Ascariasis is the most common helminthiasis, distributed around the earth
The causative agent - the human Ascaris (Ascaris lumbricoides), round
helminth. Adults have a spindle shape. Live or just
Stand out from the intestinal roundworm reddish-yellow color, after the death become
whitish. Male much smaller than the female, with a length of 15-25 cm and the rear end of the body
bent hook. The female has a straight body length of 25-40 cm and 3-6 mm in thickness.
The man in the gut which are parasitic females and males of Ascaris is
the only source of infection. A mature female roundworm can lay up
245,000 eggs per day. In the external environment with the feces stand out immature eggs of worms,
ripening occurs at a temperature conducive to the development and humidity.
The larva inside the egg matures within 9-42 days at an optimum temperature - 24-30 ° C. The mobile larva, formed in the egg, moulting and commits only
then becomes invasive (infecting) the ability. Infection with human
It occurs by ingestion of mature eggs, vegetables primary importance, on the surface
which are particles of the soil. A certain danger for spreading
ascariasis are horticultural areas, where soil fertilizer sometimes
used human feces.
Once swallowed and enters the small intestine of mature eggs larvae,
are introduced into the intestinal wall and enter the blood vessels. With the current
larvae blood to the liver and lungs (migration step 6-8 weeks), and
they can also get into the brain, eyes and other organs. In the lungs the larva
actively entering into the alveoli and bronchioles, promoted by small and large bronchi
via ciliary epithelium to the oropharynx, where the ingestion of larvae
with phlegm. Getting back to the intestine during the larva reaches 70-75 days
sexual maturity (intestinal stage 8 weeks after infection). duration
adult roundworm life reaches, after which it takes place and at the death
it is removed with the feces out.
Symptoms and flow of ascariasis
Manifestations depend on ascariasis vermin localization.
The clinical course of ascariasis distinguish two phases - early (migration) and
late (intestinal). In the migration phase of the manifestations of the disease ascariasis little
expressed, it goes unnoticed. Sometimes the onset of the disease is manifested with the expressed
malaise, there is a dry cough, or a small number of mucous
sputum, rarely mucopurulent. Sputum sometimes becomes orange color
and it has a small admixture of blood. The body temperature is usually normal or low-grade
(Up to 38 ° C). It is very typical for this stage, the skin changes that often
It appears as urticaria and fine bubbles with clear content to
hands and feet.
When X-ray light detected round, stellate,
polygonal infiltrates. Infiltrates can be either single or multiple,
found in one portion or across the lung.
The intestinal phase of ascariasis is associated with a stay in the intestines of worms. Sometimes
it flows without severe symptoms, most patients notice improved
fatigue, change in appetite (decrease), nausea, sometimes vomiting, pain
abdomen. Pains occur in the upper part of the abdomen, around the navel or below right
and have cramping in nature. Some patients are diarrhea, others
constipation or diarrhea alternating with constipation. From the nervous system in ascariasis
common headache, dizziness, mental fatigue. observed
restless sleep, night terrors, dizziness, seizures, hysterical seizures,
convulsions. In some cases, there are changes in the eye - extension
pupils, pupils of different sizes, photophobia, decreased visual acuity. by
cardiovascular system in some patients there is a decrease ascaridiasis
blood pressure. Sometimes stay ascarids in the intestine causes
occurrence of asthma and bronchitis.
Complications of ascariasis
bowel obstruction, which is caused by the closure of the lumen
tangle of intestines of Ascaris; askaridozny appendicitis; ascariasis liver and bile
tract (cholangiohepatitis) with the development; inflammation of the bile ducts - purulent
cholangitis and multiple liver abscesses; ascariasis pancreas development
acute pancreatitis; ascaris entering the airways development suffocation
Diagnosis, treatment and prevention of ascariasis
In the migration phase - detection of Ascaris larvae in the sputum;
Detection of specific antibodies in the blood via immunological reactions.
The intestinal disease stage the main method is to research on the stool
of Ascaris eggs. If eggs are found in duodenal contents it may
indicate the presence of parasites in the biliary and pancreatic ducts.
For the expulsion of Ascaris applied Piperazine adipate, Pyrantel
and Levamisole (Dekaris). An effective means of ascariasis is oxygen,
it is administered by gavage in the morning on an empty stomach or 3-4 hours after breakfast
2-3 days in a row. The amount of oxygen per session - 1500 ml after administration
oxygen the patient must lie down for 2 hours. Oxygen is contraindicated in peptic ulcer
disease and inflammatory abdominal diseases.
Piperazine adipate administered 2 times a day 1 hour before or after 30-60 minutes
after a meal for 2 consecutive days at a dose of 1.5-2 g per reception, daily dose is
Currently piperazine instead prefer to be given orally once
Levamisole (Dekaris) at a dose of 150 mg after meals. Pyrantel (Kombantrin, Gelmintoks,
Nemotsid) is assigned to inside during or after eating at a dose of 10 mg / kg body weight.
Tablet before swallowing should be thoroughly chewed.
It is necessary to protect the soil gardens, orchards and berry
fecal contamination, wash hands thoroughly before eating, thoroughly wash and scald
boiling vegetables and fruits before eating.