Ascariasis In Children: Causes, Symptoms And Treatment

Ascariasis is a fairly common disease among children. Roundworms in a child can start for various reasons, but the most common of them is non-compliance with the rules of personal hygiene.

The content of the article:

• 1 Ascariasis in children
• 2 General
• 3 Pathogenesis (what happens?) During ascariasis in children:
• 4 Causes of ascariasis in children
• 5 Symptoms of ascariasis in children and adults
• 6 Diagnosis of ascariasis in children
• 7 Treatment of ascariasis in children
• 8 Ascaris in a child: why you should not be afraid of drugs
• 9 Ascaris are afraid of celandine juice, but …
• 10 Ascaris are afraid of pumpkin seeds from a folk recipe, but …
• 11 Ascaris are afraid of garlic from a folk recipe, but …
• 12 Consequences, complications of ascaris in children
• 13 Forecast and prevention of ascariasis in children

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.

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.

General information

Most often, the disease occurs in a warm, humid climate, however, cases of infection are regularly recorded in our country. According to statistics, more than 1 billion people are infected with ascariasis in the world.

Ascaris human belongs to the order of roundworms. In their development, these worms must go through several stages. Human infection occurs by swallowing mature ascaris eggs.

Ascariasis. In the intestines, larvae emerge from the eggs, which penetrate through the intestinal lining into the blood. With the blood flow, the larvae must enter the lungs, then, with sputum, go out into the bronchi, pharynx and return to the digestive tract, and more specifically to the small intestine, where they can turn into adults, gain a foothold and begin to lay eggs.

The existence and development of ascaris in the intestine lasts about 1 year, during which females lay up to 240,000 eggs per day. Eggs along with feces fall into the soil and the entire path described is repeated over and over again.

Pathogenesis (what happens?) During ascariasis in children:

The invasive roundworm larva is released from the membranes in the upper gastrointestinal tract due to the action of enzymes. The larva from the small intestine enters the blood vessels. Ascaris larvae "pass" through the portal vein through the liver, entering the right heart, and through the small circle of blood circulation enter the lungs.

From the capillaries, the larvae penetrate the alveoli, then gradually rise along the bronchial tree to the larynx, enter the pharynx, are swallowed with saliva and again enter the small intestine. The migration process described above takes 2 to 3 weeks.

The larvae mature to adults within 2 months. In the small intestine, edema, hyperemia, proliferation of macrophage elements, lymphoid, eosinophilic reactions (local and general) occur.

In ascariasis, digestive upset is caused not only by an inflammatory reaction with hypersecretion of intestinal enzymes, but also by a disruption in the production and mutual regulation of peptide hormones.

Causes of ascariasis in children

The source of soil contamination with helminth eggs is a person with ascariasis. Roundworms themselves are not viable in the external environment, and their eggs can persist in the soil for many years. Infection with ascariasis in children is carried out by the fecal-oral route by swallowing ascaris eggs with larvae matured to the invasive stage.

The greatest risk of contracting ascariasis in children is in summer and autumn due to insufficient adherence to the rules of personal hygiene after contact with the ground and grass (while walking on the playground, in the sandbox); when consuming unwashed vegetables, fruits, herbs, unboiled water.

Ascariasis. The life cycle of the roundworm includes several phases of development. From the mature ascaris eggs that have entered the intestines, larvae are released, which penetrate through the mucous membrane into the portal vein and, circulating through the bloodstream, spread to the liver, gallbladder, right ventricle of the heart, lungs and bronchi.

When coughing up with bronchial secretions, the larvae enter the oral cavity and when swallowed with saliva - again into the small intestine, where they reach a sexually mature state.

The period from the moment of infection to the development of an adult ascaris takes 2.5-3 months, which corresponds to the early migratory stage of the disease. During the late intestinal stage of ascariasis in children, adult worms parasitize in the body. In a day, the female roundworm lays up to a quarter of a million immature eggs, which are excreted with the patient's feces.

The lifespan of adult ascaris is no more than 12 months, after which they die. A new generation of larvae in the same organism cannot appear, and even in the absence of treatment, ascariasis in children completely stops after about a year, if during this time no re-infection has occurred (including autoinvasion).

Symptoms of ascariasis in children and adults

What can bother a person after infection, what are the symptoms of ascaris that differ from other diseases? The clinical symptoms of ascaris in both children and adults directly depend on the intensity of infection, on the localization of parasites, and on the phase of development of ascaris: the first is the migration phase During this phase in the development cycle of ascaris, symptoms in adults can be mild and most often pass without complications.

In varying degrees of severity, there may be general malaise, body temperature is subfebrile, usually does not rise above 38C, a dry cough with mucopurulent or mucous sputum appears, the color of bronchial secretions may be orange with streaks of blood. Sometimes wet or dry wheezing or shortening of the percussion sound is heard, there may also be dry or effusion pleurisy. X-rays of the lungs reveal "volatile" infiltrates - round, round, stellate, polygonal, scalloped.

They can be numerous, and single, and in one, and in both lungs. If there is not an intense, minor infection of roundworm in children, it can be asymptomatic, in an erased form. Less often, with a massive intake of eggs into the body, in children even the migration phase can be accompanied by significant intoxication symptoms, while lymph nodes, fever up to 38C, headache, enlarged liver, spleen can be increased.

Ascariasis. A very distinctive feature of ascariasis in this phase of larval migration is the appearance of allergic skin reactions, especially often urticaria on the feet and hands, as well as allergic dermatoses.

Therefore, eosinophils in the blood can reach 30-40%, this is found simultaneously with infiltrates in the lungs, and a slight periodic leukocytosis is also possible, ESR is usually kept within normal limits (see causes of increased ESR). Changes in the lungs persist for about 2-3 weeks, then disappear, there are cases that infiltrates are found again after a few months and persist longer. Obstruction of the bronchi often occurs in children. Late phase - intestinal parasitism.

This phase is called intestinal, and after a secondary entry into the small intestine, roundworms lead to symptoms of dyspepsia, when diarrhea is replaced by constipation, flatulence is observed, even cholera-like, dysenteric symptoms, or signs of typhoid fever appear, however, in such cases, against a background of decreased immunity, it can there is also a combination of infectious diseases with ascaris.

In the late phase of ascariasis, children often complain of abdominal pain, nausea, less often vomiting, lack of appetite, lose weight dramatically, get tired very quickly, look emaciated and sick.

Abdominal pain is localized either on the right in the iliac region, or near the navel, cramping in nature, redness and itching may appear in the anus. On the part of the nervous system, astheno-neurotic syndrome is often pronounced - hysterical seizures, nightmares, anxious dreams, throwing in a dream, groans, screams, insomnia, meningism, epileptiform seizures. Frequent symptoms of ascaris are extremely rapid mental fatigue, dizziness, and headache.

Very rarely, but there are cases of appearance of changes in the eyes - photophobia, pupil enlargement, amblyopia, anisocoria. Many patients experience a drop in blood pressure. Sometimes the presence of ascaris, in children, leads to the development of bronchial asthma or frequent bronchitis, in blood tests due to exhaustion, reduced absorption of trace elements, vitamins, anemia is observed, and eosinophils return to normal.

With the development of ascaris in children, the symptoms listed above are often complicated by recurrent stomatitis (see stomatitis in children), purulent diseases of the mucous membranes, skin.

Ascaris invasion leads to a significant decrease in immunity, therefore, children can be seriously ill for a long time with various infectious diseases.

Complications that can cause invasions of roundworms are associated with their motor activity through the intestinal wall, during migration, they mechanically injure it.

With massive infection, this can lead to a through hole in the intestine - perforation, and getting into the cecum, can lead to the development of acute appendicitis in adults or appendicitis in children.

In severe cases of severe invasion, with ascaris crawling into the bile ducts, the development of biliary colic, purulent cholecystitis (inflammation of the gallbladder), the development of obstructive jaundice, granulomatous hepatitis with hepatosplenomegaly, liver abscess, peritonitis and the development of intestinal obstruction is possible.

The medical literature describes clinical cases when massive invasions led to the fact that worms crawled into the pharynx, paranasal sinuses, into the respiratory tract, leading to suffocation, and also found roundworms in the pulmonary artery and right ventricle of the heart and even the human brain.

Diagnosis of ascariasis in children

Diagnosis of the early stage of ascariasis in children is based on clinical and epidemiological data and the presence of additional signs: leukocytosis and eosinophilia - in a general blood test, larvae in a microscopic smear of sputum, eosinophilic infiltrates on radiography of the lungs. The proposed serological methods for the diagnosis of ascariasis in children (the reaction of precipitation on live larvae of ascaris, the reaction of indirect hemagglutination with ascariasis antigen, etc.) are not widespread.

A more accurate diagnosis of ascariasis in children is possible 3 months after infection, during the chronic intestinal stage of the disease, when the worms become sexually mature. For this, a laboratory study of feces for helminth eggs is carried out.

In some cases, adult roundworms can be detected during bowel and chest X-rays, as well as endoscopic examinations or surgical procedures in pediatric gastroenterology.

Treatment of ascariasis in children

Children with an established diagnosis of ascariasis are prescribed anthelmintic drug therapy; the type of drugs and the duration of the course of treatment are selected by the pediatrician, depending on the severity of the disease.

In the early migratory stage of ascariasis in children, desensitizing and antihelminthic agents are prescribed - thiabendazole or mebendazole, which have a wide spectrum of anti-nematode activity. Pulmonary manifestations are stopped by taking bronchodilator and corticosteroid drugs.

For the treatment of the intestinal stage of ascariasis in children, the following is used by choice: levamisole - once; pyrantel - once; piperazine, mebendazole - for children over 2 years old, especially with polyinvasion.

The effectiveness of the treatment of ascariasis in children with these drugs is 80-100%. A month after the treatment, a control examination of the child is carried out.

Ascaris in a child: why you should not be afraid of drugs

Despite the dubious effectiveness and danger of folk remedies, many parents first try to treat ascariasis in children according to grandmother's recipes, and only then go to the clinic.

Modern anthelmintic drugs are devoid of the disadvantages of folk remedies, such as the high toxicity of the active substance for humans, and have a convenient form of release that makes it easy to dose the drug.

A medicine based on albendazole (Aldazole) not only causes paralysis of the muscles of helminths, but also inhibits their respiration at the cellular level, which leads to the rapid death of worms and a decrease in intoxication with the poisons that roundworms release during agony.

Another reason for mistrust of the official drugs lies precisely … in their high efficiency. Roundworms "bite" into the outer layers of the intestinal mucosa and, after death, do not immediately come out with feces. If there were a lot of ascaris, the decomposition of dead worms may be accompanied by symptoms of intoxication, similar to the flu - "aches" in the joints, redness of the whites of the eyes, fever. Often these symptoms are attributed to side effects of drugs, which is not at all the case.

To prevent intoxication of the child's body due to the remains of ascaris, 8-12 hours after taking the anthelmintic, the child should be given a cleansing enema.

Ascaris are afraid of celandine juice, but …

The situation with celandine juice is as follows: its destructive effect on worms is based on the fact that the plant juice contains alkaloids that cause cramps and muscle paralysis. With a properly selected dosage, ascaris "paralyzes" and they, unable to move against the movement of feces, leave the intestines.

The problem is that celandine is poisonous to both helminths and humans. Unlike modern anthelmintic drugs, for example, based on albendazole (Aldazole), which is practically not absorbed in the intestine, celandine alkaloids penetrate into the blood.

In addition, the concentration of active substances in celandine juice depends on many factors - the time of year, air temperature, soil moisture in which the plant grew, etc. Therefore, it is almost impossible to find a dose sufficient for the death of worms, but safe for the child. Usually, treatment of ascariasis with celandine juice either does not give an effect, or leads to severe poisoning.

Ascaris are afraid of pumpkin seeds from the folk recipe, but …

The green peel covering the seeds contains a substance that causes muscle paralysis in roundworms (roundworms are one of them), and this drug is sold in pharmacies as an anthelmintic.

However, pumpkin seeds are more likely to treat pinworms, which are much smaller than roundworms and have thinner skin. Therefore, in order to feel the effect of pumpkin seeds with ascariasis, just eating a handful of seeds is not enough.

Traditional recipes for the treatment of ascariasis provide for insisting four tablespoons of pumpkin seeds in a glass of alcohol for three days and taking a tablespoon of tincture every hour during the day. It is clear that this method is not applicable for children - a glass of alcohol will cause much more negative consequences than an anthelmintic drug.

Roundworms are afraid of garlic from a folk recipe, but …

Garlic for roundworms, like for vampires, although unpleasant, but not fatal. Essential oils of garlic really irritate the receptors on the skin of ascaris and helminths begin to move, trying to get away from the aggressive environment. This is where the most unpleasant part begins. To survive in the intestines, roundworms constantly have to move in the opposite direction to the movement of feces, this is genetically inherent in them.

Having sensed an unpleasant odor, the worms, contrary to our expectations, are not directed to the anus, but move upward, falling into the stomach. In theory, the adult roundworm is not adapted to life in the stomach and should die from the action of gastric juice.

It is also possible that with a large number of them, the helminth will be able to get into the esophagus and rush up. At best, it will come out through the mouth and nose, as a result of which the child is guaranteed extreme stress.

At worst, they will cause blockage of the airways and asphyxiation. In this case, only immediate surgical intervention can save the child's life.

Consequences, complications of ascaris in children

Since roundworm larvae during migration can cause mechanical damage, this is dangerous, especially for an immature child's body. Both blood vessels and various organs can be damaged, accompanied by minor or severe hemorrhages, leading to ulceration, necrosis, perforation of the lungs, liver, intestines.

Moreover, with the growth of larvae and adults, they deplete the body, sucking out nutrients, and their waste products have a powerful allergic and toxic effect on the body. If the treatment of roundworm in children is not carried out in time, such helminthic invasion leads to general sensitization of the body, severe local allergic reactions (urticaria) or general (asthmatic suffocation, obstructive bronchitis) develop.

Roundworms in children, as well as in adults, lead to the development of intestinal dysbiosis, immunity is suppressed, and the immune response to various infections weakens.

With massive infection, complications can be significant, leading to spastic or mechanical obstruction of the intestinal lumen, bile ducts, intestinal obstruction, cholecystitis, acute appendicitis, pancreatitis, obstructive jaundice may develop.

Prediction and prevention of ascariasis in children

In uncomplicated cases of ascariasis, anthelmintic treatment usually leads to a complete recovery of children without any consequences; in complicated cases, the prognosis depends on the severity of the complication that has developed.

Primary prevention of ascariasis in children consists in observing personal hygiene measures, secondary - in carrying out sanitary and hygienic measures (protecting soil and water bodies from fecal contamination, actively identifying and treating patients with ascariasis, informing the population).

Find out more:

• Helminths in humans: signs, symptoms and treatment
• Ascaris in adults: symptoms, treatment and prevention