Intestinal helminthiases. Helminthiasis in children

Worm infestations (helminthiases)

Opisthorchiasis.

Symptoms of opisthorchiasis.

The disease often proceeds as a chronic invasion with sensitization of the body and allergic symptoms. The course of the disease is quite variable from asymptomatic forms to severe, sometimes with lethal outcome. More than half of the patients complain of pain in the epigastric region and right hypochondrium, dyspeptic symptoms are often detected. Characterized by an increase and soreness of the liver, its compaction. enlarged gallbladder. Are celebrated subfebrile temperature, weakness, irritability, insomnia. Eosinophilia is detected from the 2nd week (earlier than with other helminthiases), moderate anemia is observed. With opisthorchiasis, usually develop chronic hepatitis and pancreatitis.

Treatment of opisthorchiasis.

Before the start of specific treatment, table number 5, antispasmodics and choleretic drugs. Chloxyl is prescribed orally 3 times a day after meals. Per course no more than 20 g for adults. The treatment cycle takes two (0.1-0.15 g per 1 kg of body weight per day) or five days (0.06 g per 1 kg of body weight per day). Chloxyl powder is shaken in milk. Laxatives are not prescribed. Biltricid is prescribed orally after meals at 20-25 mg/kg. Maximum dose 40 mg/kg. Treatment with biltricid is carried out within one day for 1, 2 or 3 doses. The tablets are swallowed whole with a small amount of liquid. When taking a single tablet, it is recommended to take it in the evening, with 2-3 times a day with an interval of 4-6 hours. A laxative is not prescribed.

Clonorchiasis.

Symptoms and treatment of clonorchiasis.

Clinical manifestations, laboratory diagnosis and treatment of clonorchiasis are the same as for opisthorchiasis.

Nanophyetosis. Nanophyetosis helminthiasis with a predominant lesion of the intestine. In Russia, it occurs in the Primorsky Territory (basins of the Amur and Ussuri rivers) on Sakhalin, a large infection is noted in the Udege villages. The disease is also registered in North America.

Symptoms of nanophyetosis.

Clinical manifestations of the disease may be practically absent with a weak invasion or be insignificant. Most often, patients present with abdominal pain, unstable chair(alternating constipation and diarrhea), nausea, possible vomiting and other signs of enteritis. Laboratory diagnosis is based on the detection of eggs in the feces of patients (not earlier than 5-7 days after infection).

Treatment of nanophyetosis.

For treatment, male fern extract (up to 3.5 g for an adult) or quinacrine (once 0.6-0.8 g) is used.

Symptoms of fasciolosis.

Clinical manifestations depend on the intensity of the invasion. For acute phase diseases are most often characterized by manifestations of allergy with fever, skin rashes like urticaria, asthmatic attacks. Patients complain of pain in the abdomen, right hypochondrium, nausea. Hepatomegaly, less often splenomegaly, leukocytosis, eosinophilia are noted. The duration of the acute period is usually 3-4 months. The chronic stage clinically resembles opisthorchiasis with symptoms of cholangitis, hepatocholecystitis, hepatitis and cirrhosis of the liver, obstructive jaundice may develop.

Laboratory diagnosis is established on the basis of a study of feces and duodenal contents, in which the appearance of fasciola eggs is possible no earlier than 3 months after infection. Therefore, on early stages the diagnosis is based on epidemiological, clinical data and the results of an immunological examination (complement fixation test).

Treatment of fascioliasis.

Chloxil is a specific drug, prescribed at the rate of 60 mg/kg of body weight per day for a 5-day course of treatment and 150 mg/kg for a 2-day course. daily dose distributed into 3 doses 2 hours after breakfast, lunch and dinner. After 2-3 days, duodenal sounding is performed. You can repeat the course of treatment in 2-3 months.

Diphyllobothriasis.

Diphyllobothriasis is a helminthiasis with a predominant localization of the pathogen in the intestine. Belongs to the number of invasions with natural foci, distributed mainly in countries with a temperate climate. In Russia, diphyllobothriasis is registered everywhere on Kola Peninsula, in Karelia, in the regions of the Gulf of Finland, in the basins of the Northern Dvina, Pechora, Ob, Yenisei, Lena, Kama, Volga, in the Far East and Baikal. Intensive foci are located in the northern regions of the Krasnoyarsk Territory. In addition, in connection with the construction of irrigation facilities, new foci of diphyllobothriasis arose in the reservoirs Kama, Kuibyshev, Volgograd, Gorky, Rybinsk.

The causative agent of the disease are various types of tapeworms, of which highest value for a person has a wide ribbon. Their development occurs in reservoirs, where immature eggs fall with the feces of the final hosts. The final owners of tapeworms are humans, dogs, cats, pigs, wild predatory mammals. Crustaceans are the main intermediate host of tapeworms, and additional freshwater fish(pike, burbot, perch, ruff, lake and anadromous salmon, lake trout, omul, whitefish, grayling, etc.).

Symptoms of diphyllobothriasis.

Treatment of diphyllobothriasis.

Treatment is with fenasal or male fern extract. Fenasal is prescribed in the following doses: children under 3 years old 0.5 g, up to 6 years old 1 g, up to 9 years old 1.5 g; older than 12 years and adults 2 g. In some cases, the dose of fenasal is increased to 3 g (in persistent cases). There are 2 main treatment regimens with fenasal:

in the morning 10-15 minutes before taking fenasal, the patient drinks 1/2 glass of water with 1-2 g of sodium bicarbonate (soda). After 1 hour after this, you need to drink a glass of sweet tea. Laxatives are not given;

3 hours after light dinner drink soda at a dose of 1-2 g in 1 glass of water, after another 10 minutes, take a stirred suspension of fenasal in water. A saline laxative is recommended the next morning. On the eve and on the day of treatment with fenasal, the patient takes easily digestible food.

Treatment with a male fern extract provides for the following preparation of the patient: mashed, liquid, low-fat food is prescribed for 2-3 days, a cleansing enema is given on the 1st day of preparation, a saline laxative is given at night for 2-3 days, and a cleansing one is put in the morning on the day of treatment. enema.

The drug is prescribed in the following doses per course: up to 1 year 0.5 g, at 2 years 1.0 g, at 3 years 1.5 g, at 4 years 2.0 g, at 5-6 years 2.5 g, at 7-9 years old 3.0 g, at 10-12 years old 3.5-4.0 g, at 13-16 years old 4.0 g, from 17 years old and older 4, 0-7.0 g. The course dose is taken in 2-3 doses with an interval of 5-10 minutes mixed with honey, jam, jam or fractionally (in capsules) for 30 minutes. The drug is washed down with water or a 5% solution drinking soda. 1.5 hours after taking the fern extract, a saline laxative is prescribed, and even later an easy hour breakfast sweet tea with a roll.

Teniarinhoz.

Infection of livestock occurs when they eat grass and feed contaminated with tapeworm segments and eggs. Tapen larvae (Finns) are located in the intermuscular connective tissue animal, where they retain their invasive ability for up to 1 year. A person becomes infected when eating contaminated undercooked and undercooked meat, when tasting raw minced meat in the process of cooking cutlets, dumplings. In the human small intestine bull tapeworm can live for decades.

Symptoms of teniarinhoza.

Clinical manifestations of invasion in early phase missing. In the chronic phase, 3 main syndromes are observed: asthenoneurotic, pain and dyspeptic. Irritability, sleep disturbances are often noted, convulsions, appetite disturbances (both decrease and increase), rumbling and cramping pains in the abdomen, more often in the right iliac region, chair instability. Possible weight loss.

Diagnosis is based on the indication of the patient to the active discharge of the segments of the helminth. The provocation of discharge is carried out by prescribing pumpkin seeds (up to 30 g) or garlic (2-3 cloves) the day before, a saline laxative is given in the evening. In the morning after emptying the intestines, the fecal masses are washed and the departed segments are examined. The method of scraping from the perianal folds is also used. It is almost impossible to distinguish between the eggs of armed and unarmed tapeworm.

Treatment of teniarinhoza.

Fenasal is used to treat teniarinhoza. The drug is prescribed in the morning (on an empty stomach) or in the evening (3 hours after eating). The entire dose of fenasal is given as an aqueous suspension. Doses of the drug: children under 3 years 0.5 g, from 3 to 6 years 1 g, from 6 to 9 years 1.5 g, over 9 years 2 g, adults 2-3 g. After taking fenasal the patient should not eat for 3 hours. Male fern extract and pumpkin seeds may also be used.

Teniosis symptoms.

Clinical manifestations of the disease are determined by the intensity and duration of invasion, age, general condition patient and vary from mild to relatively severe. With uncomplicated teniasis, patients complain of a decrease or increase in appetite, dizziness, nausea, vomiting, unstable and unformed stools, less often - abdominal pain without a specific localization. From the side nervous system weakness, irritability, sleep disturbance are noted, weight loss is often observed in children.

Due to the fact that taeniasis can be complicated by cysticercosis in any form, it is classified as a dangerous invasion. Laboratory diagnostics is based on the detection and study of the nature of the segments and eggs in the feces and in the scraping material of the perianal folds.

Treatment of taeniasis.

Treatment is carried out in a hospital with male fern extract or pumpkin seeds, biltricid (orally after meals, 20-25 mg / kg 1-3 times a day), vermoxom (200 mg 2 times a day for 3 consecutive days until complete cure; children 100 mg 2 times a day for 3 consecutive days).

Cysticercosis.

Symptoms of cysticercosis.

Diagnosis of cysticercosis can be complex and includes a thorough epidemiological history, analysis of clinical manifestations, ophthalmoscopy, immunological methods diagnostics (reaction of indirect hemagglutination, reaction of fluorescent antibodies).

Treatment of cysticercosis.

Treatment is symptomatic, if necessary, surgical. Echinococcosis. Echinococcosis is widespread almost everywhere. In Russia, this helminthiasis is more often recorded in the Novosibirsk, Tomsk and Omsk regions, Yakutia (Republic of Sakha) and Buryatia. Man is the intermediate host of echinococcus, the final host is the domestic dog, which has the greatest epidemiological significance, as well as the wolf, jackal, fox, hyena, coyote and some other predatory animals.

Human infection occurs through close contact with infested dogs, as well as by eating greens and vegetables contaminated with echinococcus eggs, with water, by removing and cutting the skins of infected predators.

Symptoms of echinococcosis.

The clinic of invasion in humans depends on the number, size and localization of echinococcal blisters. The most common echinococcosis of the liver (60-80%). IN initial stages clinical manifestations are scarce: severity and moderate intermittent pain in the right hypochondrium, urticaria is possible as a manifestation of allergization, eosinophilia. Further, slowly progressive enlargement of the liver, ascites, edema, jaundice are determined. In cases of echinococcosis of the lungs, a persistent dry cough, hemoptysis, and chest pain appear. Physical findings in the study of the lungs are nonspecific. Echinococcosis of other organs is rare, the symptoms in these cases are similar to those of a neoplasm.

Treatment of echinococcosis.

Treatment of echinococcosis is only surgical. Alveococcosis. Alveococcosis (alveolar, or multi-chamber, echinococcosis). On the territory of Russia, alveococcosis occurs in Yakutia, Bashkiria, Tatarstan, in Magadan, Kamchatka, Irkutsk, Novosibirsk, Omsk and Tomsk regions; recently recorded also in Central European regions Russian Federation. The final hosts of the invasion are domestic dogs, foxes, arctic foxes, wolves, rarely domestic cats.

Man is an intermediate host (along with rodents, mainly voles). A person becomes infected in various ways: when removing and cutting the skins of fur animals, when in contact with dogs and cats, when drinking water, berries, garden crops contaminated with secretions of sick animals.

Symptoms of alveococcosis.

Treatment of alveococcosis.

Surgical treatment. Trichinosis. Trichinosis is found everywhere, in Russia it is more often recorded in the Magadan region, Khabarovsk, Krasnoyarsk and Krasnodar regions. A person becomes infected by eating pork infected with Trichinella larvae, less often - the meat of brown bears, wild boar and other animals. Trichinella larvae with blood flow are brought into various bodies and tissues, especially in the muscles. Incubation period is 5-45 days.

Symptoms of trichinosis.

The disease is acute, the body temperature rises, nausea, diarrhea appear, pronounced swelling of the eyelids, puffiness of the face are characteristic. Puffiness and hyperemia of the conjunctiva are noted. Later, muscle pains appear, often intense. The muscles of the neck, lower back, and calves are most often affected. A variety of rashes appear on the skin. Complications of invasion are varied: thrombosis, pneumonia, nephritis, myocarditis, meningoencephalitis.

Diagnosis of trichinosis is complex, includes an epidemiological history, analysis of clinical manifestations, immunological tests (RIGA indirect agglutination reaction, RSK complement fixation reaction, skin allergic test), examination of the animal's muscles and a piece of the patient's muscles (trapezius, deltoid or gastrocnemius) followed by microscopy.

Treatment of trichinosis.

Treatment of hymenolepiasis.

Hymenolepiasis is treated with biltricid. The drug is prescribed orally after a meal, 20-25 mg / kg 1-3 times a day. The tablets are swallowed whole with a small amount of liquid. With a single appointment, it is better to take tablets in the evening, with a 2-3-time appointment, the interval between doses should be 4-6 hours. A laxative is not prescribed when taking biltricide.

Ascariasis.

Ascariasis is the most common of all human helminthiases. Man is the only source of infection. Infection occurs by ingestion of helminth eggs with water or food. Further, ascaris larvae migrate with the blood stream through the portal system of the liver and the inferior vena cava, right heart, are brought into the lungs, where they are from several days to one and a half weeks. From the lungs, the larvae move to the trachea and pharynx and, with swallowed saliva and food, re-enter the intestine, where they turn into sexually mature helminths. Ascaris eggs are resistant to external environment and can be preserved in the soil at a depth of 20 cm in central Russia for up to 7 years, in the southern regions for more than 10 years.

Symptoms of ascariasis.

Treatment of ascariasis.

Vermox is used for treatment (adults and children over 1 year old are prescribed 100 mg 2 times a day: morning and evening for 3 consecutive days), decaris (150 mg once; children 1-6 years old 25-50 mg; 7-14 years 50-125 mg; usually 2.5 mg / kg), mebendazole (1 tab in the morning and evening for 3 consecutive days), piperazine, naftamon.

Strongyloidiasis.

Strongyloidiasis helminthiasis with chronic course, periodic exacerbations and a multiplicity of clinical manifestations: gastroduodenitis, skin rashes, bronchitis with an asthmatic component. The disease is widespread in tropical and subtropical countries. However, due to the fact that eel larvae can develop in the soil in wide range temperatures from 10 to 40 ° C, cases of strongyloidiasis are also found in temperate climates, up to Moscow and even St. Petersburg. The causative agent of the disease is intestinal acne, the main source of invasion is a sick person, as well as a dog. A person becomes infected with strongyloidiasis by drinking water and food contaminated with larvae, and by contact with soil in which the larvae have developed to the invasive stage. Migration of larvae during penetration through the skin through the blood vessels into the lungs, exit into Airways, then through the larynx to digestive system explains the sensitization of the body and the originality of the clinic of strongyloidiasis. During the course of the disease, acute and chronic phases are distinguished.

Symptoms of strongyloidiasis.

In the acute phase (it can be detected only in 7-25% of hospitalized patients), fever, skin rashes, often of a polymorphic or exudative nature, bronchitis, and less often pneumonia are observed. Bronchitis can occur with an asthmatic component. In other cases, it develops clinical picture acute ulcer duodenum or stomach. IN chronic stage The disease occurs in one of three main variants:

according to the type of chronic recurrent gastroduodenitis; with the phenomena of gastroduodenitis and chronic cholecystitis; mainly with allergic manifestations skin rashes, asthmatic bronchitis, arthralgia. The diagnosis of strongyloidiasis is supported by data microscopic examination duodenal contents or examination of feces.

Treatment of strongyloidiasis.

Enterobiasis symptoms.

The clinic of enterobiasis is characterized by irritation, itching and burning sensation in the area anus, perineum and external genital organs, mainly at night. Frequent disorders emotional sphere, and in women and girls, when pinworms crawl into the genital tract, symptoms of gynecological diseases appear. Diagnosis of enterobiasis, as a rule, is not difficult. Pinworm eggs are found in scrapings of the perianal folds.

Treatment of enterobiasis.

Treatment is carried out with piperazine, vermox (adults and children over 1 year 100 mg once and again once after 2 and 4 weeks), mebendazole (taken orally, pre-chewed or mixed with food 1 tab 100 mg once).

Schistosomiasis.

Schistosomiasis helminthiases of tropical and subtropical countries, occurring in the form chronic disease with predominant defeat genitourinary system, intestines, liver, spleen, sometimes the nervous system. Schistosomiasis is widespread in Africa, South America, and Southeast Asia.

Symptoms of schistosomiasis.

It can proceed at lightning speed, with general severe symptoms in the absence of local manifestations or in the form acute colitis, enterocolitis. In intestinal schistosomiasis predominate gastrointestinal manifestations or hepatolienal forms with the development of cirrhosis of the liver. Lung damage, encephalitis, meningoencephalitis (the result of egg drift) are also possible. Intercalated schistosomiasis is the most benign form and is relatively rare.

Treatment of schistosomiasis.

Specific treatment is carried out with biltricid at a dose of 20-25 mg/kg 1-3 times a day. The tablets are swallowed whole, without chewing.

Most patients believe that helminthic invasion is a "disease of dirty hands." This statement is only half true. Some types of worms, such as cestodes and others flatworms, can indeed live in soil, sand, therefore, in the absence of sufficient hand hygiene, a person can become infected with helminthiasis, but this transmission route is typical mainly for younger children. age group(from 1 to 6 years). In an adult, the main source of infection is poor-quality food (expired dairy products, poorly processed meat, stale eggs) and tap water.

You can become infected with worms in open rivers and reservoirs. IN rare cases while bathing, a person can become infected with leeches - representatives of the class of annelids that cause hirudinosis. The pathology is quite severe, since the main food for leeches is blood and its components, which leads to damage blood vessels, rapidly progressive anemia and blood poisoning against the background of systemic intoxication of the body. To avoid this, you should not swim in places that are not equipped with “Swimming allowed” signs. At designated areas in summer period soil/water samples are periodically taken and the risk of infection in such places is several times lower.

Other sources of infection for humans can be:

• street and domestic animals (it is necessary to clean the pet tray only with gloves, and the animal itself should be bathed regularly and treated with anthelmintic drugs 2 times a year);
• contaminated air;
• blood-sucking insects (mosquitoes, ticks);
• dust (including house dust, accumulating on soft toys and upholstered furniture).

Note! Some types of worms can enter the human body through the skin, so you should limit as much as possible bodily contact with a person who has been diagnosed with helminthiasis.

Acute infection in adults: symptoms and signs

It is possible to diagnose or suspect helminthic invasion on your own at home only during the period of acute and subacute course diseases. Depending on the type of worms, their number and the state of the immune system, it can be from 1 week to 4 months. The symptoms of the pathology during this period are most pronounced, so the chances for timely treatment and reducing the risks of complications in the acute form are maximum.

The main symptoms of acute helminthiasis are disturbances in the work of the intestines. The patient develops functional intestinal disorders in the form of diarrhea or prolonged absence stool (constipation is 4 times less common than diarrheal syndrome). The consistency of the stool when infected with worms is liquid, watery, sometimes with the addition of foam. The smell is fetid, pungent. The color can vary, but in most patients, the stool becomes lighter in color and pale yellow in color. With a heavy infestation with worms, the feces may be brown or green. Sometimes streaks of mucus and blood are found in them, which is released as a result of damage by worms to blood vessels and capillaries located in the intestinal mucosa.

Worms in feces - photo

Among other signs from gastrointestinal tract the patient may have abdominal pain, causeless, sudden vomiting, loss of appetite on the background constant nausea. Many patients lose weight during this period: weight loss can be up to 10% in 2-4 months from the onset of the disease. The skin turns pale, a polymorphic rash appears on them in the form of vesicles or nodules filled with exudate. The same rash can occur on the mucous membranes of the genital organs, oral cavity And internal organs. Approximately 10-20% during this period develop acne, boils, comedones. A small red rash may appear on the skin of the abdomen and elbows.

Other signs of acute infection in an adult include:

Important! anal itching, which is considered the main symptom of helminthiasis, is characteristic mainly of enterobiasis - infection with pinworms. It occurs as a result of irritation of the skin in the anorectal region by a secret secreted by female pinworms at night. For others acute forms helminthic invasion, such a clinical picture is not considered typical.

Chronic invasion: what symptoms to look out for?

The chronic form of helminthiasis is a very common pathology that develops in the absence of timely treatment in the acute period. Majority clinical symptoms during this period they subside and lose their intensity, but do not disappear completely. A person may periodically experience mild pain in the abdominal area, nausea, and vomiting may occur immediately after a meal or 1-2 hours after a meal. Skin rashes usually persist. With a severe reaction, the patient may experience angioedema - fatal dangerous state accompanied by spasm of the larynx and bronchospasm.

One of the main signs of chronic helminthic invasion (as well as its complication) is anemia. It is manifested by unnatural pallor, asthenia (syndrome chronic fatigue), weakness. A person's working capacity decreases, he becomes lethargic, emotional lability can be observed.

Important! Hepatobiliary helminthiasis is one of the most severe types of pathology. In the absence of adequate and timely therapy possible death of the patient acute intoxication and hepatic necrosis.

Clinical indicators - signs of helminthic invasion

How to protect yourself from infection with worms?

The main rule that helps protect the body from the penetration of worms is strict hygiene - first of all, hand hygiene. For washing, it is better to use soap with antibacterial components or natural laundry soap with a concentration of fatty acids not less than 72%. Laundry soap has a pronounced disinfectant and antimicrobial action and provides excellent prevention infectious diseases. In case of intolerance to the smell of laundry soap, you can use a product with the addition of aromatic additives.

Food must be prepared in accordance with hygienic and heat treatment. It is recommended to pour over vegetables and fruits with boiling water or wash them with soap, fry or boil the meat at high temperature at least 30-40 minutes. The minimum time for boiling eggs is 20 minutes. It is important to monitor the quality and freshness of products and carefully check expiration dates. If the product does not have the necessary information and labeling, it is better to refuse the purchase.

If there are pets in the house, it is necessary to conduct a deworming course 2 times a year, even if the pet does not visit the street, since worm eggs can be brought into the apartment on street shoes and clothes. The safest means for deworming cats and dogs are Milbemax chicken flavored tablets.

What to take with helminthiasis?

Treatment for helminthiasis should be prescribed only by a doctor, since all anthelmintic drugs are highly toxic and adversely affect the state of the liver. The table lists commonly prescribed drugs with a wide range actions, as well as their dosage, but they can only be used after laboratory diagnostics and expert advice.

Table. Popular drugs for helminthiasis.

A drug	How to use
	1 tablet per day. The duration of treatment depends on the type of pathogen and can range from 1 to 10 days.
	15 mg per kilogram of weight (divided into 2 doses). The duration of therapy is 1-5 days.
	150 mg once. Re-admission is possible in 1-2 weeks.

Helminthiasis - dangerous infectious pathology, which may cause severe complications from the heart, organs of vision, pulmonary system and other vital organs. Knowing the signs of helminthiasis in adults, you can avoid such consequences by contacting a doctor in time and passing the necessary tests.

Video - Helminthiases

The epidemic process in helminthiases, as in other infectious diseases, is a path of pathogen transmission from the organism - their source to a susceptible recipient organism, with the emergence of new sources of helminthiases. The source of invasion itself can become a recipient as a result of self-infection with contact helminthiases, and in addition, it is also possible with teniasis (extraintestinal self-infection with cysticercosis), strongyloidiasis, and even with ascariasis and trichuriasis.

The transmission of a contagious disease (including helminthiases) occurs in a certain phased (relay) order, while being under the influence of various transmission factors. All this constitutes the transmission mechanism.

As you know, only a person can be a source for some human helminthiases, for others - a person and animals (including birds - with gull diphyllobothriasis), for others - only animals (echinococcosis, trichinosis), when a person is usually an epidemiological dead end. With helminthiases, the source of which is a person and an animal, the role of the first and second in the transmission of invasion is unequal.

Well-known is the role of workers of a particular profession and residents of certain settlements as sources of transmission of the corresponding helminthiases - water workers, fishermen, timber rafting workers and residents of coastal (near rivers, lakes and reservoirs) settlements with "freshwater" helminthiases; preschoolers, schoolchildren, workers Food Industry and public catering and members of their families - with contact; livestock breeders and residents of localities who eat undercooked and undercooked beef - with taeniarhynchosis, pork - with taeniasis, etc.

In the vast majority of cases, the only set of factors that implement the first stage of the transmission path are social factors, in the first place is the level of sanitary culture of the population. This includes epidemiologically unsafe methods of fertilizing the soil of vegetable gardens, orchards and berry fields. This applies both to geohelminthiases and to all biohelminthiases, as well as to taeniarhynchosis and taeniasis.

These factors also operate in such, at first glance, "favorable" in sanitary terms Western countries like France, England, USA.

The low level of hygienic skills in the family, among preschoolers and schoolchildren determines the still high percentage of enterobiasis, and in a number of places, dwarf hymenolepiasis. The level of infection with enterobiasis is very high in Germany, and in the USA, and in France.

Only in filariasis, the foreground in the implementation of further stages of the transmission pathways are natural factors, which ensure the vital activity of carriers (mosquitoes, midges) and contact with the source organism.

The second stage of transmission of invasion is the finding of isolated eggs and larvae of helminths in the elements of the external environment. Here the role of a complex of natural factors is already very significant. For geohelminths, this is the temperature necessary for eggs and larvae to reach the invasive stage, soil moisture and soil and water aeration. The same is necessary to preserve the vital activity of invasive eggs and larvae, as well as eggs that have already entered the external environment as invasive. And for contact helminthiases (enterobiosis), natural factors [contrary to the statement of V.P. Podyapolskaya - temperature and humidity can play a significant role at the second stage of the infection transmission path, when conditions are created in the external environment (for example, in the garden soil) for the maturation of pinworm eggs.

Favorable microclimatic conditions for the maturation and maintenance of invasive germinal forms of helminths in the external environment are also created under the influence of domestic factors, such as, for example, during abundant irrigation.

However, in the second stage of the transmission pathway, natural factors such as too high or too low temperature soil, its insufficient moisture, not only prevent the maturation of eggs and larvae of helminths, but cause their death. Interestingly, the same detrimental factor in some helminthiases is excessive moisture, for example, with teniarinhoz and

Pathology is often accompanied by allergic or abdominal syndrome, chronic toxicosis or anemia. In the process of development of helminthiases, damage to the liver, lung and biliary structures, eyes and brain occurs.

With the development of helminthiasis, the patient has all the signs of exhaustion and pathological decrease immune forces. Most often, helminthiases occur in chronic form in the form of toxocariasis or trichuriasis, ascariasis, enterobiasis or hookworm.

Infection of the population among Russians is about 1-2%, but in some regions of the country it reaches 10%.

Infection with helminthic pathogens can occur by different ways transmission.

Transmission routes

Infected humans and individuals shed helminthic larvae and eggs that spread through water, soil, and plants. Then the larvae fall on vegetable crops or into water, into the soil, with which they spread over farmland.

If a person eats an unwashed vegetable from such a garden, then he can easily become infected with helminthiasis. Some helminthic forms spread exclusively from person to person.

Any route of infection leads to the development of helminthiasis, which, in the absence of therapeutic measures, can lead to dangerous complications and the consequences.

Classification

Helminthic infections are divided into various groups according to the type and localization, the way of infection and the mode of existence.

In accordance with biological characteristics helminthic infestations are divided into:

• Nematodes or roundworms;
• Cestodes or tapeworms;
• Trematodes or flukes.

The photo shows a fluke caused by helminthic liver damage

In accordance with localization, helminthiases are divided into intestinal and extraintestinal, hepatobiliary or pulmonary, as well as ophthalmohelminthiasis.

Helminthiases of tropical origin are classified as intestinal infections, which are rare in prevalence. These pathologies include:

• Schistosomiasis;
• Soil-transmitted helminthiases (trichocephalosis and ascariasis, ankylostomiasis);
• Filariasis;
• Food trematodes (fascioliasis);
• cysticercosis;
• Onchocerciasis;
• Dracunculiasis;
• Echinococcosis;

mixed

Intestinal

The term larval helminthiases indicates that the patient's helminthic larvae of the tape type have struck any intraorganic structure.

The larval invasion is short-term, but this does not make it safe, because with prolonged development it can lead to irreversible intraorganic disorders. The most common are such larval helminthiases as echinococcosis or cysticercosis.

Baby

Most often, children are affected:

• Roundworms - whipworm or pinworm, roundworms and, hookworm, etc .;
• Flukes - liver or cat fluke;
• Tapeworms - pork, bovine or dwarf tapeworm, wide tapeworm or echinococcus.

Children are affected by worms food, contact-household, skin and transmissible, as well as placental (rarely enough) way.

Natural focal

Signs of worms

Clinical manifestations of helminthiases in human body are varied.

They can consist in intoxication symptoms, signs of exhaustion of the body, itching sensations in the anal area, etc. Sometimes helminthic invasions make themselves felt only when the body has already suffered significantly from helminthic effects.

Symptoms in adults

Usually, the signs of helminthiasis depend on the specific type of pathogen. To general symptomatic manifestations include:

1. Rapid fatigue, chronic weakness, general malaise, noticeable weight loss;
2. Increase or decrease in appetite;
3. Allergic conditions type skin rashes or hives;
4. Nauseous-vomiting reactions;
5. Diarrhea or constipation, epigastric pain, painful discomfort in the intestines;
6. IN stool ah fragments of worms or whole worms are found;
7. In a dream, a person grinds his teeth;
8. Against the background of helminthiasis, pronounced anemia often develops.

Symptoms in children

Clinical picture of helminthic invasions in patients childhood practically no different from the symptoms in adults.

• In acute helminthiases, children develop an itchy, often recurrent rash on skin similar to hives.
• In this state, children often suffer from musculo-articular pain, lymphadenitis and feverish conditions.
• Some even have pulmonary syndrome, which is characterized by a prolonged asthma-like cough, chest pain and shortness of breath.
• Ascariasis may be accompanied by eosinophilic pleurisy or hemoptysis.
• Also, patients are concerned about hyperedema (against the background of helminthic invasions with trichuriasis or trichinosis.
• Abdominal lesions such as stool disorders or flatulence, belching and nausea reactions are also characteristic of childhood helminthiases.
• The child often has an unreasonable rise in temperature, sleep is disturbed, he is worried about exhaustion and weakness, he becomes irritable and capricious, convulsive seizures may occur.

With chronic helminthic invasions, children stay in sluggish state, their appetite disappears and weight is lost, academic performance falls, anemia develops.

Against the background of helminthiases, skin pathologies can develop (such as or, etc.), respiratory diseases etc. Such children often catch colds, suffer from stomatitis or SARS, skin pustular pathologies.

Video about helminthiases in children:

Diagnostic methods

Diagnosis is appointed on the basis of complaints of the patient and anamnestic data. Appointed laboratory research feces for the presence of helminths.

The patient's blood is examined by ELISA. If necessary, a contrast intestinal radiography is performed and a scraping is taken for enterobiasis.

If necessary, studies of faeces, urine, skin biopsy specimens or blood, expectoration sputum, etc. may be necessary. Also widely used ultrasound diagnostics pancreatic or hepatic structures, colonoscopy and FGDS, radiographic studies and endoscopic, CT, etc.

How to take blood and stool tests?

by the most effective method Diagnosis of helminthiases is considered to be the analysis of feces. To carry it out, the patient needs to collect at least 2 teaspoons of feces, and you need to take the upper, side and internal ones. This should be done immediately after defecation (no later than half an hour), after which it is necessary to immediately take the biomaterial to the laboratory.

Although short-term storage of the biomaterial in the refrigerator is allowed, but not longer than 6-7 hours. Sometimes a single examination of feces cannot reveal the presence of helminthic eggs, therefore, if necessary, the analysis is repeated about 3-6 times. Results are usually ready in 1-5 business days.

A blood test is also highly informative, but it should only be done on an empty stomach. Food should not be eaten within 8 hours before the study, only plain water is allowed. Biomaterial for the detection of helminthic antibodies is collected from a vein. The results of blood tests are usually ready in 2-9 days.

Differential Diagnosis

Diagnose the pathology early dates difficult enough, because the disease has symptoms of allergic reactions, fever or pulmonary infiltrates. If the pathology is severe, then the lesions are more extensive: the lungs and heart, digestive or nervous system are affected.

That's why differential diagnosis, which allows to distinguish helminthiases from pathologies similar in clinical manifestations, it's important.

Treatment of helminthiasis

Preparations

Specialists primarily prescribe anthelmintic drugs like Pyrantel, Karbendatsim, Albendazole, Levamisole, Vormil or Mabendazole, etc.

Since helminthiases are often accompanied by allergic manifestations, patients are additionally prescribed drugs antihistamine action like Zirtek, Suprastin, Tsetrin, Erius, etc.

With severe headaches and hyperthermia, drowsiness and lethargy, joint and muscle pain, which indicates severe intoxication, detoxification measures are taken, in which vitamin C is taken, intravenous administration Hemodez or glucose solution, taking vitamins and calcium chloride.

In heavy clinical cases V therapeutic complex include glucocorticosteroid drugs like Dexamethasone or Prednisolone, Betamethasone, etc.

Spetstonik chanterelle

As part of anthelmintic therapy, drugs like Spetstonik chanterelle are successfully used. This remedy is equally effective in various types helminthic invasions.

Catherine:

My nephew has already had worms several times, although his parents strictly monitor him, control him to wash his hands. But he loves animals, so in the country at least one cat or dog, but stroke. So, after another trip to the dacha, he began to show signs of infection: lethargy appeared, his stomach ached, etc. Our grandmother read somewhere about Spetstonik fox, therefore, knowing about common problem grandson, bought it in advance. It was decided to treat with a new drug. The nephew did not like the taste very much, but the effect exceeded all expectations. Now he is periodically treated for prevention. Over the past two years, I have never suffered from worms, although earlier in the warm season I even managed to get sick twice (in early summer and autumn). Conclusion: the drug is effective.

Elena:

Folk remedies

Among folk methods therapy of helminthiases, anthelmintic and laxative agents, such as elecampane or carrots, celandine and pomegranate, have positively proven themselves, walnut or garlic, pumpkin seeds, etc.

But it is impossible to take these funds as the main treatment; a preliminary consultation with a specialist is necessary.

Complications

Complications of helminthiases depend on the type of pathogen and the degree of its prevalence in the patient's body. The most common complication of helminthic invasions is considered or appendicitis.

Basic measures for the prevention of infectious diseases

Preventive measures are aimed at eliminating factors that contribute to infection with helminthiasis.

Therefore, for prevention it is necessary:

• Strictly follow the rules of hygiene;
• Before eating meat products, be sure to boil them thoroughly;
• When using spring or well water it must first be boiled;
• Vegetables, herbs, fruits, berries - all this must be thoroughly washed and poured over with boiling water before use.

According to statistics, helminth infections often occur due to the patient himself due to his neglect of the rules of personal hygiene or inattention to food consumed, therefore, be vigilant, then helminthiases will not affect you.

The video program will tell about the effect of helminthiases on humans:

• Contact route - through dirty hands (larvae enter through the mouth) or through the skin (larvae are introduced when walking on contaminated ground barefoot)
• Alimentary way - when eating insufficiently processed meat, fish, as well as when washing vegetables and fruits with contaminated water
• Household route - in contact with dishes, personal hygiene items belonging to an infected person

Classification of helminthiasis

Helminths are divided into three classes:

• Roundworms (nematodes) - cause strongyloidiasis, ascariasis, hookworm, enterobiasis, necatoriasis, trichuriasis
• Tapeworms (cestodes) - teniasis, hymenolepiasis, teniarinhoz, diphyllobothriasis
• Flukes (trematodes) - opisthorchiasis, fascioliasis

By stages, helminthiases are divided into:

Also, helminths can be divided in relation to their owners:

Depending on the habitat, helminths are divided into:

• Luminous - live in the intestines
• Tissue - live in various tissues (muscles, adipose tissue, and others)

Symptoms of helminthiasis

The acute phase is characterized by:

• Increase in body temperature. The duration of this symptom is from several days to 2 months. It does not exceed 38ºС, accompanied by general weakness, sweating
• Pain in muscles and joints
• Signs of bronchitis and difficulty breathing
• Loeffler's syndrome. It is manifested by a choking cough, severe shortness of breath, pain in the chest and on x-ray eosinophilic volatile infiltrates are determined (determined by a radiologist)
• Quincke's edema. Manifested allergic edema tongue, oropharynx, nasopharynx and trachea, leading to difficulty breathing
• Discomfort in the abdomen
• Chunky stool
• Pain in the heart (myocarditis)
• Enlargement of the spleen and liver
• Enlarged lymph nodes
• Increase in eosinophils in the blood up to 80% (normally 0-5%)

The following symptoms are characteristic of the chronic stage:

• Asthenovegetative syndrome. Manifested by increased fatigue, headaches, drowsiness, depressed mood
• Discomfort and pain in the abdomen
• Tendency to diarrhea
• Heartache
• Jumps in blood pressure
• Decreased immunity
• Nighttime teeth grinding (bruxism)
• Increased salivation

Diagnosis of helminthiases

For the diagnosis of helminthiases, laboratory and instrumental methods research:

• General blood analysis
• Analysis of feces for helminth eggs
• Enzyme immunoassay (ELISA)
• Study of duodenal contents
• Biopsy muscle tissue and affected organs
• X-ray of organs chest and abdominal cavity
• Endoscopic examination of the gastrointestinal tract
• CT scan

Treatment of helminthiases

Mainly used as a treatment medical methods treatment. The basis is anthelmintic drugs. They affect both larvae and adults. These include drugs such as mebendazole, vormil, vermox, levomisole and many others. These funds are best combined with detoxification drugs. These are solutions of sodium chloride, glucose, sodium bicarbonate with the addition of vitamins. They are administered intravenously.

With a severe allergic reaction, suprastin or prednisolone is administered. You can take it both in the form of tablets, and receive a course of treatment with injections. The need for additional drugs will be determined by an infectious disease specialist or therapist during an individual examination.

With the development of complications, it is possible to use surgical treatment to eliminate intestinal obstruction or blockage of blood vessels.

Alternative treatment of helminthiasis

• Every day, for 1-2 months, it is necessary to take crushed raw pumpkin seeds, 2 tablespoons per day and combine them with any laxative.
• Grate horseradish and garlic in equal proportions. Pour this mixture (2 tablespoons) with 500 ml of vodka. Infuse for 1-2 weeks in a dark place with the lid closed. After straining, take 1 tablespoon 30-60 minutes before meals 3 times a day.
• Mix in equal proportions bitter wormwood, elecampane root, chamomile flowers and tansy. For three days, you need to drink this dry mixture, 5 tablespoons every 2 hours, drinking necessary quantity liquids.

Complications of helminthiases

As complications of helminthiases, the following pathological conditions may occur:

• Bowel obstruction
• blockage of blood vessels
• Appendicitis
• Peritonitis
• liver abscess
• pancreatitis
• Asphyxia (suffocation)

Prevention of helminthiases

To prevent the development of helminthiasis, it is necessary:

• Follow the rules of personal hygiene
• Avoid washing vegetables and fruits in open, untested water bodies
• Process meat and fish before eating it
• Do not walk barefoot on the ground
• Periodically take tests for helminths