Ascarids are round helminths that parasitize not only in the human intestine, but also in virtually all organs - the gastrointestinal tract, the respiratory system, the nasopharynx, the liver, even the brain and the heart. This parasitic disease occurs when infecting children and adults with non-compliance with personal hygiene rules. When reproducing ascarids, the symptoms in children and adults are manifested by fever, general malaise, dry cough, disruption of the gastrointestinal tract, local allergic reactions, and a sharp decrease in body weight. Diagnosis of such helminthiosis consists in the analysis of feces for the eggs of worms, serological tests, a general blood test, and also adults are often found in fluoroscopy of the lungs or intestines. With ascarids, the treatment is to take antihelminthic drugs (see pills for worms in humans ).
What do askarids look like?
Adult roundworms are large enough round worms, the length of which in males reaches 15-25 cm, in females of 20-40 cm. Ascaris is a human white-pink spindle-shaped. Eggs of these helminths can be in soil, water, on plant products. An ascaridosis 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, and also through water, food containing the ripened ascarid eggs. The most susceptible to infection are children, in adults, ascariasis is less common.
This helminth disease is common in all climatic zones, except for deserts, highlands and permafrost zones.
According to the World Health Organization, in the world, about one billion people are carriers of ascaridosis.
However, this type of helminthosis has the greatest distribution in the tropical and subtropical zone, up to 80% of the population is affected by ascarids, the symptoms, treatment with this disease can be very diverse, depending on the stage of migration and further localization of the worm colony.
How the ascarids get into the body - the causes, the ways of infection
The owner and source of infection of this helminthic invasion is a person. With the feces of a sick person, ascaris eggs fall into the soil, where they can exist for several years, ripening in it to dangerous larvae, but they are not viable in the external environment. In the soil, when favorable conditions arise - humidity, heat + 24C, oxygen saturation - the eggs ripen and become ready for life in the human body. First of all, when contacting the soil, as well as with water or using unwashed berries and vegetables, the hands are seeded with eggs of these helminths and a person, not observing the rules of personal hygiene, may become a victim of infection with ascaridosis.
Therefore, the majority of cases of ascariasis are registered among young children who are not yet accustomed to strict hygiene rules, as well as residents of rural areas with unfavorable living conditions. Especially high risk of infection in the summer and autumn, when children and adults have the greatest contact with grass, soil, in the children's sandbox, on playgrounds, using unboiled water or not washed products - herbs, berries, vegetables.
After entering the intestines of full mature eggs, larvae form through them, through the mucous membrane, they penetrate into the portal vein, from where they can move forward to almost any organ - the right ventricle of the heart, liver, bronchi, lungs, gall bladder. After the migrating larva enters the lungs, together with phlegm after coughing, they again find themselves in the small intestine, where they grow up to adult mature sexworm.
This is called the early migration stage of the disease and lasts for about 3 months, then in the late intestinal stage, when the adult intestinal tract is already infected, 1 female per day can lay up to 250,000 eggs that are excreted with feces. A sexually mature individual lives for about a year, after which it dies. The generation of new ascarid larvae in the body can not develop, because the eggs require soil, the land to ripen, so even without treatment, ascarids die in the body after a year if the person does not again become infected.
The main rules that should be observed so as not to catch ascarids:
- When working with soil, rubber gloves should be used
- Thoroughly wash vegetables, greens, berries
- With frequent contact with the ground, have short-cropped nails
- Wash hands thoroughly after the street, before any meal, even before a light snack
- To teach children from an early age to take nothing in the mouth, except for food, and with clean hands
Symptoms of ascaridosis in children and adults
What can bother the person after infection, what are the ascarid symptoms that differ from other diseases? Clinical symptoms of ascaris both in children and adults directly depend on the intensity of infection, on the location of parasites, and on the phase of development of ascarids:
- The first migration phase
During this phase in the cycle of development of ascarids, the symptoms in adults can be mild and most often go without complications. In varying degrees of severity, there may be general malaise, body temperature is subfebrile, 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 veins of blood.
Occasionally, wet or dry wheezing or shortening of the percussion sound is heard, and there may also be dry or exaggerated pleurisy. At a roentgen of lungs are found out "flying" infiltrates - round, round, star, polygonal, scalloped. They can be numerous, and single, in one, and in both lungs.
If there was no intensive, insignificant infection of the roundworm in children, it can take a little symptomatic, in an erased form. Less often, with a massive intake of eggs in the body, in children even the migratory phase can be accompanied by significant intoxication symptoms, while lymph nodes, fever up to 38C, headache, enlargement of the liver, spleen can increase.
A very distinctive feature of ascariasis in this phase of migration of larvae is the appearance of skin allergic reactions, especially hives on the feet and hands , and allergic dermatoses.
Therefore, in the blood, eosinophils can reach 30-40%, it is detected simultaneously with infiltrates in the lungs, and minor periodic leukocytosis is possible, ESR usually keeps within the normal range (see causes of increased ESR ).
Changes in the lungs persist for about 2-3 weeks, then disappear, there are cases that infiltrates are detected again after a few months and last longer. Children often have bronchial obstruction.
- Late phase - intestinal parasitism
This phase is called intestinal, and after secondary exposure to the small intestine, ascarids lead to symptoms of dyspepsia, when diarrhea is replaced by constipation , flatulence , even cholera-like, dysenteric symptoms, or signs of typhoid fever, but in such cases against a background of decreased immunity There is also a combination of infectious diseases with ascarids.
In the late phase of ascariasis, children often complain of abdominal pain, nausea, less frequent vomiting, lack of appetite, sharply grow thin, very quickly become tired, look exhausted and sick. The abdominal pain is localized either to the right in the iliac region, or near the navel, a cramping character, reddening and itching in the anus can appear.
From the nervous system side, astheno-neurotic syndrome is often expressed - hysterical fits, nightmares, anxious dreams, dreaming, groans, cries, insomnia, meningism, epileptiform cramps. Frequent symptoms of ascaris are extremely rapid mental fatigue, dizziness, headache.
Very rarely, but there are cases of the appearance of changes from the eyes - photophobia, an increase in pupils, amblyopia, anisocoria. Many patients experience a drop in blood pressure. Sometimes the presence of ascarids, leads children to develop bronchial asthma or frequent bronchitis, in blood tests due to exhaustion, reducing the absorption of trace elements, vitamins, anemia is observed, and eosinophils come to normal.
With the development of ascaris in children, the symptoms listed above are often complicated by recurrent stomatitis (see stomatitis in children ), purulent diseases of mucous membranes, skin. Invasion with ascarids leads to a significant decrease in immunity, so children can be hard, long-term sick with various infectious diseases.
Complications that can cause invasion of ascarids are associated with their motor activity through the wall of the intestine, during migration, they mechanically injure it. With massive infection, this can lead to a through hole in the intestine - perforation, and getting into the blind can lead to the development of acute appendicitis in adults or appendicitis in children.
In severe cases of severe invasion, ascarias creeps into the bile ducts, development of biliary colic, purulent cholecystitis (gallbladder inflammation ), development of mechanical jaundice, granulomatous hepatitis with hepatosplenomegaly, liver abscess, peritonitis and development of intestinal obstruction.
In the medical literature, clinical cases are described where massive invasions led to the fact that the worms crawled into the pharynx, the paranasal sinuses, into the respiratory tract, leading to suffocation, and also revealed ascarids in the pulmonary artery and the right ventricle of the heart and even the human brain.
How to identify ascarids - diagnostic options
The general analysis of the blood - leukocytosis and eosinophilia, lung X-ray -infiltrates, sputum smear microscopy - detection of larvae. At the late intestinal stage (approximately 3 months after infection), when the larvae already become sexually mature worms - anemia, not significant leukocytosis, perhaps minor eosinophilia, stool analysis - erythrocytes, undigested food, helminth eggs or the ascarids themselves.
In rare cases, already adult individuals are found in the luminal gut with X-ray of the intestine with a contrast substance or with the X-ray of the lungs, as well as during the endoscopic examination of the FGS. Radiography can help in diagnosing the migratory phase of ascarids, when several shots are taken in a few days, a comparison of the radiographs can give an opportunity to follow the "movement" of the infiltrates. If such a phenomenon is combined with eosinophilia of the blood - this is an important argument in favor of the diagnosis of ascaridosis.
How to remove ascarids in children and adults
When determining the diagnosis of ascarids, 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 medications have high activity and the effectiveness of treatment of ascaris in children and adults is 80-100%.
In the migratory phase, both children and adults are prescribed mandatory tablets from worms of a wide range of antinematode activity, these include:
- Levamisol is the trade name of the drug Dekaris (70-90 rub)
- Mebendazole - Vermox (80-120 rub.), Vero-Mebendazole, Worming 20 rubles., Thermox, Vermakar, Mebex
- Tiabendazole - an antiparasitic agent, Arbotekt, Mintezol, Tetusim, Tecto, Tresaderm, Mertect
- In the presence of obstructive broncho-pulmonary manifestations, corticosteroids and bronchodilators are prescribed.
If helminths are found already in the intestinal stage - ascarids are treated with such drugs:
- Decaris - once, in a dose according to the weight and age of the patient
- Pirantel pamoate - Combantrin, Helmintox (80-120 p.), Nemocide, Pirantel (30-50r) also once
- Piperazine - has a less pronounced effect 10-30 rubles.
- Mebendazole - Vermox, Vero-Mebendazole, Wormin, Thermox, Vermakar, Mebex
After taking the drugs in a few days, enterosorbents such as Polyphepanum, Polysorb , activated carbon can be prescribed. After treatment of ascarids, a control examination of an adult or a child is indicated after a month. Details about all Worms for children that can be used by children under 2 or over 3 years in our article.
Consequences, complications of ascaris in children
Since ascarid larvae can cause mechanical damage during migration, this is a danger, especially for a weak 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, intestine.
Moreover, with the growth of larvae and adults, they deplete the body, sucking out nutrients, and the products of their vital activity, have a powerful allergic and toxic effect on the body.
If the time is not spent on treatment of ascarids in children, such helminthic invasion leads to general sensitization of the body, severe local allergic reactions (urticaria) or general (asthmatic asphyxiation, obstructive bronchitis ) develop. Ascarids in children, as well as in adults, lead to the development of intestinal dysbacteriosis , immunity is inhibited, 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, mechanical jaundice may develop.