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Helminthosis

Worms in the human body

Helminthosis- Helminthic diseases caused by helminths - round and flat, less often ring-shaped and thorny peculiar parasitic worms.Helminthiasis is characterized by a chronic course and systemic effects on the body with the development of abdominal, allergic, anemic syndromes and chronic toxicosis;Damage to the lungs, liver, bile ducts, brain and the organ of vision.Laboratory (helminth-ovoscopic, helminth-larvoscopic, serological) and instrumental (x-ray, endoscopic, ultrasound, etc.) methods are used in the diagnosis of helminth infections.Treatment of helminth infections depends on the type of parasite and includes specific (anthelmintic) and pathogenetic therapy.

General information

Helminth infections are helminthic infestations caused by various types of lower parasitic worms - helminths.Helminthiasis has a chronic course, which is accompanied by a decline in the body and a decrease in its natural defenses.In the structure of helminthiasis, enterobiasis, ascarida, ankylosis, trichuriasis and toxocariasis occupy a leading place.

According to official statistics, the rate of helminth infection of our country's population is 1-2%, and in some regions it reaches 10% or more.The problem of increasing cases of helminthiasis is relevant not only for infectious diseases, but also for pediatrics, therapy, surgery, gastroenterology, dermatology, allergology, urology and other practical medical fields.

Causes of helminthiasis

To date, more than 250 pathogens of helminthiasis in humans are known;About 50 species are the most common of them.Helminths parasitizing the human body are mainly represented by roundworms (class Nematoda) and flatworms (fluke class - Trematoda and tapeworms - Cestoidea);Less frequently, human infections are caused by Annelida and Acanthocephala.Representatives of roundworms are pinworms, roundworms, trichinella, tapeworms;tapeworm - bovine, pig and dwarf worms, echinococcus, broad tapeworm;flukes - cat and liver flukes.

The life cycle of helminths includes egg, larval and adult forms.Depending on the characteristics of the development of parasitic worms and the ways of infection, helminthic diseases are divided into biohelminthosis, geohelminthosis and contagious (contact) helminthiasis.

  1. GeohelminthsIt represents the majority of roundworms (nematodes).The development stages of eggs and larvae of geohelminths take place in the soil under certain temperature and humidity conditions.Infection with geohelminthiasis occurs as a result of non-compliance with personal hygiene, consumption of water, fruits, vegetables contaminated with parasites or contact with soil contaminated with feces.Geohelminthiasis includes helminthic diseases such as ascariasis, ankylosis disease, trichuriasis, strongyloidosis.
  2. to the numberBiohelminthsBelongs to fleas (trematodes) and tapeworms (cestodes), as well as some species of nematodes.To reach the invasive stage, they need to change one or two intermediate hosts, which can be fish, crustaceans, molluscs and insects.Biohelminthosis-causing agents enter the human body by eating meat or fish that has not undergone sufficient heat treatment, or by drinking raw water.Representatives of biohelminthosis are diphyllobothriasis, clonorchiasis, opisthorchiasis, taenia, taeniarhynchiasis, trichinosis, fascioliasis, echinococcosis.
  3. KInfectious helminthsBelongs to infections that are transmitted from person to person through personal contact, shared toilets, utensils, underwear or self-infection.These are enterobiasis, hymenolephiasis, strongyloidosis, cysticercosis.

classification

Helminth infections are classified according to the biological characteristics of helminths, their mode of existence in the external environment, routes of infection and habitat in the human body.Considering the biological characteristics of pathogens, the following are distinguished:

  • Nematodes(ascaridosis, enterobiasis, trichuriasis, ankylosis disease, nekatoriasis, etc.)
  • Cestodiases(Taenia, cysticercosis, hymenolephiasis, taeniarhynchiasis, echinococcosis)
  • Trematodes(opisthorchiasis, clonorchiasis, schistosomiasis, fascioliasis).

Depending on the presence of parasitic worms in the environment, geohelminthosis, biohelminthosis and contact helminthosis are distinguished.Infection with helminthiasis can occur through food, water or subcutaneous routes.According to the localization of pathogens in the human body, helminth infections are divided into:

  • intestinal.Human intestines are parasitized by ascariasis, enterobiosis, hookworm disease, trichuriasis, strongyloidiasis, trichostrongyloidiasis, diphyllobothriasis, taeniasis, taeniarhynchosis, hymenolephiasis, etc.
  • extraintestinal.Extraintestinal helminths can live in the liver, gall bladder, blood vessels and subcutaneous tissue.Extraintestinal parasites include filariasis, dracunculiasis, opisthorchiasis, schistosomiasis, fascioliasis, clonorchiasis, paragonimiasis, trichinosis, cystocercosis, etc.

In addition, according to the principle of localization, a distinction is made between lumen (including intestinal) and tissue (skin and visceral) helminthosis.

Symptoms of helminthiasis

The clinical picture of helminthiasis is very diverse and consists of a general reaction of the immune system in response to parasite invasion and organ-specific injuries.During helminthosis, there are acute or early (from 2-3 weeks to 2 months) and chronic (up to several years) phases.The main pathological effects of helminths on the human body include toxic-allergic reactions, mechanical damage to organs and tissues, nutritional and vitamin deficiency, and a decrease in immunological competence.

acute phase

In the acute period of helminthosis, the main manifestations are caused by the toxic-allergic effect of parasitic worms on the body.Patients present with fever, skin rash, muscle pain, and lymphadenopathy.Abdominal syndrome (dyspepsia, abdominal pain), pulmonary syndrome (dry cough, bronchospasm, shortness of breath), hepatoileal syndrome (enlarged liver and spleen), asthenovegetative syndrome (apathy, fatigue, sleep disturbance, irritability) often develop.

chronic phase

In the chronic phase of helminthosis, organ-specific injuries prevail, which are mainly caused by mechanical trauma to the site of helminthic parasitism.Thus, dyspeptic disorders and abdominal pain are the determining factors in the course of intestinal helminthosis.Polyhypovitaminosis and progressive loss of body weight are accompanied by disturbances in intestinal absorption processes.Iron deficiency anemia is a frequent companion of intestinal helminthosis.Prolapse of the rectum, development of hemorrhagic colitis and intestinal obstruction are possible during massive helminthic infestation.

In the chronic phase of helminthiasis, which occurs with primary damage to the hepatobiliary system, obstructive jaundice, hepatitis, cholecystitis, cholangitis, and pancreatitis may develop.In case of migration of worms during enterobiosis, it is possible to develop persistent vaginitis, endometritis and salpingitis.

The chronic stage of strongyloidiasis occurs with the formation of stomach and duodenal ulcers.Trichinosis can affect the cardiovascular system (myocarditis, heart failure), respiratory organs (bronchitis, bronchopneumonia) and the central nervous system (meningoencephalitis, encephalomyelitis).Due to the invasion of lymphatic vessels by filariasis, filariasis often develops lymphangitis, lymphedema of the limbs with swelling of the mammary glands and genitals.Liver and lung cysts are formed during echinococcosis, and complications in the form of purulent peritonitis or pleurisy are possible when they suppurate.

Against the background of helminthiasis in children and adults, the effectiveness of prophylactic vaccination and revaccination decreases, as a result of which the necessary protective level of immunity is not achieved.In the presence of concomitant diseases, helminthiasis changes and aggravates their course.The result of helminthiasis can be recovery (by natural death or expulsion of the helminth) or residual events, often with fatal consequences.

diagnosis

Based on clinical and epidemiological data, helminthiasis is mainly manifested in the chronic stage.To identify the cause of helminthiasis, special laboratory methods are used: microhelminthoscopy (scraping for enterobiasis), helminth-ovoscopic (examination of feces for worm eggs), helminth-larvoscopic, serological (ELISA, RIF, RSK, RNGA), histological coprology.For the detection of eggs, larvae or fragments of mature helminths, the test material can be feces, vomit, duodenal contents, sputum, urine, blood, skin biopsy, etc.

For intestinal helminthiasis, skin allergy tests with helminthic antigens can be informative.Instrumental diagnostics are widely used to determine and evaluate the severity of specific organ injuries: liver, pancreas, FGDS, colonoscopy, endoscopic biopsy, radiography of internal organs and CT, scintigraphy of the liver.

Worms in the intestines

Treatment of helminthiasis

A holistic approach to the treatment of helminth infections consists of etiotropic and syndromic therapy.Specific treatment involves the appointment of anthelmintic drugs taking into account the type of helminth and the stage of infestation.The effectiveness of deworming is evaluated based on the results of repeated parasitological examination.The following groups of drugs are used for etiotropic therapy of helminthiasis:

  • antinematode
  • Anticestodiasis
  • Anti trematode
  • A wide range of drugs.

Antibacterial agents, enterosorbents, enzymes, probiotics, etc. are added to the main treatment for intestinal helminthosis.Symptomatic therapy of helminthiasis may include the appointment of antihistamines, intravenous infusions, vitamins, cardiac glycosides, non-steroidal anti-inflammatory drugs and glucocorticoids.The main method of treating patients with echinococcosis is surgery (operation on liver cyst/abscess, echinococcectomy).

Prevention

Prevention of geohelminthiasis is carried out by hygienic education of the population, protection of the environment from fecal pollution and introduction of personal hygiene rules for children.In terms of the prevention of the spread of biohelminthiasis, an important role is played by deworming pets, veterinary and sanitary control over the sale of meat products, and careful heat treatment of meat and fish.In the prevention of contact helminthiasis, the main importance is given to the violation of the transmission mechanism of pathogens in organized, mainly children's groups.Seasonal helminthiasis prophylaxis in families (for example, Albendazole), regular parasitological examination of children and risk groups is recommended.