the lung tissue. Penetration strongiloidesa larvae in the human body can be active through the skin (when walking barefoot, etc..) And through the mouth (by eating contaminated fruits and vegetables, as well as drinking water). Adult parasites localized in the intestinal wall, injure the intestinal crypts (liberkyunovy gland), solitary follicles and contribute to ulceration of the mucous membrane, as larvae, making migration - liver tissue, lungs and other organs. Of great importance is toxic and allergenic effects of adult parasites and their larvae on the human body, as well as a secondary infection.

Symptoms within. Often there are signs of allergy:. Itching, burning, rash, eosinophilia, sometimes "volatile infiltrates" in the lungs, etc. In the later stage dominated by the phenomenon gastroduodenitis, enterocolitis, cholecystitis sometimes. Characterized by a triad of chronic recurrent urticaria, persistent enterocolitis and prolonged high eosinophilia. Frequent dizziness, headache, insomnia, irritability. Sometimes the disease is manifested only eosinophilia and skin itch. For a long, long-term (up to a specific treatment), as this helminthiasis (especially constipation) can autoreinvaziya. There are indications giperinvazii connection with corticosteroids and immunosuppressive agents. In severe forms of the disease developing ulcerative enterocolitis with dehydration, cachexia, anemia and death.

Diagnosis is based on clinical data and detecting ugritsy larvae in the feces (in the study by Berman's method), and in duodenal contents, at least in sputum and urine.

Treatment. Medamin a daily dose of 10 mg / kg in three divided doses after meals for 3 days or tiabendaeol (mintezol) at a daily dose of 25 mg / kg for 2-3 consecutive days. Prognosis is generally satisfactory. Prevention see. Hookworm. Beef tapeworm infection. Etiology, pathogenesis. Pathogen-bovine tapeworm. Man is infected by eating raw meat of cattle containing the Finns (bovine tapeworm larvae). In the small intestine of the Finns after 3 months developing adult worms that can live for many years. It provides mechanical, toxic-allergic and reflex effect on the human body.

Symptoms within. Patients report spontaneous vypolzanija segments from the anus and the allocation of their feces. Sometimes there may be nausea, vomiting, dizziness, abdominal pain, irritability, headache, laryngospasm, Meniere's syndrome, epileptiform attacks, the delay of the chair and gases (as in dynamic ileuse).

The diagnosis is established when there is an indication of the passage of the segments and in the perianal scrape the feces and found parasite eggs.

Treatment. Assign fenasal empty stomach at a dose of 2-3 g P r o g n o s favorable.

Prevention - not to eat raw meat, do not try raw ground beef.

Teniasis. Etiology. Pathogen - pork tapeworm, which can parasitize humans, not only in mature, but in the larval stage, disease-causing cysticercosis. Adult worms parasitize in the small intestine for years. Infection of humans occurs teniasis by eating raw or half-baked meat containing Finns.

Pathogenesis, see. Teniarinhoza.

The symptoms for the same as when teniarinhoze, but the parasite actively segments from the anus do not go (soft segments, of which the patient usually does not notice the feces occasionally depart).

Diagnosis is based on re-examination of feces for the presence of segments of worms and mucus perianal folds (by scraping) for the presence of tapeworm eggs.

Treatment. Use fenasal in the same doses as in teniarinhoze. Sometimes used the ethereal extract of male fern and pumpkin seeds. Forecast serious because of the risk of complications. Prevention: Do not eat undercooked pork and neprozharennoe.

Trichinellosis (trichinosis). Etiology, pathogenesis. Pathogen - Trichinella. The larval stage is ingested with the meat of pigs or wild animals (wild boar, bear, badger and others.). After digestion of meat muscle Trichinella exempt from capsules embedded in the villi tissue, rapidly grow, develop, and within 80-90 hours after infection, the females lay many larvae which spread throughout the body. The place of the further development of young Trichinella are striated muscles, especially intercostal, chewy, the diaphragm muscles, tongue, throat, eyes. There Trichinella 2-3 weeks roll up into a helix, encapsulated, some of them calcify. The duration of the intestinal stage Trichinella about 2 months. Muscular Trichinella can survive up to 20 years or more. Degradation products and the exchange of Trichinella sensitize the body, causing eosinophilia, microangiopathy, infiltrates in the muscle, edema and other painful events. It has a value Trichinella mechanical action in the intestine of adults and larvae in muscle and other tissues, and secondary infection.

Symptoms within. The incubation period - from 3 to 45 days. Characterized by early symptoms: puffiness of the face, accompanied by conjunctivitis, fever, muscle pain, eosinophilia. Parts of different skin rashes, and gastrointestinal disorders, hypotension, voiceless heart tones, palpitations, headache, and insomnia. In milder forms a marked swelling of the eyelids, and eosinophilia. The duration of illness by 2-3 days to 8 weeks or more. Sometimes there is recurrent for trichinosis. Complications: myocarditis, meningoencephalitis, arterial and venous thrombosis, pneumonia, nephritis, and others.

Diagnosis is based on epidemiologic (eating undercooked pork and other meat, disease group), characteristic clinical findings (eosinophilia, eyelid edema, fever, muscle aches). Use serological tests with trihinelleznym antigen. Confirmation of the diagnosis may be the detection of Trichinella and characteristic infiltrates in the muscle biopsies pieces (trapezius, deltoid, calf) or in meat residues caused by the disease. Biopsy do with 9-10-th day of illness.

Treatment. Patients hospitalized. Assign mintezol 25 mg / (kg day â,¬) in 3 divided doses for 5-10 days or Vermoxum 0.1 g 2-3 times within 7-10 days, symptomatic agents. Forecast serious.

Prevention: Do not eat raw or insufficiently cooked pork and wild boar, bear, badger and others.

Trihostrongilidozy. Pathogens - small worms from the family trihostrongilid. The main source of infestation -ovtsy, goats, cattle. Man is infected through contaminated food or water.

Symptoms within. Characterized by nausea, abdominal pain, unstable stool, dizziness, headache. Sometimes develop hypochromic or normochromic anemia and decline of power. Diagnosis is based on the detection of eggs in the feces trihostrongilid.

Treatment. Assign naftamon and kombantrin (see. Hookworm}.

Weather favorable.

Prevention: personal hygiene measures.

Trihotsefalaz. Etiology, pathogenesis. Pathogen - whipworm, parasite in the human colon. The lifespan of the parasite for about 5 years. Whipworm injure the mucous membrane of the intestine are re-matofagami and help inoculate microflora cause reflex reactions in other abdominal organs. The products of their metabolism sensitized body.

Symptoms within. Concerned about excessive salivation, decrease (less increase) appetite, pain in the right abdomen and epigastric pain, nausea, constipation or diarrhea. Can be inflammation in the intestines. Often marked headache, dizziness, trouble sleeping, irritability; possible mild hypochromic anemia and slight leukocytosis. With intensive infestation in children are described cases of rectal prolapse (due to persistent diarrhea), epileptiform attacks of Meniere's syndrome. At low intensity whipworm infestation are asymptomatic.

The diagnosis is established when detecting whipworm eggs in the feces.

Treatment. Assign difezil, mebendazole, oxygen medamin, naftamon. -to Difezil daily dose of 5 g (in fasted twice) for 5 days; He has a slight laxative effect. Mebendazole (Vermoxum) appoint 0.1 g during meals 2 times a day for 3 consecutive days. Oxygen is introduced via the rectum. Pre-patient put a cleansing enema. After 1 hour, when the patient's position on the left side through the rubber tip of the enema slowly introduce oxygen. After the introduction of oxygen the patient should lie on his back 2 hours of oxygen dose for children -. At the rate of 100 ml per year of life. The cycle of treatment lasts 5-7 days in a row or every other day. After oxygen therapy is prescribed a laxative within 1-2 days. Contraindications for oxygen therapy: anal fissure, intestinal tumor, acute and subacute inflammation in the abdominal cavity, the menstrual period and all forms of ulcerative colitis. Medamin administered in a daily dose of 10 mg / kg in two divided doses after meals for 3 days. Naftamon (alkopar) take on an empty stomach for three hours before a meal; single dose of 5 g The preparation is stirred in 30-50 ml of water (preferably sugar syrup or sweet tea) and drink at once. The patient must lie for 3 hours. The cycle of treatment 5 days. Naftamon (a half dose) may be combined with oxygen.

Weather favorable.

Prevention see. Ascariasis.

Fasciolosis. Etiology, pathogenesis. Pathogens - liver fluke and giant. The main source of infection of people - different animal. Human infection usually occurs during the warm season when ingested larvae of Fasciola water, sorrel, lettuce and other greens. Lifespan helminths in the body is about 10 years. Matter trauma and toxic-allergic damage to the hepatobiliary system. Fasciola possible drift into other tissues and organs.

Symptoms within. The disease is characterized by eosinophilia, allergic phenomena, disorders of the liver and gall bladder, reminiscent -simptomy opisthorchiasis (jaundice and seizures zhelchepuzyrnoy cramps are more common).

The diagnosis of an early stage of fascioliasis difficult as helminth eggs are allocated only after 3-4 months after infection. Use immunological methods. In late-stage diagnosis relies on the detection of Fasciola eggs in duodenal contents and feces.

Treatment. Assign hloksila as opisthorchiasis. After deworming prescribe cholagogue for 1-2 months. We need long-term (at least one year) clinical examination of patients.

The prognosis for a favorable treatment. Prevention. Prohibition of the use of water from stagnant water; thorough washing and scalding with boiling water greens.