Recognize Ascaris. Ascaris: symptoms and treatment in adults and children

Adult roundworms are rather large roundworms, the length of which in males reaches 15-25 cm, in females 20-40 cm. Ascaris is human, white-pink in color, spindle-shaped. The eggs of these helminths can be in the soil, water, plant products. Ascariasis is transmitted from person to person by the fecal-oral route, but not directly, but through the soil in which the helminth eggs are located, as well as through water, food containing ripe ascaris eggs. Children are most susceptible to infection, in adults ascariasis is recorded less frequently.

This helminthic disease is common in all climatic zones, except for deserts, highlands and permafrost zones.

According to the World Health Organization, about one billion people in the world are carriers of ascariasis.

However, this type of helminthiasis is most widespread in the tropical and subtropical zone, here up to 80% of the population is affected by roundworms, symptoms, treatment for this disease can be very diverse, depending on the stage of migration and further localization of the colony of worms.

How roundworms enter the body - causes, ways of infection

The host and source of infection of this helminthic invasion is a person. With the faeces of a sick person, roundworm eggs enter the soil, where they can exist for several years, maturing in it to dangerous larvae, but at the same time they are not viable in the external environment. In the soil, when favorable conditions arise - humidity, heat + 24 ° C, oxygen saturation - the eggs ripen and become ready for life in the human body. First of all, upon contact with the soil, as well as water or the use of unwashed berries and vegetables, the hands are seeded with eggs of these helminths and a person, not observing the rules of personal hygiene, can become a victim of infection with ascariasis.

Therefore, most cases of ascariasis are registered among young children who are not yet accustomed to strict adherence to hygiene rules, as well as residents of rural areas with unfavorable living conditions. The risk of infection is especially high in the summer and autumn seasons, when children and adults have the greatest contact with grass, soil, in the children's sandbox, on playgrounds, using unboiled water or unwashed products - greens, berries, vegetables.

After entering the intestines of full-fledged mature eggs, larvae are formed from them, which through the mucous membrane penetrate into the portal vein, from where they can further move to almost any organ - the right ventricle of the heart, liver, bronchi, lungs, gallbladder. After the migrating larva enters the lungs, along with sputum during coughing, they again find themselves in the small intestine, where they grow to an adult sexually mature roundworm.

The main rules that should be observed in order not to become infected with roundworms:

• When working with soil, rubber gloves should be used.
• Thoroughly wash vegetables, herbs, berries
• With frequent contact with the ground, have short-cut nails
• Wash your hands thoroughly after the street, before any meal, even before a light snack
• To teach children from an early age not to take anything in their mouths, except for food, and with clean hands

• First migration phase

During this phase in the roundworm development cycle, symptoms in adults may be mild and most often resolve without complications. In varying degrees of severity, there may be general malaise, subfebrile body temperature, usually does not rise above 38 ° C, a dry cough with mucopurulent or mucous sputum appears, the color of the bronchial secretion may be orange with streaks of blood.

Sometimes wet or dry rales or shortening of the percussion sound are heard, and there may also be dry or effusion pleurisy. X-ray of the lungs reveals "flying" infiltrates - rounded, round, star-shaped, polygonal, scalloped. They can be numerous, and single, and in one, and in both lungs.

If there was not an intense, slight infection of roundworm in children, they can proceed asymptomatically, in an erased form. Less often, with a massive intake of eggs in the body, in children, even the migration phase can be accompanied by significant intoxication symptoms, while lymph nodes may increase, fever up to 38 ° C, headache, enlargement of the liver, spleen.

A very distinctive feature of ascariasis in this phase of migration of larvae is the appearance of skin allergic reactions, especially often occurs, as well as allergic dermatoses.

This phase is called intestinal, and after a secondary entry into the small intestine, roundworms lead to symptoms of dyspepsia, when it changes, it is observed that even cholera-like, dysentery symptoms, or signs of typhoid fever appear, however, in such cases, against the background of a decrease in immunity, a combination infectious diseases with ascaris.

In the late phase of ascariasis, children often complain of abdominal pain, nausea, less often vomiting, lack of appetite, lose weight dramatically, get tired very quickly, look exhausted and sick. Pain in the abdomen is localized either on the right in the iliac region, or near the navel, of a cramping nature, redness and may appear.

On the part of the nervous system, astheno-neurotic syndrome is often pronounced - hysterical seizures, nightmares, disturbing dreams, throwing in a dream, groans, screams, insomnia, meningism, epileptiform convulsions. Frequent symptoms of ascaris are extremely rapid mental fatigue, dizziness, headache.

Very rarely, but there are cases of changes in the eyes - photophobia, enlarged pupils, amblyopia, anisocoria. Many patients experience a drop in blood pressure. Sometimes the presence of ascaris leads in children to the development of bronchial asthma or frequent bronchitis, in blood tests due to exhaustion, a decrease in the absorption of trace elements, vitamins, anemia is observed, and eosinophils return to normal.

With the development of ascaris in children, the symptoms listed above are often complicated by recurrent stomatitis (see), purulent diseases of the mucous membranes, and skin. Ascaris invasion leads to a significant decrease in immunity, so children can be seriously ill for a long time with various infectious diseases.

Complications that can cause ascaris invasions are associated with their motor activity through the intestinal wall, during migration, they mechanically injure it. With massive infection, this can lead to a through hole in the intestine - perforation, and getting into the caecum, it can lead to the development or

In severe cases of severe invasion, when ascaris crawls into the bile ducts, it is possible to develop biliary colic, purulent), the development of obstructive jaundice, granulomatous hepatitis with hepatosplenomegaly, liver abscess, peritonitis and the development of intestinal obstruction.

The medical literature describes clinical cases when massive invasions led to the fact that worms crawled into the pharynx, paranasal sinuses, into the respiratory tract, leading to suffocation, and also found roundworms in the pulmonary artery and right ventricle of the heart and even the human brain.

How to identify roundworms - diagnostic options

Complete blood count - leukocytosis and eosinophilia, x-ray of the lungs - infiltrates, sputum smear microscopy - detection of larvae. At the late intestinal stage (about 3 months after infection), when the larvae have already become sexually mature worms - anemia, not significant leukocytosis, possibly slight eosinophilia, fecal analysis - red blood cells, undigested food residues, helminth eggs, or roundworms themselves.

In rare cases, already adults are found in the intestinal lumen with an x-ray of the intestine with a contrast agent or with an x-ray of the lungs, as well as during an endoscopic examination of the FGS. Radiography can help in diagnosing the migratory phase of ascaris, when several pictures are taken with a short interval of several days, a comparison of radiographs can make it possible to follow the "movement" of infiltrates. If such a phenomenon is combined with blood eosinophilia, this is an essential argument in favor of the diagnosis of ascariasis.

How to remove roundworms in children and adults

When establishing the diagnosis of roundworm, the treatment is prescribed by the doctor, taking into account the weight of the child or adult. as well as the severity of the invasion. To date, anthelmintic drugs have a high activity and the effectiveness of the treatment of ascaris in children and adults is 80-100%.

If helminths are found already in the intestinal stage, roundworms are treated with such drugs:

• Decaris - once, in a dose according to the weight and age of the patient

Pyrantel pamoat - Kombantrin, Helmintox (80-120 rubles), Nemocide, Pirantel (30-50 rubles) also once

• Piperazine - has a less pronounced effect 10-30 rubles.
• Mebendazole - Vermox, Vero-Mebendazole, Wormin, Thermox, Vermacar, Mebex

After taking the drugs, enterosorbents, such as Polyphepan, activated charcoal, can be prescribed after a few days. After the treatment of ascaris, a control examination of an adult or a child is necessarily indicated in a month. Details about all that can be used for children under 2 or older than 3 years in our article.

Consequences, complications of ascaris in children

Since roundworm larvae during migration can cause mechanical damage, this is dangerous, especially for a fragile child's body. Both blood vessels and various organs can be damaged, accompanied by minor or severe hemorrhages, leading to ulceration, necrosis, perforation of the lungs, liver, and intestines.

Moreover, with the growth of larvae and adults, they deplete the body, sucking out nutrients, and their metabolic products have a powerful allergic and toxic effect on the body.

If the treatment of roundworm in children is not carried out in time, such a helminthic invasion leads to a general sensitization of the body, pronounced local allergic reactions (urticaria) or general ones (asthmatic suffocation,) develop. Roundworms in children, as well as in adults, lead to development, immunity is suppressed, and the immune response to various infections weakens.

With massive infection, complications can be significant, leading to spastic or mechanical obstruction of the intestinal lumen, bile ducts, intestinal obstruction, cholecystitis, acute appendicitis, pancreatitis, obstructive jaundice may develop.

Worms belong to the genus of roundworms. The body is long, with a pointed end on both sides. The color is reddish. Dead individuals become gray or white in appearance. The helminth reaches an impressive size. The average body length of the worm is 15 cm. An adult female reaches a length of 40 cm, and in medicine there are cases when the helminth in the human body grew up to 1 meter. Worms are mainly localized in the small intestine, do not attach to its walls, move freely in it, feed on food debris. An individual of roundworm moves in the direction opposite to the movement of food. Therefore, in the feces, worms are found extremely rarely. Worm eggs get there and then not every time. This makes it difficult to diagnose ascariasis.

Features of the development of roundworm

The helminth cycle from egg to adult roundworm occurs in several stages. Initially, the eggs come out with feces. Remain in soil and water. When a person is infected, they enter the intestines. From here originates the life cycle of roundworm inside the patient. There are 2 stages - migratory, intestinal. The first is characterized by a fuzzy location of the helminth. In the intestines, the eggs continue their development, turn into larvae. Initially, their sizes are so small. That through the walls of the intestine, the larvae penetrate into the blood vessels. Together with the bloodstream, they are carried throughout the body.

At first, the larva stops in the liver, moves to the heart, and completes its journey with the lungs. Migration processes of roundworms are associated with the feeding habits of the larvae. After emerging from the egg, they consume blood serum, gradually switching to erythrocytes. They have more oxygen. To detect the latter, the larva moves through the body, internal organs. In the lungs, full nutrition of roundworm larvae is carried out. They stay there for about 1.5 weeks. Provoke lung disease, cough with a lot of sputum. In the sputum, the larvae come out of the patient. A certain part of them is again swallowed by a sick person. In this process, the larva completes the migratory phase of development, which lasts approximately 14 days. Intestinal begins. In the intestine, the larva transforms into an adult roundworm.

Where do helminths live

The last stage of development of the roundworm larvae takes place in the small intestine. An adult roundworm feeds on the remnants of food that a person consumes. The main site of localization of ascaris is the small intestine. The female lays approximately 240 eggs per day. Ascaris eggs gradually leave the body along with feces. After that, the person becomes contagious to others. The development of the larva in the intestine takes several months. The worm lives there for the rest of its life. However, there are times when roundworms do not adhere to the generally accepted scheme. They remain to live in different organs - the heart, lungs, liver.

How long do worms live

Helminth eggs enter the soil cover with faeces. Then they find themselves on ripened vegetables, fruits, berries, greens. With inadequate heat treatment, roundworm eggs enter the intestines. You can get infected anywhere, anytime. Holding the money in your hands, touching the pen in public transport. But agricultural workers are especially affected by ascariasis. Especially in the area where human feces are used as fertilizer. You can get infected from unwashed hands if basic hygiene rules are not followed.

Children are at risk. Especially at a young age. When little creatures put everything they can get into their mouths. So they know the world, and everything tastes. A fragile organism, an unformed intestine, a weak immune system is the most favorable place for the existence of helminths. Children can become infected with roundworms when playing in the sandbox, just on the playground.

Complications of ascariasis

If one roundworm survives in the patient's body, there will be no obvious symptoms of the disease. Signs of ascariasis will be limited to abdominal discomfort, bloating, and dysbacteriosis. With a strong infection and large sizes of roundworms, worms can form tangles, which cause intestinal obstruction.

Ascaris in the body is an extremely dangerous phenomenon. With their presence, worms irritate the nervous system, cause toxicosis, a decrease in hemoglobin, and a weakening of the body as a whole. For children, helminths are dangerous due to backwardness in mental and physical development.

Diagnosis of the disease

Currently, several methods are used to study the human body for ascariasis.

Treatment of the disease

The average duration of treatment for ascaris is 2 months. To do this, use medications, folk recipes.

Drug treatment is carried out in courses of one week with interruptions. They are periodically examined. The basic rule in the presence of ascaris in the body is that cough cannot be treated with medicines. Sputum should be spit out, the mouth should be periodically rinsed with a decoction of bitter wormwood.

Treatment for ascaris folk recipes involves the use of herbs, various products. Wormwood, tansy, pumpkin seeds, garlic with milk, walnuts, pomegranate with peel and many others are widely used. Before starting the treatment of the disease, you should consult with a specialist.

Disease prevention

The disease can be prevented by following simple rules:

Roundworms are able to exist in the patient's body for a long time. Do not forget about the danger, neglect the simple rules of hygiene. In this case, prevention plays an important role.

With an early-stage invasion, ascaris eggs that have entered the gastrointestinal tract lose their shell under the influence of enzymes, and the released larvae spread to various organs: the liver, heart, and lungs. With further migration, ascaris larvae enter the oral cavity through the respiratory tract, from where, together with saliva and ingested food, they return to the intestine for further existence and reproduction at the chronic stage of ascariasis.

What do roundworms look like?

An adult roundworm looks like a spindle-shaped reddish worm (after death, the body color changes to yellowish-white). The length of a mature helminth depends on age and sex: males can reach a length of 25 cm, a width of 4 mm, females - up to 40 cm and up to 6 mm.

Photo: Rattiya Thongdumhyu/Shutterstock.com

Ascaris eggs cannot be seen with the naked eye. Depending on the presence of the fertilization factor, they differ in size and shape, but even the largest of them do not exceed 100 x 45 microns.

Roundworms are exceptionally prolific worms; the body of a female can contain up to 27 million eggs in different stages of formation. One adult female is capable of laying up to 240 thousand eggs per day, up to 64 million per year, as a result of which roundworms are the most common type of helminth with a type of infection through the soil. Carriers of ascaris are, according to general estimates, almost 1.2 billion people, in some countries the percentage of patients with ascariasis reaches 20.
The high fecundity of these worms is due to a rather low, compared with the number of eggs laid, survival in the external environment: for further maturation, the eggs must be in the soil, passing through the biological cycle of the formation of an invasive larva. At the same time, the soil temperature should remain within the range of 13 to 26 ° C, and the humidity of the environment should be from 4 to 8%.

Ways of infection with ascariasis

Ascariasis is a disease with an oral route of infection. Roundworms are helminths that go through a stage of development inside and outside of a person. A patient with ascariasis, in the presence of heterosexual adults in the body, along with feces, spreads roundworm eggs. After a period of development in the soil, microscopic roundworm larvae, along with earth, plants or water, fall on a person’s hands or directly into the mouth.

Eggs are quite easily removed during hygiene procedures (washing hands, vegetables, greens) or pre-treatment of food and heating over 50 ° C or boiling water, which causes a pronounced difference in the number of infected people among different age and social groups. Ascariasis is most often diagnosed in children who are actively in contact with nature and do not have hygiene skills due to age, as well as in rural areas with unfavorable sanitary and hygienic living conditions. Occupational risks include ascariasis in sewage treatment plant workers and diggers.

After ingestion, ascaris larvae in the intestinal environment lose their egg shell and begin to migrate throughout the body. The purpose of migration is to reach the oral cavity and subsequent transport to the intestines. However, with the blood flow, the larvae can spread to different organs and tissues, settling in the veins, liver, heart and forming inflammatory infiltrates with a high content of eosinophils. Full-fledged formation of an adult helminth in such cases does not occur, but significant harm is done to the body.

On average, the early stage of larval development and reaching the oral cavity lasts about 3 months. After secondary ingestion, the late intestinal stage of development of a sexually mature individual begins in the small intestine.

The life span of an adult roundworm is an average of 12 months, after which the helminth dies and is excreted from the intestine with feces.

Among the individual measures for the prevention of infection with helminths, there is a need for such as mandatory washing of hands before eating, the use of protective equipment for brushes (rubber gloves) when working with soil, and careful processing of vegetables, fruits, and berries.

Places where ascaris eggs are likely to accumulate (country, village toilets equipped with cesspools) must be neutralized by covering the feces with earth for at least 2 years, after which the compost can be used to fertilize the soil. Otherwise, neutralizing chemicals are used.

Symptoms of the disease at various stages

Symptoms of the early stage of ascariasis: the first signs of infection

How and when can you detect the presence of helminths of this species in the body? After penetration, the first clinical manifestations of the disease occur after 1-2 months. Non-intensive invasion may be asymptomatic or subclinical.
With a pronounced reaction of the body, such signs as headache, general weakness, increased fatigue, fever to subfebrile indicators, allergic manifestations (itching, skin rash) prevail. Less commonly, infection is accompanied by a clinical picture of pulmonary pathologies, manifested by cough, sputum (possible bloody inclusions), shortness of breath, pain in the chest, the examination may reveal signs of exudative pleurisy, the presence of eosinophilic infiltrates of lung tissue, bronchi. There is also an increase in lymph nodes, spleen, liver. Migration of larvae can cause the development of pneumonia and bronchitis, as well as signs of impaired activity of the cardiovascular system and liver.

intestinal stage

Ascaris: symptoms in children

The most pronounced symptom that manifests itself in the presence of roundworm in children is intestinal dyspepsia: stool disorders (diarrhea, constipation, often alternating), progressive enteritis may develop. The presence of cramping pains in the abdomen, arising arbitrarily or on palpation, is noted. At the same time, pain sensations in childhood are not localized and can cover the entire peritoneal region, in adults they are limited and localized in the upper right quarter.
Roundworms in children also cause appetite disorders, more often - a steady decrease in it, "whims" when eating, nausea, increased salivation, and can also cause intolerance to certain foods (in most cases - dairy).

Photo: Evgeny Atamanenko/Shutterstock.com

On the part of the nervous system, ascariasis in childhood is manifested by astheno-neurotic syndrome, weakness, fatigue, headaches, absent-mindedness, decreased concentration, and irritability. Sleep disturbances (anxiety, fears, motor activity during sleep), as well as a decrease in the level of intelligence, hysterical seizures, and epileptiform convulsions and the occurrence of Meniere's symptom complex are included in the clinical picture of severe ascariasis.
As well as at the migration stage, allergic reactions may occur in the form of urticaria.

Ascaris in children, to a much more pronounced degree than in adults, affect the state of the immune system and may be accompanied by frequent colds, viral and fungal infections (of the mouth), inflammatory processes of the mucous membranes and skin of bacterial etiology.

Ascaris: symptoms in adults

Diagnosis of ascariasis

When ascaris invades the body in adults and children, the symptoms and signs of the disease are variable, diagnosis and treatment based on manifestations alone are not made. Diagnosis is carried out by several methods.

Coprological studies

The most common method for detecting ascaris is the analysis of feces for worm eggs. This diagnosis is effective only in the late phase of the disease, when a mature individual is in the intestinal cavity; at the migration stage, scatology is ineffective.

Indicators of the analysis of blood and biological fluids

Although in the early stages the excess of leukocytes and eosinophils in the blood is one of the signs of helminthic invasion, a classic blood test does not provide an opportunity to draw unambiguous conclusions about the diagnosis, since the presence of anemia, leukocytosis, and eosinophilia may not accompany the disease during adaptation of the body or indicate about other reasons.
Several methods of serological testing have been developed, but they are not widely used in laboratory conditions. In most cases, it is possible to detect larvae 2-3 months after infection in sputum, but this type of analysis is quite rare.

X-ray examination and operational methods

In the migratory stage, it is possible to use fluoroscopy to detect volatile infiltrates in the lungs. For diagnosis, several images of the lungs are taken, examining the presence and change in the position of infiltrates, indicating the migration of larvae.

If there is a possibility of infection, a general clinical picture and the absence of confirmation of infection with several consecutive coproovoscopies, prophylactic treatment is prescribed and its effect on the body is assessed.

Ascaris: treatment of ascariasis

If the presence of ascaris is suspected or confirmed, treatment is prescribed primarily with medication, unless complications of the disease require another priority method of therapy.

The modern choice of anthelmintic drugs allows you to achieve a quick recovery in 80% of cases after the first course of administration. To determine the dose and choice of the drug, you need to contact a specialist: the choice of the active substance and the features of the reception are calculated depending on the age, body weight, severity of the invasion, as well as the characteristics of the patient's physiological periods. So, ascariasis, detected during the gestational period, can have an extremely negative effect on the development of the fetus. However, drug treatment is possible not earlier than the second trimester, although this period also depends on the woman's well-being.

In the migration phase, broad-spectrum anthelmintics based on levamisole (Decaris), mebendazole (Vermox, Thermox, etc.), thiabendazole (Mertekt, Tekto, Tetusim, etc.) become the first choice drugs.

In the intestinal stage, the following drugs are used: Decaris, Pirantel (and its analogues), Piperazine, Vermox (and analogues).

If the disease is accompanied by symptoms of bronchopulmonary obstruction, exudative pleurisy, symptomatic treatment with corticosteroids and bronchodilators is performed.

Photo: anatolypareev/Shutterstock.com

In severe stages of the disease or in the presence of contraindications to drug therapy, the introduction of oxygen through a tube into the stomach cavity is indicated in a course of 2-3 times (1 time per day, daily). This method is not suitable in the presence of peptic ulcers or inflammatory processes in the organs of the gastrointestinal tract.
In case of complications, symptomatic and / or surgical treatment is indicated.

Complications of ascariasis

Complications of the disease occur during the migration of roundworm larvae to various organs and tissues, as well as with a large number and / or active movement of mature individuals in the intestinal region and their movements along the gastrointestinal tract. The lack of therapy or independent, especially alternative "folk" treatment also leads to this: roundworms can not only significantly harm health, but also cause death.
Among the most common complications of the disease are:

• intestinal obstruction;
• perforative peritonitis;
• acute pancreatitis;
• acute appendicitis;
• development of liver abscesses;
• acute cholecystitis and inflammation of the biliary tract;
• suffocation when adults enter the respiratory tract;
• purulent pleurisy, pneumonia;
• tissue sepsis;
• complicated course of pregnancy and childbirth, fetal malformations;
• pronounced decrease in immunity, etc.

B77

General information

Causes of ascariasis

The causative agent of ascariasis - Ascaris lumbricoides (ascaris) belongs to the class of roundworms. Roundworms have an elongated fusiform shape, yellowish-pink color. Helminths are dioecious: the length of the female roundworm is 20-40 cm, the male is 15-25 cm, and the width is 4-6 mm. Every day, a sexually mature roundworm is capable of laying more than 200 thousand non-invasive eggs, which are excreted with feces into the external environment. In the soil, under favorable temperature and humidity conditions, within 12-14 days, eggs mature to the invasive stage, i.e., to a state capable of causing disease.

A potential source of the spread of ascariasis is a person infected with helminths. The invasion is realized through the fecal-oral mechanism, in the alimentary way. This means that eggs released into the environment and ripened in the soil to the invasive stage enter the body of a new host through the mouth from unwashed hands, household items, as well as when eating contaminated vegetables, berries, fruits, etc. if the measures are not followed hygiene. Children, workers of sewage treatment plants, agricultural workers, gardeners, etc. are more susceptible to the incidence of ascariasis. The season of increased risk of infection lasts from spring to autumn.

Further development of ascaris occurs in the host organism, where the early (migratory) and late (intestinal) phases of ascariasis take place. In the human gastrointestinal tract, namely in the small intestine, roundworm larvae emerge from the eggs, which penetrate into the venous vessels, enter the portal vein with the blood flow and then through the blood vessels into the capillary network of the lungs. There, the larvae penetrate the alveoli, rise into the lumen of the bronchi, trachea and pharynx. Together with bronchial secretions and saliva, they are swallowed and returned to the small intestine, where sexually mature individuals develop from them. The full cycle of transformation of an invasive egg into a sexually mature roundworm is about 2.5-3 months.

In the early phase of ascariasis, the body is sensitized by the metabolic products of the larvae, as well as mechanical trauma to the tissues of the intestine, liver, blood vessels, bronchopulmonary system. In the late phase of ascariasis, the toxic effect on the body of waste products and decay of adult roundworms, injuries of the small intestine, malabsorption of nutrients, and immune suppression are more pronounced.

Symptoms of ascariasis

The clinical symptoms of ascariasis are diverse and depend on the massiveness of the invasion, the age of the patients, and the phase of the disease. In the phase of migration of larvae, allergic, infectious-toxic, hepatic and pulmonary syndromes can develop. This stage of ascariasis in children is often asymptomatic.

Allergic manifestations are characterized by vesicular or urticarial rashes on the trunk, hands or feet, severe itching. Infectious-toxic syndrome in ascariasis is accompanied by febrile fever, weakness, malaise, sweating, lymphadenopathy. Signs of the liver syndrome can be an increase in the liver and spleen, moderate pain in the right hypochondrium, increased activity of liver enzymes, etc. In almost all cases, bronchopulmonary syndrome develops in the migratory phase of ascariasis (eosinophilic pneumonia, Loeffler's syndrome). It occurs with a dry or wet cough, shortness of breath, chest pains, wheezing in the lungs. Often, against this background, exudative pleurisy develops. When examining a pleural effusion obtained as a result of thoracocentesis, eosinophils are found in large numbers, rarely ascaris larvae.

The late (intestinal) phase of ascariasis is characterized by the development of 2 clinical syndromes - gastrointestinal and asthenovegetative. On the part of the gastrointestinal tract during this period, there is a decrease in appetite, nausea in the morning, vomiting, abdominal pain, diarrhea, constipation, bloating, weight loss. Toxic effects on the nervous system can be manifested by weakness, sleep disturbance, memory loss (in children - delayed psychomotor development), meningism, epileptiform convulsions.

Massive helminthic invasion can cause complications: for example, when ascaris migrates into the bile and pancreatic ducts, obstructive jaundice, purulent cholangitis, multiple liver abscesses, acute pancreatitis, appendicitis, peritonitis can develop. Perhaps the development of mechanical obstruction of the respiratory tract by helminths, leading to acute ascariasis asphyxia. In children, ascariasis is most often aggravated by intestinal obstruction. Ascariasis in pregnant women contributes to severe toxicosis, delayed fetal development, complicated delivery and the postpartum period.

Diagnostics

Suspect the presence of ascariasis in a child or adult allow complaints of unexplained and persistent temperature, cough, skin rashes, digestive disorders, weight loss, nervousness. The identification of antibodies in the blood serum using enzyme immunoassay and latex agglutination helps to recognize helminthic invasion in the early phase. Changes in the general blood test are characterized by eosinophilia, elevated ESR, slight leukocytosis, and anemia. When performing radiography of the lungs in patients with bronchopulmonary syndrome, the so-called "flying Löffler infiltrates" are found - foci of infiltration that change their position along with the migrating larva. Microscopic examination of sputum may reveal roundworm larvae.

Drug therapy is carried out with anthelmintic drugs, of which thiabendzol or mebendazole are prescribed in the early phase of ascariasis, and levomisole, pyrantel, etc. are prescribed in the intestinal phase. To reduce allergization, a short course of antihistamines is recommended simultaneously with anthelmintic drugs. In order to normalize the digestive function, enzymes (pancreatin) are used. Correction of the intestinal microflora is carried out with the help of probiotic preparations. Monitoring the effectiveness of anthelmintic therapy is carried out 2 weeks and 1 month after the course of treatment three times. For a patient who has had ascariasis, a dispensary observation is established for a period of 3 years with an annual coproovoscopy.

Forecast and prevention

Prevention of ascariasis should be aimed at timely detection and deworming of patients, hygienic education of children, and raising the level of sanitary culture among adults. Observance of elementary hygiene standards will help to avoid infection with ascariasis: washing hands before eating, after the street, visiting the toilet; thorough washing under running water of berries, fruits, vegetables before serving. With an uncomplicated course of ascariasis, the prognosis is favorable. In the absence of re-infestation, after about a year, self-healing occurs due to the natural death of ascaris. Complications develop relatively rarely, mainly in children and debilitated patients.

The main place of life of ascaris is the small intestine. At the same time, the worms do not have any adaptations such as scolex, which allow them to attach to the walls of the intestines. In order to stay in the intestines, an adult roundworm has to constantly make movements in the opposite direction to the movement of the food bolus. This helminth cannot be found alive in the feces. Only dead individuals or eggs laid by roundworm females get there. Reproduction begins only when there are sexually mature females and males in the intestines. Individuals of the same sex are not capable of reproduction, most often they exist in the human body until the natural end of their lives. Such cases are rare, since in mass invasion there is no shortage of both sexes.

Ascariasis in most cases does not lead to death, although violations in the human body can result in dangerous complications. Most often, this development threatens children and adults with weakened immune systems.

Who is Ascaris?

What do roundworm eggs look like in stool?

How many eggs does roundworm lay daily?

Every day, a sexually mature roundworm in the human intestine lays more than 200,000 non-invasive eggs. They, together with faeces, are released into the external environment. After entering the soil, under favorable conditions, the eggs acquire the ability to cause disease two weeks later.

Symptoms of ascariasis

Ascariasis in an adult who does not have severe chronic pathologies can be asymptomatic for a long time. Such signs of ascariasis as belching, heartburn, indigestion, pain in the intestines, patients can attribute to violations of the usual diet or diet. The reason for this carelessness is that ascariasis does not have specific symptoms that are unique to this disease. In most cases, it has to be differentiated from other disorders of the digestive system.

Manifestations of symptoms of ascariasis depend on the stage of the disease and comorbidities. Distinguish between the early stage of helminthiasis (migratory), and late (intestinal). The migratory phase lasts for 2-3 weeks, while the larvae migrate through the bloodstream through the liver and lungs. The intestinal phase lasts a year or more, as long as roundworms are in the patient's small intestine.

In what organs do symptoms of ascariasis occur?

Organs into which ascaris can get during a massive invasion:

The intestines throughout its length, including the caecum and appendix;

ducts of the pancreas;

Stomach and esophagus (short term);

Gallbladder and choledochus (bile ducts);

In other organs, the presence of ascaris is atypical for this type of helminth. In such cases, they form cavities like abscesses. Such formations do not increase and cannot be destroyed on their own. They do not pose a danger, since roundworm larvae cannot develop into adults in them.

Symptoms of ascariasis in the migration phase

Symptoms of ascariasis most often appear in the gastrointestinal tract and respiratory system. Helminths damage the tissues of the lungs and intestines, and also cause allergic manifestations. The time of manifestation of symptoms depends on the concentration of ascaris in the human body. Invasion with a small number of roundworms causes erased, mild symptoms (fatigue, weakness, decreased performance) or does not provoke any manifestations at all.

Symptoms of ascariasis with massive invasion:

If roundworm larvae have entered the lungs of an unborn child, he will most likely suffer from chronic bronchitis or pneumonia, inflammation of the respiratory tract, manifestations after birth. These diseases are extremely difficult to treat. Roundworms that enter the liver of a newborn baby cause inflammation (hepatitis) and chronic jaundice.

When choosing an anthelmintic agent for the treatment of ascariasis in a pregnant woman, the doctor prefers the least toxic drug. Piperazine and Heptylresorcinol are most commonly used.




Measures for the prevention of ascariasis:

• Early screening of the disease. If you suspect infection with roundworms, you should undergo the necessary diagnostic test: a fecal test for helminth eggs, a blood test to detect antibodies to roundworms, and other studies. With a positive result, treatment is carried out, and an explanatory conversation on the observance of hygiene rules. Infection of at least 10% of the population prescribes in some countries a mandatory check once a year for all residents of the region. At 40% infection, general prophylactic treatment with anthelmintic drugs is recommended.

  Thorough hygienic hand washing. Since the earth is the most likely environment for the spread of roundworms, the development of their larvae from eggs, everyone who has contact with the soil should pay special attention to thorough hand washing.

  Washing products that do not undergo heat treatment before eating. Fruits, vegetables, bird eggs may be in contact with soil containing roundworm larvae. Since these products can be used for food without heat treatment, they should be washed with special care. Short-term heating at a temperature of about +50°C will completely eliminate the risk of contamination from products.

  Conducting briefings by SES employees. Categories of the population at increased risk of contracting ascariasis should have full information about this disease and precautions. These are employees of public catering, preschool institutions, agricultural workers and sewers. Such briefing is required to be carried out by the sanitary and epidemiological services of the region. Particular attention should be paid to educating children in the skills to comply with hygiene standards by their parents and kindergarten teachers.

  Soil protection from faecal contamination. Sanitary protection of the soil includes the following measures: analysis of the composition of the soil before the start of construction of facilities and the allocation of agricultural land, mandatory cementing of cesspools, and the creation of an appropriate legislative framework.

  Monitoring of the state of water and sewer networks. A worn-out sewerage system, due to its defects, pollutes the soil with feces. Through damage to water pipes, roundworm eggs enter the water for drinking and cooking.

  Disease vector control. Ascaris eggs can be transferred to food by flies and cockroaches through contact with faeces and contaminated soil. That is why the fight against them in catering enterprises is of such great importance.

High-quality protection against infection with ascariasis is created by the joint efforts of SES doctors, epidemiologists and infectious disease specialists, as well as the regional administration. But their efforts will be in vain if the patient is exposed to infection due to non-observance of elementary hygiene rules.




Education: in 2008 he received a diploma in the specialty "General Medicine (Therapeutic and Preventive Care)" at the Russian Research Medical University named after N. I. Pirogov. Immediately passed the internship and received a diploma in therapy.