Symptoms Of Ascariasis In Children: Primary Diagnosis And Treatment

Symptoms of ascariasis - headache, general weakness, increased fatigue, fever up to subfebrile levels, allergic manifestations (itching, skin rash). Ascaris in a child is perhaps one of the most common types of helminthiasis. This type of helminthic invasion is dangerous for the child's body due to the fact that roundworms can move through the body and affect internal organs.

The content of the article:

• 1 What is ascariasis in children
• 2 Diagnosis of ascariasis in children
• 3 Symptoms of ascariasis in children

• 4 Symptoms of the disease at various stages

  • 4.1 Symptoms of the early stage of ascariasis
  • 4.2 Intestinal stage

• 5 Treatment of ascariasis in children

  • 5.1 1st stage of treatment of ascariasis in children
  • 5.2 2nd stage of treatment of ascariasis of ascariasis in children
  • 5.3 3rd stage of treatment of ascariasis in children
• 6 Drugs for the treatment of ascariasis in children
• 7 Diet food during treatment
• 8 Complications of ascariasis in children
• 9 Measures for the prevention of ascaris in children

What is ascariasis in children

Ascariasis is an infestation by a roundworm called ascaris, a disease that can initially progress as an allergic disease with fever, skin rashes, hypereosinophilia of the blood, and "volatile" eosinophilic infiltrates in the lungs.

In the chronic stage of ascariasis in children, as a rule, it is manifested by moderate abdominal pain, gastrointestinal disorders, and sometimes asthenia.

Ascariasis symptoms. According to the international classification, there are such types of ascariasis in children: with intestinal complications; with other complications; ascariasis, unspecified.

Ascariasis occurs in countries with different climates, with the exception of highlands, permafrost regions, and deserts. The highest incidence rate is in countries with humid and subtropical climates.

Ascariasis belongs to the group of geohelminthiasis. With feces, the eggs of the worms enter the soil, where they mature for 2 to 3 weeks.

A child becomes infected by eating vegetables, fruits, drinking water, which contain eggs of the parasite. Eggs cannot withstand high ambient temperatures and drying out. They can be stored in moist soil for up to 6 years.

In the countries of the middle lane, ascariasis is transmitted from April to October. In areas with a tropical climate, you can get infected all year round. At risk are children from 5 to 10 years old, because they are the most active and do not have sufficient hygiene skills and immunity.

Experiments with self-infection with pork ascariasis, the parasite reaching the sexual maturity stage in most cases, as well as with malnutrition, experiments in the infection of piglets with human ascariasis indicate a great proximity of both types of ascaris and, possibly, according to A. I. Krotov, the existence of one species with two hosts. …

Ascariasis symptoms. Cases of infection of children with pork ascariasis as a result of their consumption of vegetables grown on soil fertilized with pork manure are described.

Diagnosis of ascariasis in children

It is possible to differentiate ascariasis in children from diseases similar in symptoms when conducting an accurate diagnosis. The doctor tries to collect a preliminary history, to determine the stage of development of helminthiasis.

Measures for the diagnosis of ascariasis in children:

• general blood test - when the larvae migrate into the lungs, an increase in the concentration of leukocytes in the blood is noted;
• analysis for blood biochemistry - the fraction of eosinophils that react first to helminthic invasions increases;
• a blood test for antibodies to ascaris is an accurate serological diagnostic method, specific antibodies to the Ascaris lumbricoides parasite are formed almost immediately after the ascaris larvae enter the body;
• sputum analysis - it is carried out with the pulmonary form of ascariasis in children, with an intense cough, ascaris larvae and a large number of eosinophils are found in the sputum;
• analysis of feces - during microscopic examination, yellow-brown fertilized eggs of ascaris are found in excrement, at the larval stage of development of the parasite, the analysis of feces may be false-negative;
• urine analysis - the release of volatile fatty acids may indirectly indicate the presence of ascaris, even in the larval form.
• chest x-ray - within 10 days with the pulmonary form of the development of invasion, it can show characteristic changes, volatile infiltration of the lung;
• X-ray of the abdominal cavity - used in differential diagnosis with gastrointestinal diseases, can reveal intestinal obstruction from a large number of ascaris in the intestinal lumen;
• anthropometry - is used in children, since in the chronic form of ascariasis, especially in mass invasion, the parasite takes away nutrients and vitamins from the child's body.

Symptoms of ascariasis in children

From 2-3 to 10 years old, children become active, their diet expands, and they most often get helminthic invasion.

Symptoms of ascariasis in children:

• staying tall, underweight;
• delayed physical development;
• staying in mental and mental development during mass invasion;
• weakness, lethargy, frequent headaches;
• manifestations of allergies;
• with complications - pneumonia, hyperthermia, cough with phlegm;

In infants, ascariasis practically does not occur, since they are protected by the mother's specific antibodies through breast milk. Accidental ingestion of parasites into the body of children under one year ends with their removal.

Occasionally, symptoms such as restless sleep, photophobia, and abdominal pain may appear.

Symptoms of the disease at various stages

Signs of ascariasis differ depending on the scale of the invasion, localization of parasites, individual characteristics of the patient and the stage of development of the disease.

The clinical pictures of the early migratory and late intestinal stages have marked differences.

Symptoms of the early stage of ascariasis

Ascariasis symptoms. The first signs of infection how and when can the presence of this type of helminths be detected in the body? After the penetration of helminths, the first clinical manifestations of the disease appear in 1-2 months. Non-intensive invasion can be asymptomatic or subclinical.

With a pronounced reaction of the body, such signs as headache, general weakness, increased fatigue, an increase in temperature to subfebrile parameters, allergic manifestations (itching, skin rash) prevail.

Less often, infection is accompanied by a clinical picture of pulmonary pathologies, manifested by cough, sputum separation (bloody inclusions are possible), shortness of breath, pain in the chest area, during the examination, signs of exudative pleurisy, the presence of eosinophilic infiltrates of the tissues of the lungs and bronchi can be detected.

There is also an increase in lymph nodes, spleen, liver. The migration of larvae can cause the development of pneumonia and bronchitis, as well as signs of impaired activity of the cardiovascular system and liver.

Intestinal stage

The late phase of the disease can manifest itself in various symptoms and the severity of the course.

In adults, ascariasis can be mild or asymptomatic. In a clinically pronounced case, frequent complaints relate to gastrointestinal dysfunction and asthenic syndrome.

Accelerated transport of food mass in the intestine, damage to the mucous membrane, a decrease in the absorption of nutrients, vitamins, as well as the constant presence in the body of toxins secreted by parasites lead not only to morphological and functional disorders in the small intestine, but also to asthenic conditions and various symptoms from the nervous systems.

Treatment of ascariasis in children

Effective medicinal products are: 1) levamisole (decaris); appoint 150 mg once for adults, 50 mg for children weighing up to 20 kg; 21-40 kg - 100 mg; 2) kombantrin (pyrantel): once, after meals, at the rate of 10 mg / kg body weight; 3) mebendazole (vermox): for 3 days, 0.1 g 2 times a day.

Ascariasis symptoms. In the absence of these drugs, piperazine adipate is prescribed, for 2 days, 3-4 g per day for adults, children by age. In intensive foci, where the incidence of ascariasis is 25-30% and higher, the fight against ascariasis is carried out in 3 stages.

1st stage of treatment of ascariasis in children

The entire population of the outbreak is subjected to deworming 2 times a year. It is rational to carry out the first deworming shortly after the beginning of the season of mass infection (in late spring - early summer), the second - at the end of the infection season (late autumn or early winter).

Ascariasis symptoms. So, in the middle lane, the first deworming should be carried out in June, the second - in October - November. From the second half of December to March, a control survey of a sample group of 200-300 people is carried out to take into account the epidemiological effectiveness of the entire complex of measures.

Continuous deworming with an incidence of more than 40% is performed for 2 years in a row with a control examination at the end of the 2nd - beginning of the 3rd year of work.

New micro-foci are taken into account both according to the results of laboratory studies of outpatients and inpatients, schoolchildren, children in child care facilities, etc., and according to the results of a survey on the allocation of ascaris (independent and after deworming).

2nd stage of treatment of ascariasis of ascariasis in children

After a decrease in the infestation below 25-30% (for foci with an average infestation, this stage will be the first) deworming is carried out only to all residents of estates, where either during a scatological examination or ascaris discharge at least one infected person was detected in the previous 2-3 years or in the current year.

For the detection and registration of micro-foci, a survey is still being carried out among organized groups, patients in inpatient and outpatient receptions, in estates whose inhabitants have not been examined or where no infested ones have been identified.

3rd stage of treatment of ascariasis in children

With a decrease in the incidence of up to 3-5%, children's teams and other groups of the population subject to an annual routine examination, families living in unsanitary conditions, as well as people who apply to medical institutions are examined.

Deworming is carried out immediately after the identification of the patient. The estates where the sick live are considered as micro-foci, and work is carried out in them, similar to that at the 2nd stage. If, within 2-3 years, the secretion of ascaris is not noted and with a double coproovoscopic examination, ascariasis is not detected in any of the inhabitants of the estate, including children, the micro focus is removed from the register.

At the same time, the sanitary condition of the estate, living quarters, the level of sanitary and hygienic knowledge and skills of residents are taken into account. Work in persistent micro-foci must be continued until the inhabitants and the soil are completely recovered, that is, until the focus is completely eliminated.

Examination and rehabilitation is carried out among those contingents of adults who, by the nature of their occupation, can become infected with ascariasis (workers of sewage treatment plants and sewage wagons, workers of greenhouses, greenhouses, nurseries, fruit and vegetable canneries, gardeners, sellers of vegetable stores, etc.). The inspection is organized by the SES 2-3 months after the end of the season of mass infection.

Ascariasis symptoms. Once transferred ascariasis in children cannot be a guarantee against re-infection. When eggs enter the digestive tract, a new cycle of development of the parasite begins and the appearance of symptoms of the disease. Specific immunity to ascariasis is not formed either in children or adults.

If you suspect infection with worms, the child should be shown to the pediatrician for referral for stool analysis. If ascaris eggs are found in it, the treatment is usually carried out by an infectious disease specialist. Due to the fact that many organs and systems can be affected with ascariasis, in severe cases of the disease, consultation of a gastroenterologist, cardiologist, neurologist, nephrologist, hematologist, allergist, and sometimes a surgeon is required.

Drugs for the treatment of ascariasis in children

Treatment of ascaris in children is reduced to taking anthelmintic drugs. In no case should you independently select this or that remedy, only a doctor can do this.

First, not every drug can be used to treat children. Secondly, the dose for them is selected on an individual basis. Thirdly, all anthelmintic drugs have a toxic effect on the body, so self-medication can bring significant harm to health.

If roundworm is diagnosed in a child in the migration phase, then he is shown desensitizing drugs and anthelmintics. Thiabendazole (Mintezol) or mebendazole (Vermox) is most often prescribed in childhood. They have a wide spectrum of activity and have a detrimental effect on ascaris larvae. If the child has severe pulmonary symptoms, then a dose of bronchodilators and corticosteroids is selected for him.

In the intestinal stage, the following drugs are prescribed: Vermox (Mebendazole); Decaris (Levamisole); Pirantel (Combantrine); Piperazine.

Ascariasis symptoms. These drugs are highly effective and often one course of treatment is enough to save the child from the invasion. Re-diagnosis of the disease is required 30 days after treatment.

If a child suffers from acute ascariasis, regardless of the purpose of the drug, antihistamines are a mandatory component of treatment. They stop allergic reactions resulting from the release of toxins by helminths. For sensitization, calcium gluconate, calcium chloride, ascorbic acid, glucocorticosteroids are used.

• Mintezol. The daily dose is 25 mg / kg / day, it is divided into 3 doses, the course of treatment is 5 days;
• Medamin. The daily dose is 10 mg / kg / day, it is divided into 3 doses, taken during the day, with massive invasion, the course takes 2-3 days;
• Decaris (Levamisole). The daily dose is 2.5 mg / kg / day, it is divided into 2-3 doses, taken during the day;
• Combantrine. Used in pill form according to age and body weight;
• Vermox (Mebendazole). The daily dose is 25-50-100 g / day, it is divided into 2 doses, the course of treatment is 3-4 days. It is not used in children under 2 years of age, as well as in case of mass invasion, as it can provoke ascaris into the lungs, into the pharynx, stopping intestinal motility, vomiting, and acute pain.

To correct the intestinal microflora, patients are recommended to take Bifiform, Linex and other prebiotics and probiotics. Enterosorbents prescribed after a course of anthelmintic therapy. They are aimed at reducing the desensitization of the body.

These can be drugs such as Polyphepan, White activated carbon, Polysorb, etc. In addition to specific drugs, enzymes, multivitamins, iron supplements are prescribed (if there is anemia).

During the treatment of the child, it is advisable to transfer to a dietary diet, with meals rich in vitamins and proteins of animal origin. It is necessary to give up simple carbohydrates (sweets, flour and confectionery products), from fatty foods.

Monitoring the effectiveness of treatment is carried out 3 weeks after its completion. In laboratory conditions, feces are examined three times. The prognosis for the treatment of ascariasis is favorable, special care must be taken when treating helminthic invasion of infants.

Asphyxia after the migration of ascaris into the airways can be fatal; it is stopped during urgent surgical intervention. As a rule, the prognosis for recovery is favorable. Complications are infrequent, but surgery may be required in an emergency.

Diet food during treatment

For the duration of treatment and recovery, the child should be transferred to a special diet. This will make it easier to endure intoxication, quickly fill the lack of vitamins, micro- and macroelements.

Recommended products: wheat bread rusks; lean meat, soups, broths; slimy decoctions of cereals, rice, semolina, buckwheat porridge; dairy products; from vegetables potatoes, carrots, beets, tomatoes, cauliflower are useful. You can give honey, fruits, berries, any jam, marmalade. It is useful to brew rose hips, echinacea, fees to maintain immunity; exclude from the diet: muffins, cocoa, chocolate, fatty meat and broths, canned food, cabbage, legumes, radishes, cucumbers.

Complications of ascariasis in children

Ascariasis is dangerous because, as they develop in the child's body, they can move deeper into the body and affect the internal organs. Ascaris larvae gradually move into the bronchi, irritating the lung tissue and mucous membranes. With a cough, they again enter the mouth, then go to their permanent habitat - into the small intestine.

This is how the next stage of the disease begins, the intestinal. Moving through the body and affecting internal organs, helminthic invasion can cause diseases of other organs and systems, which can be not only dangerous, but also deadly for the child. Therefore, at the slightest sign of illness, parents need to contact a pediatrician and get a referral for enterobiasis.

Ascariasis symptoms. Children infected with worms get sick more often and more severely, they can hardly bear the slightest stress. Kids begin to lag behind their peers in physical and mental development. With a strong invasion, convulsive seizures are observed. In order to prevent this, at the slightest suspicion of ascariasis, you should consult a doctor.

It is important to diagnose the disease in the early stages of infection, otherwise the child's body will face serious complications. Roundworms secrete a very strong allergen that irritates the intestines and lungs, causing conjunctivitis.

Ascariasis leads to chronic respiratory diseases. The weakened body of the child is unable to resist the attacks of viruses and bacteria.

Prevention measures for ascaris in children

Active explanatory work should be carried out among the population. Parents should teach children, starting with the smallest, to use pots or latrines (if they are safe for children), as well as to ensure that young children point out where they contaminate the soil with feces so that it can be cleaned and neutralized in a timely manner.

An important object in sanitary and educational work is the school, where there are all conditions for its systematic conduct among students and their parents (especially mothers), using parental committees and women's councils.

The task of medical workers is to help teachers correctly cover the issues of fighting ascariasis and advise them on the education of hygiene skills in order to prevent infection with ascaris.

Teachers, after appropriate training, can provide significant assistance in carrying out educational work not only among students, but also among their parents.

The school program in zoology provides for familiarization of 7th grade students with parasitic worms (ascaris, pinworms, tapeworms). The primary school curriculum includes a section on the prevention of certain infections, which allows children to be given the necessary information about ascariasis and to instill in them the appropriate hygiene skills. The school should also carry out extracurricular sanitary and educational work in biological circles.

Find out more:

• Ascariasis in children - causes, symptoms, diagnosis and treatment
• Ascariasis in children: causes, symptoms and treatment