Trichinosis (worm infection): causes, symptoms, diagnosis and treatment.
Heartworm disease is a disease in humans, animals and plants caused by parasitic worms (helminths).
Causes of the appearance of helminthiasis
Currently, in our country, there are more than 70 species out of 250 species of helminths known to parasitize in the human body. The most common are roundworms (roundworms, pinworms, roundworms, whipworms), tapeworms (swine, cow, tapeworm, broad tapeworm, tapeworm), tapeworm (liver fluke, cat fluke).
Helminths are characterized by stages of development: egg → larva → sexually mature form.
Helminth infections most commonly occur after ingestion of their eggs and/or larvae. Depending on the mechanism of infection and route of transmission, helminths are divided into: geohelminthiases, biohelminthiases and contact helminthiases. Earthworms develop without an intermediate host, a biological helminth - with successive changes of one, two or three hosts, the helminths are transmitted by contact.
Pork tapeworms, beef tapeworms, beef tapeworms and other worms develop with a succession of one, two or three hosts. The intermediate host can be fish, molluscs, crustaceans, insects. A person becomes infected with these helminths by eating foods that have not been heat-treated:
- beef with fins (larvae) of beef tapeworms;
- swine tapeworm affected by Finns;
- raw and lightly salted fish with larvae of opisthorchis or broad tapeworms;
- raw water or vegetables and fruits processed with this water.
Vlasoglav, roundworm, hookworm, hookworm develop without an intermediate host. The eggs and larval forms of these parasites enter the soil in feces. If the rules of personal hygiene are not observed, they will enter the body of the new owner.
By contact - i. e. when a healthy person comes into personal contact with an infected person, when sharing utensils, toilets, bed linen, when breathing dust in an infected room - intestinal worm disease (causative agent - pinworm) and transmission of night sweats (pathogen - dwarf tapeworm). In the case of intestinal infections, autoinfection usually occurs.
Certain types of helminths parasitize certain organs, causing a variety of helminths:
- in the large intestine - pork, beef, dwarf tapeworms, roundworms (hookworms, roundworms, strongyloides), pinworms, whipworms. From the intestinal lumen, pork tapeworm larvae can enter the bloodstream and travel throughout the body, settling in adipose tissue, muscle vessels, eye cavity, brain;
- in the liver and biliary tract - flukes (opisthorchis, clonorchis, small liver flukes). The cysts are mainly located in the liver, and after rupture, the cysts can be found in the mesentery, peritoneum, spleen and other organs;
- in the respiratory system - echinococci, alveoli, lung flukes cause paragonimiasis;
- in the nervous system - schistosomiasis, paragonimiasis, leukemia and pneumococcal disease;
- in the organs of vision - cancer, oncology, complex forms of teniasis;
- in the circulatory organs - necrosis, schistosomiasis, filariasis;
- in the lymphatic system - filariasis, filariasis;
- in the skin and subcutaneous tissue - hookworms, parasitic diseases, tapeworms, the larval stage of schistosomiasis;
- in the skeletal system - echinococcosis;
- in skeletal muscle - filariasis, cystic muscle disease.
The lifespan of helminths in the final host can vary, depending on the type of parasite, and ranges from a few weeks (pinworms) to several years (ices) and decades (small liver flukes). ).
Classification of diseases
Humans are parasitized by two types of worms:
- Nemathelminthes - roundworm, class Nematoda;
- Plathelminthes is a flatworm that includes the classes Cestoidea - tapeworms, Trematoda - classes of flukes.
Depending on the distribution of the parasites and their biology, there are:
- contact with worms.
Symptoms of helminthiasis
Worms have many effects on the human body:
- antigenic effect when local and general allergic reactions develop;
- toxic effect (the waste products of helminths cause dyspepsia, weakness, dyspepsia);
- traumatic effect (when the parasite is fixed to the intestinal wall, blood supply is disrupted leading to necrosis and subsequent atrophy of the mucous membrane; absorption may be disturbed; mechanical compression ofhelminthic tissues);
- inflammation secondary to bacterial invasion after the migration of helminth larvae;
- violation of metabolic processes;
- as a result of blood absorption of some helminths, anemia occurs;
- neuroreflex effect - stimulation of nerve endings by helminths causes bronchospasm, intestinal dysfunction, etc. v. ;
- psychotic effects, manifested by neurotic conditions, sleep disturbances;
- immunosuppressive action.
Helminthiases are characterized by developmental stages. Each stage is characterized by its clinical symptoms.
During the initial acute phase, most of the helminths have not yet released eggs, the body is susceptible (producing antibodies, releasing inflammatory mediators, increasing vascular permeability) and traumatizing the organs in which the larvae are affected. move over there. Clinical symptoms may be absent, but in some cases, the disease can occur with severe clinical manifestations. The acute phase lasts from 1 to 4 months, sometimes 8-10 months or more.
Complaints of patients in the acute phase:
- fever for several days to two months (fever below 38º or above 38ºС, with chills, severe weakness, and sweating);
- recurrent itchy skin rash;
- local or systemic edema;
- enlargement of regional lymph nodes;
- muscle and joint pain;
- cough, asthma attack, chest pain, prolonged catarrhal phenomenon, bronchitis, tracheobronchitis, symptoms simulating pneumonia, asthmatic syndrome, hemoptysis;
- abdominal pain, nausea, vomiting, stool disorders.
In the final stage of helminthiasis, the acute allergic phenomenon gradually subsides, the clinic of the chronic stage has not yet had time to develop.
The acute phase turns to the subacute stage, when the "young" helminths gradually mature. Then comes the chronic phase, which corresponds to the development of the parasite into sexually mature individuals. The clinical picture develops on the background of toxic effects of helminthic waste products, damaging effects of helminths on organs (tapeworms, gnathostomiasis, etc. ), mechanical effects (cysts in the liver develop, compressing adjacent organs; cysts - in the brain), secondary inflammatory processes (with strongyloidiasis, duodenitis is observed), metabolic disorders (reduction or anemia)), dysfunction of the stomach and duodenum, secondary immunodeficiency, etc. v.
Symptoms depend on the organs in which the worms live, and on their size and number.
Becauseintestinal worm diseaseThe following syndromes are characteristic:
- indigestion (abdominal discomfort, feeling of fullness after eating, early fullness, bloating, nausea);
- neurasthenia (severe fatigue, increased nervous excitability and irritability).
Enterobiasis is characterized by nocturnal perianal itching. With massive invasion, roundworms can cause intestinal obstruction, pancreatitis, obstructive jaundice.
Intestinal helminth disease(taeniarinhoz, diphyllobothriasis, hymenolepiasis, teniosis and others) asymptomatic or with some minor symptoms (with dyspepsia, pain, anemia).
Liver fluke(small fascioliasis, fascioliasis, fascioliasis) causes:
- chronic pancreatitis;
- Neurological disorders plant.
Thornhead Wormsis manifested by asthenic syndrome (asthenia, fatigue, pale skin) due to the development of iron deficiency anemia.
Heartworm disease is characterized by an allergic syndrome of varying severity and regional lymphadenitis.
Genitourinary schistosomiasismanifested by symptoms at the end of urination, blood in the urine, frequent urination, pain when urinating.
Alveococcosis, cysticercosis, echinococcosisThere may be no symptoms for a long time. In the later stages, the cyst containing the parasites is flattened or ruptured leading to anaphylaxis, peritonitis, pleurisy and other severe consequences.
For diseases caused by migratory parasitesZoomelminthswhen a person is not a natural host, distinguish between the skin form and the visceral form. The skin form is caused by the penetration of a number of animal helminths under the human skin: liver flukes (flukes), roundworms of dogs and cats, strongyloides (roundworms). When a person comes into contact with soil or water, the larvae of the worms penetrate the skin. There is a burning, tingling, or itching sensation at the site of the infection. Short-term fever may be present, signs of general malaise. After 1-2 weeks (less often 5-6 weeks), recovery occurs.
The visceral form develops from ingesting helminth eggs with water and food. At the beginning of the disease, there may be an unpleasant, allergic rash (rashes on the skin). In the human intestine, larvae emerge from helminth eggs, penetrate the intestinal wall into the bloodstream, reach internal organs, where they grow and are 5-10 cm in diameter, compressing tissues and disrupting function. of agencies. When the larvae of the tapeworm (cysticerci, cenura) are located in the membranes and substance of the brain, headache, signs of cerebral hypertension, paralysis and paralysis, epileptiform seizures are observed. Larvae may also be located in the spinal cord, eyeballs, serous membranes, connective tissue between muscles, etc. v.
The result of helminthiasis can be a complete recovery with the elimination of helminths or the development of irreversible changes in the host organism.
Diagnosis of helminths
The diagnosis of helminthiasis is established on the basis of a set of complaints, information received from the patient about the course of the disease, data from laboratory and instrumental examination methods.
In the acute phase of helminthiasis, there is a blood reaction to the presence of helminths in the body, so the following studies are recommended:
- clinical blood tests: general analysis, leukoformula, ESR (with microscopy of blood smear in the presence of pathological changes);
- blood chemistry:
- total protein, albumin, protein fractions;
- assessment of indicators of kidney function (urea, creatinine, glomerular filtration rate);
- assessment of liver function indicators (bilirubin, ALT, AST, alkaline phosphatase);
- pancreatic alpha-amylase;
- assessment of carbohydrate metabolism: glucose (in the blood), glucose tolerance test with determination of glucose in venous blood on an empty stomach and after exercise after 2 hours.
The following biological materials can be examined for the presence of helminths: feces, blood, urine, duodenal contents, bile, sputum, muscle tissue, rectal and perianal mucus.
Since helminths are not eliminated in the feces at any stage of their development, it is recommended to donate faeces three times - every 3-4 days.
- Fecal analysis for helminth eggs.
- Intestinal microbiological analysis (pinworm eggs), cotton swab.
- Microscopic stool examination to detect eggs of the causative agent of the roundworm Enterobius vermicularis (pinworm).
- Analysis for helminths (pinworm eggs), flagellates.
- The analysis is necessary in case of suspected pinworm infection, as well as during the hospital stay, registration of medical records.
- Analytics for kindergartens and schools.
The child testing program is designed to be passed before entering kindergarten or school. The results of these studies require a medical certificate according to the form 026U approved by the Ministry of Health of the Russian Federation.
Immunological studies are carried out - identification of specific antibodies to helminths:
- antibodies to Ascaris IgG;
- antibodies of class IgG to toxocar antigens;
- Anti-Opisthorchis felineus IgG (antibody of class IgG to feline fluke antigen);
- antibodies of the class IgG to trichinella antigens;
- antibodies against the causative agent of anisakiasis (nematodes of the genus Anisakis), IgG;
- antibodies to the causative agent of ascariasis, IgG;
- Antibodies to Strongyloides stercoralis, the causative agent of strongyloidiasis, IgG.
A test for the detection of IgG antibodies to the causative agent of strongyloidiasis is used for the early serological diagnosis of strongyloidiasis in cases of clinical suspicion (eosinophilia, serpentine skin lesions, pulmonary or gastrointestinal symptoms) for this disease.
In difficult cases, the following studies may be recommended:
- Simple chest radiograph;
- complex ultrasound examination of the abdominal organs (liver, gallbladder, pancreas, spleen);
- CT of the abdominal cavity and retroperitoneal space;
- CT scan of the chest and mediastinum;
- CT scan of the brain and skull.
Which doctor to contact?
If you suspect a helminthic infection, you should contact a general practitioner or general practitioner, and with a child - a pediatrician.
If surgical treatment is indicated, the patient is referred to a surgeon.
Treatment of helminths
Most patients with helminth infections do not require hospitalization. Patients with tissue helminth infections, regardless of severity, patients with severe and complicated disease are treated at the hospital.
Therapy is carried out with dewormers. The frequency and dosage of the drug depends on the age and body weight of the patient and is prescribed by the doctor.
Desensitization, detoxification, and vitamin therapy may be shown. To reduce the temperature, non-steroidal anti-inflammatory drugs are prescribed, with allergic reactions and itching - antihistamines, with severe edema - diuretics. In severe cases, hormonal medications are required.
The presence of helminths in organs and tissues may be an indication for surgical treatment.
- Bowel cancer.
- portal hypertension.
- Stomach bleeding.
- Liver abscess.
- allergic myocarditis.
- Chronic glomerulonephritis.
- Chronic kidney disease.
- hemostasis disorder.
- Loss of vision.
Prevention of worms
Preventive measures to prevent helminth infections include:
- compliance with the rules of personal hygiene (use of personal towels, toiletries and other accessories of daily use);
- use only high quality water in daily life;
- periodic vaccination, deworming for pets;
- thoroughly wash vegetables, fruits, berries before use;
- Sufficient heat treatment of meat and fish products.
The information in this section should not be used for self-diagnosis or self-treatment. In the case of pain or other exacerbations of the disease, only the attending physician should prescribe diagnostic tests. For proper diagnosis and treatment, you should contact your doctor.