Diagnosis of human ascariasis is based on. What are roundworms? Symptoms, diagnosis, treatment and prevention of ascariasis. Biochemical urine tests

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Obviously, certain signs of ascariasis depend on the stage of the disease and its severity. Read more about the manifestation of the disease at different stages of its development.

Signs of early ascariasis

Experts distinguish two main phases of helminthiasis:

• Immediately after the “host” has become infected with worms, the disease is asymptomatic and subclinical. The patient may complain of:
• fatigue;
• general weakness;
• severe headaches;
• malaise;
• sometimes the patient’s body temperature rises;

The patient's skin develops characteristic rashes resembling urticaria.

If a person is infected with helminths multiple times, even at an early stage of the pathology, he may develop a clinical picture of respiratory infections or bronchitis - the patient is bothered by a cough with a large amount of sputum, sometimes asthmatic attacks occur, and chest pain appears.

Symptoms of ascariasis in the early stages of development of the disease are most often supplemented by signs of cardiac and liver dysfunction.

Clinical picture of intestinal helminthiasis

The second stage of the disease - intestinal - is also distinguished by symptoms characteristic of ascariasis. Most often, the patient develops signs of gastrointestinal pathology or asthenic syndrome.

• For the convenience of carrying out diagnostic measures and to select the correct treatment, experts identify several symptom complexes of ascariasis characteristic of its intestinal phase:
• gastropathic symptoms;
• anemic symptoms;
• gastroenterocolitic complex;
• neurological signs;

hypotensive symptoms.

• Patients often complain of:
• loss of appetite;
• vomiting, nausea;

profuse salivation.

At this stage, the patient has a tendency to diarrhea, which alternates with constipation. Often, patients infected with roundworms show signs of progressive enteritis.

Children with ascariasis suffer from dyspeptic symptoms, which are accompanied by strong contractions (they occur independently or upon palpation).

Ascariasis often causes bloating (flatulence), and the patient has a feeling of a certain movement in the intestinal area. With this type of helminthiasis, in order to minimize clinical symptoms, the patient requires a strict diet.

With the gastroenterocolitic type of disease, symptoms may appear in the small and large intestines. inflammatory processes. The patient suffers from loose stools with characteristic mucous or bloody discharge. Adult motile roundworms are found in feces (as shown in the photo).

• weakness;
• apathy;
• absent-mindedness and impaired memory function;
• restless sleep;
• asthenic manifestations;
• epileptic seizures, hysterical states.

Sometimes patients with the neurological type of ascariasis may notice photophobia or loss of voice - with such manifestations of the disease, additional symptomatic treatment is required.

The intestinal stage of ascariasis is also accompanied by the following characteristic symptoms:

• allergic manifestations on the skin (they can be of different etiologies);
• eosinophilia;
• in children in the intestinal phase of ascariasis, signs of moderate hypochromic anemia may appear.

Also at this stage of ascariasis in patients, venous and arterial pressure, this phenomenon is caused by anemia. The patient's level of red blood cells and platelets in the blood decreases, and hemoglobin decreases.

Ascariasis obstruction is symptomatic of flatulence, stool disturbances, and the appearance of periodic spasms in the lower abdomen.

Entry of helminths into gallbladder often causes the appearance of obstructive jaundice, and if any infection is associated with the disease, the patient experiences more serious complications:

• liver abscess;
• purulent cholangitis;
• sepsis;
• peritonitis.

Signs of extraintestinal forms of the disease

Diagnostic measures

Helminthiasis also affects the course of pregnancy - women infected with roundworms more often suffer from early and late toxicosis. They may be diagnosed with a disorder of intrauterine development of the fetus, and the course of the postpartum period will be aggravated. Prevention of ascariasis in pregnant women occupies an important place in gynecological and obstetric practice.

The clinical picture of ascariasis in children and adults is atypical and is similar to the symptoms of many diseases of the gastrointestinal tract. This fact complicates the process early diagnosis illness and does not allow timely selection of appropriate treatment.

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Ascariasis, what is it: symptoms and causes, treatment

The causative agent of the disease is roundworms, which belong to the group of nematodes. Ascaris by appearance resembles a large spindle-shaped helminth, has a red or yellowish tint. The length of the female reaches up to 45 cm, and the male is no more than 25 cm.

Symptoms of the disease in adults, as well as children, depend on the phase of the disease. There are two phases of the course of the disease: the early phase (also called the migration phase), and the late or intestinal phase.

When the infection is intense, mechanical damage to the intestines, blood vessels, lungs, and liver cannot be ruled out. At this stage of the disease, curing the disease is much easier, because the human body is not severely damaged by helminths.

The early stage of the disease lasts from one month to two. As a rule, at this stage, ascariasis does not have pronounced symptoms, and the course is mostly asymptomatic.

Symptoms

Signs of ascariasis vary depending on its stage. It is worth noting that the clinical picture of the disease in adults is more pronounced than in children. But the symptoms of the disease do not appear in children for a long period of time.

The signs of the migratory stage of development of the disease are distinguished by their diversity. Although it often happens that their manifestations are not observed at all. However, in medical practice there are common signs.

Firstly, there is an acute infectious and toxic syndrome, as a result of which the temperature regime body temperature up to 40 degrees, general malaise, weakness, increased sweating, and decreased ability to work are detected. This picture may be present for the first 5-15 days after infection.

Secondly, a blistering rash appears on the feet and hands; in medicine, this manifestation is called an allergic syndrome.

The migration phase is characterized by the following symptoms:

1. The liver increases in size, pain appears in the area of ​​the right hypochondrium, and painful sensations in the abdomen. Such signs do not appear in all patients, but in approximately 50%.
2. Chest pain, coughing fits, shortness of breath.

When an adult individual is formed from a larva, the intestinal phase of the disease develops (chronic ascariasis), which is characterized by separate symptoms:

• Loss of appetite, nausea, vomiting, pain in the abdomen, dysfunction of the digestive and gastrointestinal tract.
• Sleep disturbance, deterioration of general condition, decreased ability to work. Sudden and severe headaches develop, and a nervous syndrome is observed.

Ascariasis (photo) in its clinical picture is similar to other helminthiasis, however, there are certain symptoms that characterize exclusively this pathological condition:

1. Complete loss of appetite, I don’t want any food.
2. Systematic pain in the abdominal area.
3. Grinding of teeth at night.
4. The secretion of saliva increases.
5. Adults can be visually seen in feces.
6. Constipation occurs periodically, alternating with diarrhea.
7. The skin of the body is pale, sometimes jaundice is observed.
8. Anemia (anemia); skin rash.

• Headache.
• High body temperature (antipyretic drugs do not help reduce the temperature).
• Allergic reactions with manifestations on the skin - acne, redness and flaking of the skin, small watery blisters, rash.

Isolated ascariasis is a type helminthic infestation, which is characterized by damage to only one internal organ. Due to the isolated form of the disease, the following complications may develop:

Therefore, if a person has characteristic features diseases, you need to see a doctor, take a blood test for ascariasis and undergo other diagnostic measures to verify the presence of helminthiasis and begin surgical treatment.

Diagnostics

Ascariasis, what it is and how it occurs, has been clarified. Now you need to figure out how to identify ascariasis?

Undoubtedly, the easiest way to detect the disease is to examine stool in a laboratory setting. However, this method makes it possible to diagnose the disease only at the final phase of its development.

A blood test for ascariasis has the following advantages:

• High degree of susceptibility.
• Quick results.
• Low probability of error.
• Having identified ascariasis, this type of diagnosis makes it possible to detect other types of helminthiasis.
• Through this analysis, it is possible to trace the dynamics of helminthic infestation.

The main goal of such a study is to confirm or refute specific antibodies of a certain class in human blood, such as ascariasis IgG.

How to treat the disease?

In the vast majority of cases, hospitalization is recommended when patients develop serious complications due to helminthiasis.

Has the maximum effect drug treatment, but it is prescribed only after all diagnostic measures and confirmation of helminthiasis.

Symptoms and treatment of the disease are closely interrelated, since in a number of situations those are recommended medications, the action of which is aimed at restoring a specific damaged organ and relieving severe symptoms on its part.

The menu must include the following:

• Slimy and liquid porridge.
• Dried bread made from wheat flour.
• Marmalade.
• Rice, semolina, buckwheat in the form of pureed porridge on water.
• Lean pork, beef.
• Low-fat broths.
• Tomatoes, potatoes, carrots.

During treatment of the disease, it is necessary to avoid fatty and fried foods, canned food, fatty meats, cakes and chocolate, pasta, cream, full fat milk, pearl barley.

Upon completion of treatment, it is necessary to take tests again to ensure the success of therapy. Prevention of ascariasis is recommended, which includes the following measures:

1. Strict adherence to all basic hygiene rules. And this point is quite relevant, since the disease is transmitted by fecal and oral routes. It is recommended to wash your hands more often and eat only clean vegetables and fruits.
2. Do not bite your nails or lick your fingers (applies to small children).
3. Drink only boiled water.

Upon completion of treatment, a control study of its effectiveness is carried out. As a rule, it is carried out after 10-20 days for three days in a row, then after two weeks also for three days in a row (they donate blood and feces for analysis).

Treatment of ascariasis with folk remedies

Having learned what ascariasis is, how to treat it, and what preventive measures are recommended, it is necessary to consider the advice of alternative medicine. So, how to treat ascariasis with folk remedies?

Raw pumpkin seeds are the best remedy against any type of helminths. To prepare homemade medicine, you will need to grind 500 grams of seeds in a meat grinder or grind them in any other way.

To the resulting mass add 60 ml of warm water and a little natural honey to improve the taste. This amount of “medicine” is for one time, it must be eaten within one hour. The portion is intended exclusively for an adult.

For a child, the dosage will be slightly different: up to 2 years of age no more than 50 grams, from 2 to 4 years old no more than 80 grams, from 5 to 7 years old - 100-110 grams, at the age of 10-12 years - 160 grams. An hour after taking it, drink a laxative, and after another half an hour you need to do a cleansing enema based on warm water and chamomile.

Effective herbal tea:

• Pharmaceutical chamomile (5 grams), common tansy (5 grams), sea wormwood (7 grams), bitter wormwood (8 grams).
• Mix everything, take one tablespoon and pour boiling water - 250 ml.
• Cool naturally and strain.
• Divide into two servings, take in the morning on an empty stomach, and then in the evening just before bed.
• The duration of treatment is 3 days.

How to treat opisthorchiasis in children and what are its symptoms?

• Epidemiology of the disease
• The mechanism of development of opisthorchiasis
• Symptoms of opisthorchiasis in children
• Diagnosis of opisthorchiasis in children
• Treatment of opisthorchiasis in children

Opisthorchiasis is a natural biohelminthiasis with focal distribution. For of this disease the most typical lesion is the pancreas together with the liver and bile ducts.

Epidemiology of the disease

Opisthorchiasis is characterized by focal distribution. In large outbreaks, morbidity during outbreaks affects up to 95% of the entire population, and children in the first year of life are no exception.

This biohelminthiasis is most often characterized by an acute course in a child. This is due to the widespread consumption of fish products. In areas bordering river basins, opisthorchiasis is detected in more than 25% of children under three years of age, and in adolescence in 50-60%.

The causative agent of the disease is the cat fluke (Opisthorchis felineus). The main source of invasion in natural foci are wild mammals, whose main food product is fish. Sometimes the spread of the disease is facilitated by a sick person, cat or pig. With the feces of animals and humans that have been exposed to infestation, the eggs end up in rivers and lakes. In water they remain viable for 5-6 months.

The mechanism of development of opisthorchiasis

Opisthorchiasis is characterized by a heterogeneous clinical picture. The disease occurs in two phases: acute and chronic. It is characterized by the following forms:

• Erased.
• Easy.
• Medium-heavy.
• Heavy.

Also, the course of a severe form of opisthorchiasis can have typhus-like, gastroenterocolic and hepatocholangic variants.

For the structural phase of opisthorchiasis in childhood Allergic manifestations are typical. Acute opisthorchiasis rarely develops in indigenous residents of areas with a high probability of infection, since in them it is of a primary chronic nature. This is due to the developed immunity and the intensity of the invasion. Children suffer from acute opisthorchiasis if they arrive in endemic areas.

Clinical symptoms of the acute phase are presented:

• An increase in body temperature to 38 -39 °C.
• An increase in the content of eosinophils in general analysis blood.
• An increase in the number of leukocytes.
• Hepatomegaly (enlargement of the liver).
• Development of painful sensations in the epigastric abdomen and right hypochondrium.
• Myalgia (painful sensations in the muscles).
• Arthralgia (joint pain).
• Skin reaction in the form of irritation and redness.
• Malaise and increased fatigue.

Chronic opisthorchiasis is characterized by the development of symptoms characteristic of diseases such as recurrent cholecystitis (inflammation of the gallbladder) with decreased tone of the gallbladder, gastroduodenitis (combined inflammation of the stomach and duodenum) and pancreatitis (inflammation of the pancreas). The clinic of chronic opisthorchiasis can manifest itself in adolescence and older childhood.

Characteristic symptoms of chronic opisthorchiasis:

• Painful sensations in the epigastrium and right hypochondrium.
• Dyspeptic symptoms (nausea, vomiting, change in stool consistency, alternating diarrhea with constipation).
• Intolerance to spicy and fatty foods.
• Sensation of bitterness in the mouth.

Features of the flow different forms opisthorchiasis in a child:

Features of the course of the typhus-like variant of the severe form of the disease:

• Acute onset.
• Increased body temperature.
• Conjunctivitis (inflammation of the mucous membrane of the eyes).
• Damage to the respiratory tract with the manifestation of bronchial obstruction.
• Manifestations of gastroenterocolitis develop (joint inflammation of the stomach, large and small intestines), accompanied by pain.
• Urinary disorder.
• Polymorphic rash.

Changes in the general blood test are presented:

• Severe eosinophilia (increased number of eosinophils to 80-90%).
• Leukocytosis.

When performing a biochemical blood test, the following changes are observed:

• Increased levels of C-reactive protein.
• Increased fibrinogen content.
• Slight increase in bilirubin levels.

The acute period of the disease lasts from 2 to 3 weeks, then over the course of 10-14 days the clinical symptoms gradually subside, which indicates the onset of a latent period. The latent period can last from several months to several years.

Clinical manifestations of the hepatocholangitis variant:

• Hepatitis with severe hepatomegaly (enlargement of the liver).
• General intoxication.
• Hemorrhagic phenomena (development of bleeding).

Changes in the general blood test with the hepatocholangic variant are presented:

• Severe eosinophilia.
• An increase in ESR (erythrocyte sedimentation rate) - up to 30-60 mm/h.

Blood chemistry:

• Moderate increase in the level of cytolytic enzymes (ALT, AST).
• A sharp increase in cholestasis markers (alkaline phosphatase, gamma-glutamyltransferase - GGT).
• Bilirubinemia due to direct bilirubin.

In children aged 1 to 3 years in an endemic focus, the following is noted:

• Decreased appetite.
• Children are lagging behind in physical development.
• Biliary tract dysfunction (BDT) with increased tone.
• Enlarged liver.
• Increased number of eosinophils.
• Decrease in the amount of hemoglobin.

Clinical manifestations of the disease increase rapidly from the age of four. Symptoms are most pronounced between the ages of 8 and 12 years. At older ages, symptoms do not progress. This is due to the increase in immune defense factors.

An important role is played by differential diagnosis of signs of worms in a child from opisthorchiasis. Deworming should not be used as empirical therapy for a child.

Diagnosis of opisthorchiasis in children

Description of studies of opisthorchiasis in a child:

• Study of epidemiological history data (stay in an area of ​​endemic spread of the disease, consumption of fish of the carp family that has not undergone sufficient heat treatment).
• Ultrasound diagnostics of the abdominal organs (US), computed tomography (CT) and magnetic resonance imaging (MRI) can identify changes such as dyskinesia of the gallbladder and biliary tract, decreased excretory capacity of the liver, and dilation of the bile ducts. These changes are observed in the acute stage of the disease.
• Serological diagnostics (ELISA, RNGA) indicates an increase in the titer of specific antibodies to feline fluke antigens.
• Functional gastroduodenoscopy (FGDS) with analysis of duodenal contents allows identifying helminth eggs.
• A stool test for opisthorchiasis is positive.

Treatment of opisthorchiasis in children

• Under the age of 3 years with acute and chronic phases of the disease.
• For all children with manifestations of acute opisthorchiasis.
• For children over 3 years of age with severe complications combined with chronic opisthorchiasis.

Treatment of opisthorchiasis includes taking medications such as:

• Praziquantel.
• Choleretic drugs (during the first 2-3 days of treatment).
• Antihistamines (in case of severe allergic reactions).

Opisthorchiasis is dangerous disease, which most often occurs in acute form in childhood. Opisthorchiasis in adults is characterized by a more favorable course. Due to the lack of developed immunity in children who do not live in endemic areas, only fish that has undergone high-quality heat treatment should be consumed.

Many people now have no idea what ascariasis is. This disease is very dangerous, as it affects both adults and small children at the same time. Ascariasis is a common nematode helminthic disease that is caused by the human roundworm. Its larvae can freely migrate throughout the body, affecting organs and systems. Their development occurs in the intestines.

Ascariasis is a very common disease (an average of 60 to 85 cases per 100 thousand inhabitants). Most often it affects young children - about 65% in general structure. Ascariasis appears very easily in children. Infection can occur through sand or soil while playing in the sandbox, as children often put unwashed hands in their mouths. Adults are also infected with roundworms – about 35% of the total population.

Etiology

It is also worth noting that a sick person, in some way, does not pose a danger to others, since the eggs that he will excrete along with feces must still be fully matured in the soil. Their ripening period is from 10 to 40 days.

A person becomes infected with ascariasis the moment he ingests mature ascaris eggs. They are localized in small intestine where the larvae emerge from the eggs. They easily pass through the intestinal lining and penetrate into the blood vessels. With the blood flow, the larvae move throughout the body - first to the liver, then to the right atrium and to the lungs. In the lungs, the larvae invade the alveoli and ascend to the pharynx along the tracheobronchial tree. The person swallows them again, and they enter the small intestine. It is in it that the larvae grow and become adult worms. This phase in medicine is called migration. Its duration ranges from 10 to 12 days. Roundworms fully mature in the body in 8 weeks. The lifespan of the worm is 12–18 months.

Phases of the disease

Symptoms of ascariasis in adults and children largely depend on the phase in which this moment there is an illness. They are also used in medicine for more accurate diagnosis and choice of treatment methods. There are two phases:

From the moment immature eggs enter the human body until the first signs appear, most often it takes from one to two months. Symptoms vary depending on the phase of the disease. Signs of the disease in adults are often more intense than in children. Symptoms of ascariasis in children, as a rule, may not appear for a long period of time.

The symptoms of the migration phase are very diverse. Ascariasis in children in this phase sometimes occurs without clinical manifestations, but in severe forms of the disease the following signs are noted:

As soon as the process of transformation of the larva into an adult is completed, the intestinal phase (or chronic ascariasis) will begin, which is characterized by its own symptoms:

• loss of appetite, vomiting and nausea, mainly in the morning, abdominal pain (in the navel area), upset stool. In medicine, this condition is called gastrointestinal syndrome;
• general health worsens, sleep is disturbed, performance decreases, and severe headaches occur. This is a nervous syndrome. Children often experience epileptiform seizures in this phase, as well as manifestations of meningism.

The symptoms of the disease are very similar to other known helminthic infestations, but there are some signs that are characteristic exclusively of this pathology:

• no desire to eat any food;
• frequent attacks of abdominal pain;
• grinding teeth in sleep;
• increased salivation;
• roundworms may appear in feces;
• constipation alternates with loose stools;
• the skin is pale, sometimes with a yellow tint.

Diagnostics

The main analysis that helps confirm the presence of roundworms is a coprogram. In the initial stage of ascariasis, larvae can be detected in sputum or using x-ray examination (they will be visible in the image as infiltrates).

Diagnosis of ascariasis is also carried out using serological research methods:

• latex agglutination;
• indirect hemagglutination;
• acceleration of erythrocyte sedimentation.

Treatment

Not many people know how to treat ascariasis in order to avoid the development of complications and completely cleanse the body of worms. This disease can be treated both at home and in a hospital. Most often, people who have developed complications due to pathology need hospitalization.

Diet therapy is an important component of successful treatment of ascariasis. You need to eat 5 times a day. There should not be long intervals between meals.

You should include the following foods in your diet:

• mucous decoctions from cereals;
• wheat bread (dried only);
• marmalade;
• pureed porridge from buckwheat, semolina and rice;
• lean meats;
• low-fat broths;
• rosehip decoction;
• potatoes, ripe tomatoes, carrots and beets;
• soft berries and fruits.

The following products are excluded:

• fatty cabbage soup or soups;
• canned food;
• fatty meats;
• chocolate;
• cakes;
• cocoa;
• milk and cream;
• pearl barley, barley;
• pasta.

Folk recipes

Treatment of ascariasis with folk remedies can be carried out, but it is not recommended to use only such therapy. It is imperative that you visit a qualified specialist.

Among folk remedies the most effective are the following:

• milk and garlic. Boil one head of garlic in milk. The finished broth should be cooled and strained. This remedy is excellent for treating children. Enemas are made from milk-garlic broth. They are placed only at night;
• pumpkin seeds. They take a certain amount pumpkin seeds and grind them in a mortar. Then boiled water is added to them. The mixture can be sweetened a little with honey or jam. Take a teaspoon of pumpkin mixture on an empty stomach.

Ascariasis in children and adults is a helminthic disease, accompanied by the migration of pathogenic larvae throughout the body and their subsequent “maturation” in the intestines.

The life cycle of roundworms consists of several stages. As soon as a person swallows a number of eggs, they move to the intestines, where larvae appear. These organisms “travel” through circulatory system a person, feeding on red blood cells and the patient’s plasma itself.

Together with the next portion of blood, they enter the lungs, and then return through the pharynx and bronchi back to the intestines (due to the release of sputum). At this stage, the larvae develop into adults. During the entire cycle, manifestations of roundworms can be noted in other organs: liver, veins, heart.

The main factor in the transmission of ascariasis is contaminated soil. Nematode eggs fall onto open ground along with the feces of infected people. The shell allows the larvae to remain viable for a long period. Practice shows that most often the disease affects children preschool age. They come into contact with soil and sand during walks in the park, on the playground in the courtyard of the house, and then “taste” their fingers and contaminated objects.

Symptoms of roundworms depend on the stage of the lesion and the location of the worms. At the stage of movement of the larvae, the patient’s lungs suffer the most, which can develop into the so-called eosinophilic pneumonia(Leffler's syndrome). The early type of invasion has the following signs:

1. Dry and sharp cough, which is accompanied by chest pain.
2. Discomfort and burning sensation in the sternum.
3. Allergic rashes, the manifestations of which are similar to urticaria.
4. Discharge of a small amount of blood-streaked sputum.
5. Inflammation of the liver tissue, a slight increase in the size of the organ.
6. A slight increase in the patient's body temperature.
7. Roundworms in the heart cause disruptions in the functioning of the cardiovascular system and inflammation of the heart muscle.

Characteristic symptoms are usually observed around 7-10 days. The exception is cough due to ascariasis, which can bother an infected person for up to six months. The severity of intoxication depends on how many larvae enter the lungs.

The settling of roundworms in the intestines (intestinal stage) is expressed in the form of the following symptoms:

• Discomfort and pain in the abdomen;
• Sharp loss of body weight or insufficient weight gain in case of helminthic infestation in a child;
• Frequent diarrhea (or constipation), nausea leading to vomiting;
• Lack of appetite or, conversely, severe hunger.

All patients, without exception, complain of general weakness, decreased vitality, fatigue and poor sleep.

Diagnostics

Modern medicine offers patients the following types of studies to detect roundworms in the human body:

Treatment of ascariasis in adults is carried out at home or in a day hospital. Hospitalization is only required in particularly severe cases when there are surgical complications of ascariasis.

As mentioned earlier, classification life cycle Ascaris divides it into a migratory and intestinal phase. During migrations of nematodes, adult patients and children are prescribed drugs (usually tablets) for a wide range of worms. These are the following medications: Decaris (Levamisole), Mintezol, Vermox, Arbotect, Vormin, etc. If obstructive changes have occurred in the bronchi or lungs, the doctor will prescribe corticosteroids and bronchodilators. Diet for ascariasis can improve general state patient, regulate the functioning of the digestive tract.

As soon as helminths are localized in the intestinal area, therapy is recommended with the following drugs: Decaris (single dose), Pirantel, Nemotsid, Helmintox, Thermox.

After taking one of the above medications, it is recommended to undergo a course of cleansing the body of toxins. For this purpose, energy sorbents are prescribed: white or Activated carbon, Policy

Ascariasis can be effectively treated with regular oxygen. During the procedure, gas is supplied through a special tube into the patient's stomach before the morning meal. The course of treatment is 2-3 procedures.

Nutrition for ascariasis should be determined by a diet based on treatment table No. 5. It is recommended to limit the consumption of fatty and spicy foods and alcohol.

Possible complications

The most common complication of ascariasis in medical practice is intestinal obstruction. This acute pathology occurs due to blockage of the intestinal lumen by a ball of roundworms. And feces cannot break through this barrier. Proper nutrition supports the natural process of defecation, but only up to a certain time.

Clogging of the pancreas with roundworms leads to its acute or chronic inflammation - pancreatitis.

In rare (even exceptional) cases, nematodes reach the oral cavity, fill the respiratory tract and cause suffocation in the patient.

Prevention of ascariasis in children and adults

Preventing roundworm infection comes down to taking the following measures:

• Thorough processing using running water of all fruits, vegetables, berries;
• Maintain hand hygiene and use antibacterial agents;
• Monitoring children while playing in open areas. It is very important to place sandboxes and playgrounds in sunny parts of the city, since roundworm eggs die under the influence of direct rays of the sun;
• Avoid drinking raw water.

B77 Ascariasis

Epidemiology of ascariasis

Ascariasis refers to geohelminthiases. Source of infection environment- only a person with ascariasis. It becomes infected by ingesting invasive eggs. Transmission factors include contaminated vegetables, berries, other foods, water, and hands. In the temperate climate zone, the infection season lasts up to 7 months - from April to October, in warm conditions humid climate- all year round.

A female roundworm lays up to 240,000 eggs per day. The maximum number of eggs is released at 5-6 months of the female’s life. By the 7th month, ovulation ends and the female stops releasing eggs.

In order for eggs to become invasive, the following conditions are necessary: ​​the presence of oxygen, humidity not lower than 8%, temperature 12-37 ° C and a certain time. Under optimal conditions (temperature 24-30 °C and humidity 90-100%), an invasive larva is formed in the egg after the first molt, capable of infecting humans. Egg development takes longer in temperate and cool climate than in warm. Under favorable conditions, eggs can remain viable for up to 10 years.

In temperate climates, egg development in the soil begins in April-May. In winter, egg development does not occur. In May-July, infective larvae will form in the egg. Human infection with invasive roundworm eggs can occur throughout the year, since they are resistant to external influences and remain viable for a long time. Largest number Infective eggs accumulate in the soil in the summer-autumn period, when mass infection of the population with ascariasis occurs. The longest infection season is observed in the south, and the shortest in the northern regions. The highest degree of infestation of the population by adult roundworms occurs in winter, and the lowest in early summer.

Transmission factors for ascariasis are soil contaminated with ascaris eggs, vegetables, berries, fruits, water. Wastewater from sewers or fecal matter from nearby restrooms. Mechanical carriers of eggs can be flies and cockroaches.

Human infection occurs through direct contact with soil containing infective eggs. If personal hygiene rules are not followed, eggs from the soil with unwashed hands end up in a person’s mouth. Infection can occur through various household items and food products contaminated with roundworm eggs. Eggs can enter living areas with dust and be carried on the soles of shoes.

Foci of ascariasis vary in intensity of transmission of invasion, depending on the degree of contamination of the external environment with invasive ascaris eggs, sanitary conditions, hygiene skills of the population and climatic factors. Foci of ascariasis usually form in rural areas or in those areas of cities where there are sources of infection, insufficient sanitary facilities, and there are peculiarities of life and economic activity, facilitating the penetration of invasive eggs from the external environment to humans. In cities, people most often get sick with ascariasis after returning from rural areas, from garden plots and dachas, where undisinfected human feces are sometimes used as fertilizers, as well as when eating unwashed vegetables and fruits, berries brought from ascariasis foci, and in case of non-compliance with rules of personal hygiene.

Susceptibility to ascariasis is high. In highly epidemic areas, up to 90% of children have ascariasis. This is explained by the fact that ascariasis does not leave pronounced immunity.

Ascariasis is the most common helminthiasis in the world. According to WHO, more than 1.2 billion people are infected with ascariasis worldwide. Of these, approximately 100 thousand people die annually from this invasion. Ascariasis is common in 153 of 218 countries in the world, located in temperate, subtropical and tropical climates.

More than 50% of the population surveyed is infected with ascariasis in Nigeria, Congo, Brazil, Ecuador, Iraq, Malaysia, Afghanistan, and Indonesia. In areas of deserts, semi-deserts and permafrost ascariasis is very rare.

Causes of ascariasis

Ascariasis is caused by Ascaris lumbricoides, which belongs to the phylum Nematheiminthes, class Nematoda, order Rhabditida, family Oxyuridae. In the development cycle of A. lumbricoides, the following stages are distinguished: sexually mature form, egg, invasive egg, larva.

Due to significant morphological and metabolic changes at different stages of development in roundworm, as in other types of helminths, exogenous and endogenous antigens and their immunogenic properties change significantly.

The development cycle of ascariasis

A person becomes infected with ascariasis by ingesting eggs containing larvae that have reached the invasive stage. In the small intestine of humans, the larvae are released from the egg membranes, penetrate through the intestinal wall into blood vessels and migrate through the bloodstream and tissues of the host. With the blood flow they enter the portal vein, liver vessels, inferior vena cava, right atrium and through the pulmonary artery into the capillaries of the alveoli of the lungs.

Through the walls of the capillaries, the larvae penetrate into the cavity of the alveoli, then bronchioles and migrate along the airways. From the trachea, when coughing up sputum, the larvae enter the pharynx, are swallowed a second time and again end up in the small intestine. During migration, the larvae molt twice and increase in size from 0.19-0.25 mm to 1.5-2.2 mm. The migration of roundworm larvae lasts about two weeks. The larvae grow in the intestines, molt again and become sexually mature after 2-2.5 months. The lifespan of adult roundworms is about 1 year.

Next, the larvae migrate through the portal vein system to the liver, then to the lungs, where their development continues for 1-2 weeks. In the liver on the 5-6th day after infection and in the lungs (on the 10th day) the larvae molt. In the lungs, breaking the capillary network and the walls of the alveoli, they penetrate the lumen of the bronchi and move along the airways into the oropharynx. With ingested saliva and food, the larvae re-enter the small intestine, where they transform into sexually mature males and females, having previously completed two more molts. The duration of migration of larvae is about 2 weeks, and the maturation of females before laying eggs lasts more than 10 weeks. An adult lives in the human body for 11-13 months.

Symptoms of ascariasis

There are two clinical stages of the disease - early (migratory) and late (intestinal). There are often no symptoms of ascariasis in the early stages. In the clinically pronounced form, on the 2-3rd day after infection, symptoms of ascariasis such as malaise, weakness, and low-grade fever appear. Urticarial rashes on the skin are observed, and an enlargement of the spleen and liver is possible. More typical is a symptom complex of lung damage with the formation of transient infiltrates, determined by x-ray, and eosinophilia in the peripheral blood (Loeffler's syndrome). In these cases, a dry cough appears, sometimes with sputum streaked with blood, shortness of breath, chest pain, and suffocation. Dry and moist rales are heard in the lungs.

IN intestinal stage ascariasis in adults often occurs with mild symptoms or asymptomatic. The observed symptoms of ascariasis (decreased appetite, nausea, sometimes vomiting, cramping abdominal pain, diarrhea or unstable stool) are not very specific. The health of patients deteriorates, performance decreases, and headache, dizziness.

Children in the early stages of ascariasis may develop pneumonia, and with intense infestation - severe intoxication. Body weight decreases, children become capricious, absent-minded, epileptiform seizures, meningism, Meniere's syndrome are possible; in the blood test - normo- and hypochromic anemia, eosinophilia.

Complications of ascariasis

There are intestinal and extraintestinal complications of ascariasis, which occur in the late stage of invasion and are often caused by increased mobility of adult helminths. The most common complication, especially in children aged 4 to 8 years, is intestinal obstruction. With destructive changes in the intestinal mucosa or after surgical interventions, roundworms may penetrate the abdominal cavity and develop peritonitis. The introduction of helminths into the biliary and pancreatic ducts can lead to mechanical jaundice, reactive pancreatitis; in the case of a secondary bacterial infection, purulent cholangitis, liver abscesses, and sometimes appendicitis develop. With vomiting and antiperistaltic movements, roundworms can enter the esophagus, from where they penetrate the pharynx and respiratory tract, causing asphyxia.

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The digestive system begins with the mouth opening, surrounded by 3 lips (ridges). Semi-digested food by the host first enters the short pharynx, then into the midgut, where it is finally digested and absorbed. The midgut passes into the hindgut, ending in the anus.

The male reproductive system is represented by one testis, which passes into the vas deferens, which flows into the hindgut. Females have 2 ovaries. Oviducts depart from them, passing into the uterus, which merge into an unpaired vagina, opening with a hole in the ventral side of the body. Fertilization is internal. Roundworms reproduce only sexually. These are dioecious organisms. The reproductive organs look like convoluted tubes. In a fertilized female, at the border of the anterior and middle third of the body there is an annular depression - the constriction of Mozgova A. A., Ascaridates of animals and humans and the diseases caused by them, book. 1, M., 1953. .

The female lays up to 240,000 eggs in the human intestine every day, which are excreted in the feces. external environment. The eggs are covered with 5 shells, so they are very resistant to adverse conditions; they can only be killed by substances that dissolve fat: alcohol, ether, gasoline or hot water, direct sunlight. The development of roundworm occurs without a host; the eggs reach maturity in the soil after leaving the human intestine. Moist soil, direct access to oxygen and a temperature of 25-27 ° C contribute to the formation of larvae in the egg on the 16-17th day. At lower or more high temperature ripening times change.

The morphological structure of roundworm eggs is shown in the table.

Drawing - Human roundworm

2. Laboratory diagnosis of ascariasis

Diagnosis of ascariasis in the migratory stage is based on the recognition of eosinophilic infiltrates, taking into account clinical, radiological, hematological and immunological data. The X-ray picture of these infiltrates can simulate tuberculosis, pneumonia, or lung tumor. The main difference between infiltrates in ascariasis is their rapid disappearance without any residual effects. Similar infiltrates can be found in other helminthiasis - hookworm and strongyloidiasis.

Laboratory diagnosis of ascariasis is carried out by identifying helminth eggs in feces. Laboratory diagnosis is based on the detection of roundworm eggs in feces using the Kato method or enrichment according to Kalantaryan, Fulleborn, etc. or adult roundworms after diagnostic deworming. Larval ascariasis can be diagnosed using immunological methods (RP, RNGA, RSK, RLA, bentonite-flocculation reaction).

Moving along the bronchi to the pharynx, roundworms with sputum enter the mouth, and from there into the esophagus, stomach and intestines. In the intestines, roundworms are retained by pushing against the intestinal walls, causing inflammation, infiltration and hemorrhage. Complications are possible if roundworms enter the nasal sinuses, liver, bile ducts, pancreas and kidneys. Intestinal obstruction and suppurative processes in the abdominal cavity occur. The diagnosis is based on stool tests (at least 3 times), immunological tests - in the larval period.

The eggs mature in the soil after leaving the human intestine. In wet soil with access to oxygen and a temperature of 25-27 degrees, a larva forms in the egg on days 16-17. Infection occurs if such eggs are ingested with unwashed vegetables, fruits, or water, as well as if eggs are transferred by flies to food. Microscopic larvae emerge from the swallowed eggs in the intestine, which then migrate through the intestinal walls into the blood vessels, liver, inferior vena cava, right atrium and ventricle of the heart, and then into the lungs. When coughing up, larvae from the lungs with a current of mucus through the respiratory tract enter the pharynx and are swallowed a second time, stopping at small intestine where they reach sexual maturity.

Ascaris injure the human intestinal mucosa and poison the body with toxic substances (metabolic products). Cause pain in the stomach and intestines, indigestion, decreased appetite, decreased performance and other phenomena. To protect against roundworm infection, you must follow the rules of personal hygiene - carefully wash your hands before eating, do not eat poorly washed vegetables and fruits, and protect food from flies, cockroaches and other insects. Patients with ascariasis should consult a doctor and, on the doctor’s recommendation, use medications (santonin, hexylresorcinol) or oxygen therapy to remove ascaris from the intestines.

presentation, added 04/26/2016

The concept and background of ascariasis as an anthroponotic geohelminthiasis, characterized by damage to the respiratory tract and allergic reactions, chronic damage to the gastrointestinal tract and complications. Description of the pathogen and route of infection.

presentation, added 07/09/2016

Examination of stool to detect helminths, their fragments, larvae or eggs. Thick smear with cellophane (Kato method). Enrichment and tape techniques, muscle biopsy. Diagnosis of tissue helminthiasis. Distinctive features of helminth eggs.

abstract, added 09/08/2009

Study of the etiology, pathogenesis, symptoms, methods of diagnosis and treatment of ascariasis - helminthiasis from the group of intestinal nematodes, caused by roundworms, manifested by allergies, dyspeptic symptoms when helminths penetrate other organs.

presentation, added 03/24/2019

course work, added 04/09/2014

presentation, added 02/02/2017

Dependence of susceptibility to infectious diseases from many factors: age, previous and concomitant diseases, nutrition, vaccination. Main types of helminthic worms. Characteristics of hookworm disease, ascariasis, hymenolepiasis.

presentation, added 03/09/2016

Criteria for the pathological process, degree and pathogenesis of eosinophilia. Level of eosinophilia, symptoms, clinical manifestations, diagnosis and surgical complications of helminthiases: ascariasis, toxocariasis, trichinosis, schistosomiasis, echinococcosis, giardiasis.

abstract, added 04/10/2009

abstract, added 09.29.2012

general characteristics, epidemiology and etiology of ascariasis in children. Clinical and pathogenetic characteristics and principles of diagnosis of this disease, approaches to treatment. Implementation of therapeutic and diagnostic interventions for ascariasis in children.