Ascariasis(ascaridosis) -helminthiasiscaused by parasitism in the small intestine of roundworms - ascaris (Ascarididae). The waste products of parasites cause a number of neurological., Hematological. and other toxic. disorders, bowel dysfunction,sensitizationorganism; possibly fur. bowel irritation.
ETIOLOGY. The causative agent of the disease (Ascaris lum-bricoides) is a bisexual parasite from the group of roundworms. Female the individual is larger and longer (25–40 cm), male (15–25 cm) with one spiraling end. The female lays eggs in the intestinal lumen.
EPIDEMIOLOGY. The only source of invasion is patient A., the male and female ascaris parasitic in the intestine of which are parasitic. Fertilized eggs with excrement fall in the external. environment, where under favorable conditions (sufficient moisture, heat, the absence of direct light) the eggs mature with the formation of a larva. When it enters the mouth (with food, water, etc.) and advances into the intestine, the egg's egg membrane dissolves, and the larva, piercing the intestinal wall, enters the lymph flow, then blood and enters the lungs.
There, the larva proburavlyaet the vessel wall, alveoli and penetrates into the lumen of the respiratory tract, from which the movement of cilia of the ciliated epithelium lining the bronchi, enters the mouth, mixes with saliva, is swallowed and moves to the small intestine, where it is fixed on the mucous membrane and develops into a mature individual . The affection of A. children is higher than that of adults, due to their insufficient compliance with the personal hygiene measures and, possibly, due to the relativeimmunityto A. with repeated infections.
PATHOGENESIS. During migration, the larvae irritate the respiratory tract, sensitize the body. Living in the intestine, eat edible gruel, irritate the intestinal wall mucosa. Parasite toxins cause intoxication, loss of appetite, abdominal pain, disorders of function in. n with. CLINIC. In children, in the first, early, or migratory phase, t-ra is more normal, sometimes subfebrile, rarely high. The condition of the child is usually satisfactory, sometimes there is general malaise, chest pain, cough. Are possiblebronchitis, pneumonia, pleurisy,eosinophilic infiltrates of the lung, allergic rashes on the skin. In the blood - eosinophilia, ESR is often increased.The intestinal phase may be asymptomatic or with a variety of clinics. manifestations, usually more severe in young children. There is a decrease in appetite, weight loss, nausea in the morning, vomiting, excessive salivation, and stool disorders in the form ofconstipation, diarrheaor their alternation. The most common symptom is pain in the abdomen (around the navel in older children), most of which are paroxysmal.
Diagnosis is based onhistoryand coproaitoscopy (detection of ascaris eggs). Take into account the discharge of worms with feces. Recently used serologich. (immunological.) research methods. Diagnosis of a volatile eosinophilic infiltrate in the lungs during the larval migration period presents a certain complexity.
TREATMENT. Appointment of piperazine adipinate 2 times a day for two days. The use of levamisole decaris is effective: children with a body weight of 10 kg - 1/2 tablets. (25 mg); 20 kg - Table 1. (50 mg); 30 kg - 1.5 Table. (75 mg); up to 40 kg -2 tab. (100 mg) per dose. Kombantrin (Pyrantel pamoat) administered at a dose of 10 mg / kg 2 times a day (after meals) 1-3 days in a row. They also resort to the introduction of oxygen (100–150 ml per year of life) into the stomach for 2–3 days in a row (contraindicated for diseases of the gastrointestinal tract).
PREVENTION.Compliance with the rules of personal hygiene and sanitation, the consumption of thoroughly washed fruits and vegetables, preferably after heat treatment. Identification and treatment of sick A.