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Helminthiasis

worms in the human body

Helminthiasis– helminthic diseases caused by helminths – round and flat, less commonly ring and spiny 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 duct, brain and organ of vision.In the diagnosis of helminth infections, laboratory (helminth-ooscopic, helminth-larvoscopic, serological) and instrumental (x-ray, endoscopy, ultrasound, etc.) methods are used.Treatment of helminthic infections depends on the type of parasite and includes specific (anthelmintic) and pathogenetic therapy.

General information

Helminthic infections are helminthic infestations caused by various types of lower parasitic worms - helminths.Helminthiasis has a chronic course, which is accompanied by exhaustion of the organism and reduction of its natural defenses.In the structure of helminths, the leading positions belong to enterobiasis, ascariasis, hookworm, trichuriasis and toxocariasis.

According to official statistics, the rate of infestation of the population of our country by helminthiasis is 1-2%, but in some areas it reaches 10% or more.The problem of the increasing incidence of helminthiasis is relevant not only for infectious diseases, but also for pediatrics, treatment, 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.The most common of them are about 50 species.Helminths that parasitize the human body are mainly represented by roundworms (class Nematoda) and flatworms (class flukes - Trematoda and tape - Cestoidea).Less often, human infections occur with annelids (Annelida) and acanthocephala (Acanthocephala).Representatives of roundworms include pinworms, roundworms, trichinella, whipworms.tape - bovine, porcine and dwarf tape, echinococci, broad tape.bloated - cat and liver bloated.

The life cycle of helminths includes the egg, larva and adult stages.Depending on the development characteristics of the parasitic worms and the routes of infection, helminthic diseases are divided into biohelminthiasis, geohelminthiasis and contagious (contact) helminthiasis.

  1. Geohelminthesthey make up the majority of roundworms (nematodes).The egg and larval stages of development of earthworms take place in the soil under certain temperature and moisture conditions.Infection with geohelminthiasis occurs through failure to maintain personal hygiene, consumption of water, fruits, vegetables contaminated with parasites or contact with soil contaminated with feces.Geohelminthiasis includes helminthic diseases such as roundworm, hookworm, trichuriasis, roundworm.
  2. In the numberbiohelminthsThey belong to bagworms (trematodes) and tapeworms, as well as some types of nematodes.To reach the invasion stage, they need a change in one or two intermediate hosts, which can be fish, crustaceans, molluscs and insects.The causative agents of biohelminthiasis enter the human body by eating meat or fish that has not undergone sufficient heat treatment or by drinking raw water.Representatives of biohelminthiasis are diphyllobothriasis, clonorchiasis, opisthorchiasis, taeniasis, teniargiasis, trichiniasis, fascioliasis, echinococcosis.
  3. Kcontagious helminthiasisbelong to infestations transmitted from person to person through personal contact, through shared hygiene products, dishes, underwear or through self-contamination.These are enterobiasis, hymenolebiasis, tycoidiasis, cysticercosis.

Classification

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

  • nematodes(ascariasis, enterobiasis, trichuriasis, hookworm, necatoriasis, etc.)
  • you paid(tapeworm, cysticercosis, hymenolepiasis, teniargiasis, echinococcosis)
  • foraminifera(opisthorchiasis, clonorchiasis, schistosomiasis, fascioliasis).

Based on the mode of existence of the parasitic worms in the environment, geohelminthiasis, biohelminthiasis and contact helminthiasis are distinguished.Infection with helminthiasis can occur through food, water or percutaneous routes.Depending on the localization of pathogens in the human body, helminthic infections are divided into:

  • Intestinal.Human intestines are parasitized by pathogens of ascariasis, enterobiasis, hookworm disease, trichuriasis, roundworm, trichostronygillosis, biphyllobothriasis, taeniasis, taenarychosis, hymenolepiasis, etc.
  • Extraintestinal.Extraintestinal helminths can live in the liver, gall bladder, blood vessels and subcutaneous tissue.Extraintestinal parasites include filariasis, dracunculiasis, opisthorchiasis, schistosomiasis, aponeurosis, clonorchiasis, paragonimiasis, trichinosis, cystocercosis, etc.

In addition, according to the principle of localization, helminths of the lumen (including the intestine) and tissues (skin and viscera) are distinguished.

Symptoms of helminths

The clinical picture of helminthiasis is very diverse and consists of the general reaction of the immune system in response to the invasion of parasites and damage to specific organs.During helminthiasis, acute or early phases (from 2-3 weeks to 2 months) and chronic phases (up to several years) can be distinguished.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 reduced immune capacity.

Acute phase

In the acute period of helminthiasis, 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), hepatic syndrome (enlarged liver and spleen), asthenophytic syndrome (apathy, fatigue, sleep disorders, irritability) often develop.

Chronic phase

The chronic phase of helminthiasis is dominated by organ-specific lesions caused mainly by mechanical trauma at the site of helminthic parasitism.Thus, the determining factors in the course of intestinal helminthiasis are dyspeptic disorders and abdominal pain.Violation of absorption processes in the intestine is accompanied by polyhypovitaminosis and progressive weight loss.Iron deficiency anemia is a frequent companion of intestinal helminthiasis.With massive helminthic infestation, rectal prolapse, development of hemorrhagic colitis and intestinal obstruction are possible.

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

The chronic stage of roundworm occurs with the formation of stomach and duodenal ulcers.With trichinosis, the cardiovascular system (myocarditis, heart failure), the respiratory organs (bronchitis, bronchopneumonia) and the central nervous system (meningoencephalitis, encephalomyelitis) can be affected.Due to the invasion of lymphatic vessels by filariasis, filariasis often develops lymphangitis, lymphedema of the extremities with swelling of the mammary glands and genitals.With echococcosis, cysts of the liver and lungs appear, and when they blow, complications in the form of purulent peritonitis or pleurisy are possible.

In the context of helminthiasis in children and adults, the effectiveness of preventive vaccination and revaccination decreases, as a result of which the necessary protective level of immunity is not achieved.In the presence of accompanying diseases, helminthiasis modify and worsen their course.The outcome of helminthiasis can be recovery (with natural death or elimination of the helminth) or residual effects, often with disabling consequences.

Diagnostics

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

For intestinal helminthiasis, skin allergy tests with helminthic antigens can be informative.In order to identify and assess the severity of organ-related damage, diagnostic instruments are widely used: ultrasound of the liver, pancreas, FGDS, colonoscopy, endoscopic biopsy, X-ray and computed tomography of internal organs, liver scintigraphy.

worms in the intestines

Treatment of helminthiasis

A holistic approach to the treatment of helminthic infections consists of etiotropic and syndromic therapy.Specific treatment includes the prescription of anthelmintic drugs, taking into account the type of helminth and the stage of invasion.The effectiveness of deworming is evaluated based on the results of a repeated parasitological examination.For the etiotropic treatment of helminthiasis, the following groups of drugs are used:

  • antifilamentous
  • antivenom
  • anti-tremor
  • broad spectrum drugs.

For intestinal helminthiasis, antibacterial drugs, enterosorbents, enzymes, probiotics, etc. are added to the main treatment.Symptomatic treatment for helminthiasis may include the prescription of antihistamines, intravenous infusions, vitamins, cardiac glycosides, NSAIDs, and glucocorticoids.For echinococcosis, the main treatment method for patients is surgery (surgery for liver cyst/abscess, echinococcectomy).

Prevention

The prevention of geohelminths is carried out through the hygienic education of the population, the protection of the environment from faecal pollution and the instillation in children of the rules of personal hygiene.Regarding the prevention of the spread of biohelminthiasis, an important role is played by the deworming of domestic animals, veterinary and sanitary control of the sale of meat products and careful heat treatment of meat and fish.In the prevention of contact helminthiasis, the main importance is to break the mechanism of transmission of pathogens in organized, mainly children's, groups.Seasonal drug prevention of helminthiasis in families (for example, albendazole), regular parasitological examination of children and risk groups is recommended.