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helminthiasis

worms in human body

helminthiasis– Helminthiasis caused by helminths – round and flat, and less commonly ring-shaped and spiny-headed parasites.Helminthosis is characterized by a chronic course and systemic effects on the body, leading to abdominal, allergic, anemic syndromes and chronic intoxication; damage to the lungs, liver, biliary tract, brain and visual organs.In the diagnosis of helminth infections, laboratory (helminthoscopy, helminthoscopy, serology) and instrumental (X-ray, endoscopy, ultrasound, etc.) methods are used.Treatment of helminth infections depends on the type of parasite and includes specific (anthelmintic) and pathogenic treatments.

General information

Helminth infection is a helminth infection caused by a variety of lower parasites - helminths.Helminthiasis has a chronic course, accompanied by breakdown of the body and a decrease in natural defenses.In the structure of helminth diseases, the leading ones are pinwormiasis, ascariasis, hookworm disease, whipworm disease and toxocariasis.

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

Causes of helminthiasis

To date, more than 250 human helminthiasis pathogens are known; of these, approximately 50 are the most common.The helminths that parasitize the human body are mainly represented by roundworms (Class Nematoda) and flatworms (Class Trematodes - Class Trematodes and Class Cestodes - Class Cestoda); less commonly, human infections occur in Annelida (Annelida) and Acanthocephala (Acanthocephala).Representatives of roundworms include pinworms, Ascaris lumbricoides, Trichinella spiralis, and whipworms; tapeworms - cattle, pork and dwarf tapeworms, Echinococcus, and broad tapeworms; flukes - cat flukes and liver flukes.

The worm life cycle consists of egg, larvae and mature stages.According to the developmental characteristics of parasites and infection routes, helminthiasis is divided into biological helminthiasis, soil helminthiasis and infectious (contact) helminthiasis.

  1. soil wormare most roundworms (nematodes).The developmental stages of soil worm eggs and larvae occur in soil under certain temperature and humidity conditions.Infection with geohelminths is caused by failure to maintain personal hygiene, consumption of water, fruits, vegetables contaminated by parasites, or contact with fecal-contaminated soil.Geohelminths include helminth diseases such as ascariasis, hookworm, whipworm, and strongyloidiasis.
  2. to the numberbiological wormBelongs to trematodes (flukes) and cestodes (taenia) as well as certain types of nematodes.To reach the invasive stage, they need to change one or two intermediate hosts, which can be fish, crustaceans, molluscs, and insects.The pathogens of biological helminthiasis enter the human body through the consumption of meat or fish that has not been adequately heat treated or by drinking raw water.Representatives of biological helminth diseases are dilofilariasis, clonorchiasis, opiodosis, taeniasis, taeniasis, trichinellosis, fascioliasis, and hydatid disease.
  3. Kcontagious helminthiasisInvasions that are spread from person to person through personal contact, through sharing toiletries, cutlery, underwear, or through self-infection.These are pinwormiasis, hymenoderma, strongyloidiasis, cysticercosis.

Classification

Helminth infections are classified based on the biology of the worm, its presence in the external environment, its route of infection, and its habitat within the human body.Taking into account the biological characteristics of pathogens, they can be divided into the following categories:

  • Nematodes(Ascariasis, pinworms, whipworms, hookworms, nematodes, etc.)
  • Taeniasis(Taeniasis, cysticercosis, hymenococcosis, taeniasis, hydatid disease)
  • fluke(Opisthorchiasis, clonorchiasis, schistosomiasis, fascioliasis).

According to the way parasites exist in the environment, they can be divided into soil helminthiasis, biological helminthiasis and contact helminthiasis.Infections with helminthiasis can occur through food, water, or the transdermal route.Depending on the location of the pathogen in the human body, helminth infections are divided into:

  • intestinal.Human intestinal parasites include ascariasis, pinworms, hookworms, flagellosis, strongyloidiasis, trichostrongyliasis, dilofilariasis, taeniasis, taeniasis, hymenoderma and other pathogens.
  • parenteral.Extraintestinal worms can live in the liver, gallbladder, blood vessels, and subcutaneous tissue.Extraintestinal parasitic diseases include filariasis, dracunculiasis, opium flukes, schistosomiasis, fascioliasis, clonorchiasis, paragonimiasis, trichinellosis, cysticercosis, etc.

Furthermore, a distinction is made between luminal (including intestinal) and tissue (skin and visceral) helminthiasis based on localization principles.

Symptoms of helminthiasis

Clinical manifestations of helminthiasis are diverse and include general immune system responses to parasite invasion and organ-specific lesions.Helminthiasis can be divided into an acute or early phase (2-3 weeks to 2 months) and a chronic phase (up to several years).The main pathological effects of worms on the human body include toxic allergic reactions, mechanical damage to organs and tissues, nutritional and vitamin deficiencies, and decreased immunity.

acute phase

The acute phase of helminthiasis is mainly caused by the toxic and allergic effects of parasites on the body.Patients develop fever, rash, muscle pain, and swollen lymph nodes.Abdominal syndrome (dyspepsia, abdominal pain), pulmonary syndrome (dry cough, bronchospasm, shortness of breath), hepatosplenic syndrome (enlarged liver and spleen), vegetative syndrome (apathy, fatigue, sleep disturbance, irritability) often occur.

Chronic phase

In the chronic phase of helminthiasis, organ-specific lesions predominate and are primarily caused by mechanical trauma to the site of worm parasitism.Therefore, the decisive factors in the course of intestinal helminthosis are dyspepsia and abdominal pain.Disruption of the intestinal absorption process can lead to vitamin deficiencies and progressive weight loss.Iron deficiency anemia is a common complication of intestinal helminthiasis.When a large number of worms become infected, rectal prolapse, hemorrhagic colitis, and intestinal obstruction may occur.

In the chronic phase of helminthiasis, the primary hepatobiliary system is damaged and obstructive jaundice, hepatitis, cholecystitis, cholangitis, and pancreatitis may occur.If pinworms migrate during pinworm disease, persistent vaginitis, endometritis, and salpingitis may develop.

The chronic phase of strongyloidiasis is accompanied by the formation of gastric and duodenal ulcers.Trichinosis affects the cardiovascular system (myocarditis, heart failure), respiratory organs (bronchitis, bronchopneumonia) and the central nervous system (meningoencephalitis, encephalomyelitis).Because filariasis invades lymphatic vessels, filariasis often causes lymphangitis, lymphedema of the limbs, and swelling of the breasts and genitals.With coccidiosis, cysts in the liver and lungs develop, and when they suppurate, complications such as purulent peritonitis or pleurisy may occur.

In the context of helminthiasis in children and adults, the effectiveness of preventive vaccinations and revaccinations decreases, so that the necessary level of immune protection cannot be achieved.In the presence of concomitant diseases, helminthiasis can modify and aggravate its course.The outcome of helminthiasis can be recovery (natural death or expulsion of the worms) or residual, often disabling consequences.

diagnosis

According to clinical and epidemiological data, helminthiasis is mainly diagnosed in the chronic phase.To determine the causative agent of helminthiasis, special laboratory methods are required: microhelminthoscopy (scraping out pinworms), helminthoscopy (checking the feces for eggs), helminthoscopy, serological tests (ELISA, RIF, RSK, RNGA), histological fecal examination.Testing materials for detecting eggs, larvae or mature worm fragments can be feces, vomitus, duodenal contents, sputum, urine, blood, skin biopsy, etc.

For intestinal helminthiasis, skin allergy testing for helminth antigens can be informative.To identify and assess the severity of organ-specific lesions, instrumental diagnostics are widely used: liver, pancreatic ultrasound, FGDS, colonoscopy, endoscopic biopsy, internal organ radiography and CT, liver scintigraphy.

There are worms in the intestines

Treatment of helminthiasis

A holistic approach to treating helminth infections includes both symptomatic and symptomatic treatment.Specific treatment includes prescribing anthelmintics, taking into account the type of worm and the stage of the infestation.The effectiveness of deworming is assessed based on the results of repeated parasitological examinations.For the ectopic treatment of helminthiasis, the following groups of drugs are used:

  • Resistant to nematodes
  • Anti-taeniasis
  • Anti-trematodes
  • Broad spectrum drugs.

For intestinal helminths, antibacterial drugs, intestinal adsorbents, enzymes, probiotics, etc. are added to the main treatment.Symptomatic treatment of helminthiasis may include antihistamines, intravenous fluids, vitamins, cardiac glycosides, nonsteroidal anti-inflammatory drugs, and corticosteroids.For hydatid disease, the main treatment for patients is surgery (liver cyst/abscess surgery, hydatidectomy).

prevention

Prevention of geohelminths is carried out through hygiene education of the population, protection of the environment from faecal contamination and instilling in children the rules of personal hygiene.Deworming of domestic animals, veterinary and hygienic control of meat sales and careful heat treatment of meat and fish play an important role in preventing the spread of biological helminth diseases.In the prevention of contact helminthiasis, the most important thing is to break the mechanism of transmission of pathogens in organized groups, mainly children.Seasonal helminthiasis drug prophylaxis (such as albendazole) is recommended for families and regular parasitological examinations of children and high-risk groups are recommended.