Ascariasis In Children - Causes, Symptoms, Diagnosis And Treatment

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Ascariasis In Children - Causes, Symptoms, Diagnosis And Treatment
Ascariasis In Children - Causes, Symptoms, Diagnosis And Treatment
Video: Ascariasis In Children - Causes, Symptoms, Diagnosis And Treatment
Video: Ascariasis | Infectious Medicine Video | Medical Online Education | V-Learning™ 2023, February

Ascariasis in children is common and has very serious consequences for children's health. Signs of ascariasis can manifest itself in the form of a cough, an allergic reaction, fever, and rapid fatigue of the child. To establish a diagnosis, it is necessary to conduct a number of laboratory tests, including blood, urine and feces, as well as chest and abdominal x-rays.

The content of the article:

  • 1 What is roundworm
  • 2 What roundworms look like
  • 3 What is ascariasis
  • 4 Diagnosis of ascariasis in children
  • 5 Ascariasis in children - symptoms
  • 6 Ascariasis in children - treatment

    • 6.1 Early treatment
    • 6.2 Treatment of the intestinal stage of ascariasis
  • 7 Forecast and prevention of ascariasis in children

What are roundworms

Ascariasis in children
Ascariasis in children

Roundworms are roundworms-parasites Ascaris lumbricoides. The carrier, or the only host of this species of roundworm, is a person: the parasite matures and multiplies in the human body, not requiring other mammals to be found in the organisms for development.

Symptoms of ascariasis depend on the stage of the disease, the number of parasites and the response of the immune and other systems, and can manifest themselves in a wide range. When diagnosing the presence of ascaris, treatment is carried out with antihelmid drugs, as well as symptomatic medicines aimed at reducing intoxication, and the appointment of a certain diet.

Ascariasis in children. With the invasion of the early stage, ascaris eggs that have entered the gastrointestinal tract, under the influence of enzymes, lose their membrane, and the released larvae spread through various organs: liver, heart, lungs.

With further migration, the ascaris larvae enter the oral cavity through the respiratory tract, from where, together with saliva and ingested food, they return to the intestines for further existence and reproduction at the chronic stage of ascariasis.

What roundworms look like

An adult ascaris looks like a spindle-shaped reddish worm (after death, the body color changes to yellowish-white). The length of a sexually mature helminth depends on age and sex: males can reach a length of 25 cm, a width of 4 mm, females - up to 40 cm and up to 6 mm.

Depending on the presence of a fertilization factor, they differ in size and shape, but even the largest of them do not exceed 100 x 45 microns.

Ascaris carriers are, according to general estimates, almost 1.2 billion people, in some countries the percentage of patients with ascariasis reaches 20. The high fertility of these worms is due to the rather low, compared to the number of eggs laid, survival in the external environment: for further maturation, eggs must be in the soil, passing through the biological cycle of formation of the invasive larva.

Roundworms are exceptionally fertile worms; a female's body can contain up to 27 million eggs in different stages of formation. One adult female is capable of laying up to 240 thousand eggs per day, and up to 64 million eggs per year, as a result of which roundworms are the most common type of helminth with the type of infection through the soil.

In this case, the soil temperature should remain in the range from 13 to 26 ° С, and the humidity of the environment should be from 4 to 8%. With such restrictions on temperature indicators, roundworm is considered a typical parasite-geohelminth, depending on the natural and climatic conditions of habitation.

Ascariasis in children. The most infected habitat is the countries of Africa, Asia, Latin America. In the middle lane, the biological cycle of larval formation is possible only in warm periods, and determines the summer-autumn seasonality of ascaris infection by the consumption of insufficiently pure root crops, berries and greens. Winter cases of infection are due to the storage of vegetables in cellars and storage facilities with an average temperature that supports the vital activity of the larvae.

What is Ascariasis

Ascariasis is the most widespread parasitic disease among humans, which is caused by helminths (ascaris). These are round worms of white, pink or yellow color up to 40 cm long, living mainly in the small intestine, but their larvae migrate throughout the body. In this case, a person himself becomes a source of infection.

Ascaris females lay about 250 thousand eggs per day. With the feces of an infected person, eggs go outside and fall into the soil. Under the right conditions - sufficient oxygen, moisture and heat - they begin to ripen, which takes only two weeks.

Within 2-8 days, they enter the bloodstream, where they circulate for some time and feed on serum and erythrocytes. The liver, gallbladder, heart are the organs into which they enter with the blood stream, after which they are sent to the lungs. The grown larvae stay there for 4 to 14 days.

If the conditions for the maturation of eggs are unfavorable, ascaris eggs can lie in the ground for up to two years thanks to their five-layer shell. In this case, they can only be destroyed with ether, gasoline, alcohol, boiling water or direct sunlight. After entering the human body, larvae are released from the eggs in the small intestine after a few hours.

Ascariasis in children
Ascariasis in children

Over time, the most active of them perforate the alveoli of the lungs and enter the bronchial secretions. When it is coughed up, followed by swallowing, the parasites from the oral cavity again enter the gastrointestinal tract, where they move to their permanent place of localization, the small intestine. There they begin to develop and within two to three weeks turn into sexually mature individuals capable of laying eggs. This entire development cycle takes 2-3 months.

Roundworms parasitize in the body for no more than a year, and then die and leave with feces. Therefore, the disease can go away on its own even without treatment, provided that there was no re-infection. But if this did happen, then later the child will develop relative immunity. And yet, letting the disease take its course is not worth it, since roundworms cause considerable harm to the body.

Ascariasis in children. And first of all, this is allergization and mechanical damage, since when moving with the blood flow, they can rupture capillaries in various organs, especially in the small intestine, liver and lungs, as a result of which hemorrhages appear in them, sometimes quite extensive. Ascariasis occurs only in countries with warm and humid climates. In the deserts and polar regions, no cases of the disease have been recorded, since helminths do not survive in such climatic conditions.

Diagnosis of ascariasis in children

Ascariasis in children
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.

Methods for diagnosing 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.

Ascariasis in children - symptoms

Ascaris can be found everywhere, except perhaps in the deserts and polar regions. Ascaris is a round, up to forty centimeters long, worm of the Nematode class. Ascariasis in children. If a long white worm is found in the child's stool, go to the hospital urgently.

Take the found parasite with you to the doctor, after placing it in a glass jar, and this will make it easier for the doctor to make an accurate diagnosis and allow you to choose the appropriate drug.

The disease of ascariasis has two stages. This is due to the developmental cycle of the helminth. At an early stage, mature eggs enter the gastrointestinal tract, where they turn into larvae and migrate throughout the body, affecting the liver, heart, and lungs.

This is due to the symptoms of an early stage:

  • cough, chest pain, less often shortness of breath;
  • an allergic reaction in the form of a rash;
  • general weakness;
  • rapid fatigue of the child, even from simple actions;
  • sometimes a rise in temperature is possible;
  • the liver may be enlarged.

Such symptoms can be rather mild in children and are in no way associated with helminthic invasion. If a child coughs, but there are no other symptoms of a cold, a rash appears, there is nausea, bloating, pain in the chest and abdomen, it is possible to assume infection with helminths. Especially in the warm season, when children spend a lot of time outdoors in direct contact with the ground, actively eat vegetables, berries, pick fruits from the ground.

But if a child has bad habits such as sucking fingers, or biting his nails, then parasite infection is possible at any time of the year. Dirt accumulates under the nails, which may contain parasite larvae, which can easily enter the body through the oral cavity.

In addition, the habit of sucking fingers and biting your nails is harmful for other reasons. This can cause the development of a malocclusion in children, impaired sound pronunciation, speech, etc. Therefore, do not be surprised if the baby sucking fingers cannot start speaking on time and correctly, and over time you will have to attend speech therapy classes with him.

Ascariasis in children
Ascariasis in children

After two months, adults become sexually mature and send hundreds of thousands of eggs per day to the external environment. The negative effect on the body increases, the symptoms are more noticeable. The quality of digestion deteriorates, the child does not receive the necessary substances for the full development. There is a lack of vitamins.

Ascariasis in children from 3 to 9 years old is an acute form of the disease. As a rule, it passes with a high subfebrile condition or fever, skin exudative rashes. The most common pulmonary syndrome in the form of dry or wet cough with the development of "volatile" infiltrates, less often - pneumonic foci, blood eosinophilia up to 20-40% against the background of leukocytosis.

With ascariasis, children may have heart damage with deafness of heart sounds, tachycordia. Without timely therapy in young children, massive invasion can lead to death.

Ascariasis in children
Ascariasis in children

Sometimes symptoms such as nausea, pain throughout the abdomen, and stool disorders are recorded. If a large amount of the pathogen has entered the child's body, not only pneumonia and pleuropneumonia may develop, but also granulomatous hepatitis with moderate jaundice, hepatosplenomegaly, an increase in serum alkaline phosphatase, transaminase activity, all globulin fractions, bilirubin levels, and shifts in sediment samples.

Ascariasis in children in the chronic stage is manifested by recurrent pain in the epigastrium, as well as around the navel, in some cases, in the right iliac region. Less commonly, symptoms such as increased hunger, constipation, and unstable stools appear.

Weakened children and infants experience diarrhea, and defecation occurs only 2-3 times a day. The stool contains mucus impurities.

Signs of ascariasis in the intestinal stage:

  • Sharp bouts of abdominal pain that suddenly stop;
  • regular disorders of the digestive system in any manifestation (nausea, vomiting, increased salivation, bloating, constipation, loose stools); poor appetite, aversion to food;
  • pale skin with a yellowish tinge;
  • weight loss that occurs even with a dense diet of the child;
  • lag in physical development;
  • mental disorders - fatigue, irritability, headaches, poor sleep;
  • frequent infectious colds.

Ascariasis in children - treatment

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.

Ascariasis in children. 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.

Early stage treatment

Anthelmintic drugs:

  • Helmintox or Thiobendazole (Mintezol);
  • desensitizing drugs;
  • bronchodilators;
  • corticosteroids.

Treatment of the intestinal stage of ascariasis

At the intestinal stage of ascariasis, the following is prescribed: a single dose of Decaris (Levamisole) at a dose of 2.5 mg per 1 kg of weight or Pirantela (Kombantrin) to choose from; multivitamins; iron preparations; enzyme preparations. For the treatment of ascariasis in infants, pediatricians recommend the use of Albendazole. Children over two years of age can take Piperazine for two days. The dose is chosen depending on the age of the child, divided into two doses and given after meals with an interval of 1.5-2 hours.

Paftamon belongs to low-toxic drugs. The dose of the medicine prescribed by the doctor should be diluted in ¼ glass of water and given to the child to drink at one time, then give him a lump of sugar or a spoonful of jam to eat, since the tablets have a bitter taste. This medication is contraindicated for liver problems.

Effective in the intestinal stage and Vermox (Mebendazole), but it is taken within three days. This drug causes increased motor activity in helminths, which can manifest itself as antiperistalsis, vomiting and the ingress of the parasite into the respiratory tract, therefore, Vermox is not prescribed to young children.

Ascariasis in children
Ascariasis in children

Medamin for children with ascariasis is used in a one-day course (the daily dose is divided into three doses). The drug Mintezol helps against larvae. Its daily dose is divided into three doses. This medicine is taken after meals for 5 days.

Ascariasis in children. Before treatment and while taking pills, sour, salty, spicy, fatty, spicy foods should be excluded from the child's diet. In this case, there may be transient side effects in the form of nausea, vomiting, headache and weakness, which disappear immediately after the end of therapy.

During the treatment of ascariasis, the doctor should definitely monitor the child to prevent complications. For the purpose of prevention, all family members are treated with antihelminthic drugs. Repeated analysis of feces for eggs, the worm is given in a month.

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.

Prediction and prevention of ascariasis in children

Roundworms are human parasites, so a child cannot be infected with this type of helminth from cats and dogs. The use of uncooked meat and fish is also not a source of ascariasis.

From an early age, teach your child to wash their hands after contact with the ground, animals, handrails in transport, after visiting public places. Wash outdoor toys with soap and a washcloth, you can process washed toys with hot steam in the dishwasher.

Wash fruits and vegetables thoroughly with a sponge, soak herbs in water with a drop of detergent added; install playgrounds and sandboxes in sunny areas, keep out of debris and feces, loosen the soil - direct sunlight kills ascaris eggs.

Ascariasis in children
Ascariasis in children

Ascariasis in children. Wean your child off the bad habit of biting their nails and pulling their fingers into their mouth. Do not drink raw water or let your children do it. The presence of a cesspool in the courtyard, an outdoor toilet increases the risk of ascaris infection. Do not use faeces to fertilize the soil: this way you can bring parasite eggs onto the site with your own hands.

The health of our children, their well-being and development depends only on the attitude of the parents themselves to this. Teach children to observe basic hygiene rules, undergo a preventive examination in the laboratory and regularly carry out preventive treatment for worms, and then your child will not meet these parasites.

Ascaris eggs have a sticky shell, which makes it difficult to get rid of food and household surfaces. During wet cleaning, you need to change the water as often as possible, use special tools.

After recovery, the child does not acquire immunity to ascariasis. It is necessary to constantly follow the rules of hygiene and precautions to prevent re-infection.

Find out more:

  • Ascaris: symptoms, tests and treatment in adults and children
  • Ascaris in adults: symptoms, treatment and prevention
  • Ascariasis in children: causes, symptoms and treatment

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