Ascaris: Symptoms, Tests And Treatment In Adults And Children

Roundworms are parasites causing helminthic invasion. Ascariasis is a fairly common disease, especially among children. The analysis for roundworm is an important stage of diagnosis, the timely implementation of which helps to prevent the development of complications of ascariasis.

The content of the article:

• 1 Ascariasis
• 2 Ascaris. Symptoms
• 3 Ascaris. Complications
• 4 Indications for examination
• 5 Diagnosis of ascariasis
• 6 Material for research
• 7 Comparative characteristics of laboratory diagnostic methods
• 8 Laboratory diagnostics
• 9 X-ray examinations for ascariasis
• 10 Features of the interpretation of laboratory research results

Ascariasis

Ascariasis - helminthiasis caused by roundworms ascaris (Ascaris lumbricoides, string).

A man, in whose intestines females and males of Ascaris parasitize, is the only source of invasion. Adult roundworms live in the small intestine, where females, after fertilization, lay about 200,000 eggs per day. Getting into the environment with faeces, under favorable conditions, the eggs ripen for 10-15 days or more.

When a person swallows mature eggs, larvae emerge from them in the upper part of the small intestine, which penetrate through the intestinal wall into the inferior vena cava, then into the vessels of the liver and lungs, from where they pass into the alveoli and bronchi. In the lungs, they rise along the epithelium of the respiratory tract into the pharynx and are swallowed into the gastrointestinal tract. After re-entering the small intestine, they develop within 70 to 75 days into adult parasites capable of producing eggs.

The lifespan of an adult roundworm reaches a year, after which it dies and, together with feces, it is removed outside. Therefore, the presence of ascaris in one person for several years is explained only by repeated infections.

The mechanism of transmission of the causative agent of ascariasis is fecal-oral; transmission routes - food, water, household. The use of vegetables, berries and herbs from vegetable gardens, the soil of which is fertilized with non-neutralized feces, contributes to the spread of ascariasis.

In the clinical course of ascariasis, two phases are distinguished - early (migratory) and late (intestinal). The first phase coincides with the period of migration of the larvae, while the second is due to parasitism of helminths in the intestines and possible complications. The main clinical signs of ascariasis are symptoms of lung damage (dry cough, shortness of breath, chest pain), low-grade fever, urticaria, itching, malaise, weakness, headaches, eosinophilia up to 20-30%, hyperleukocytosis.

In the chronic phase of ascariasis, nausea, intestinal dysfunction, abdominal pain, and sleep disturbances occur. Possible complications of ascariasis: pancreatitis, appendicitis, intestinal obstruction.

Ascaris. Symptoms

In the human body, the presence of roundworm can be suspected when, at first glance, common diseases occur: from colds to heart disease.

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  At the very beginning of the disease, ascariasis can be confused with the common cold At the very beginning of the disease, ascariasis can be confused with the common cold. There is malaise, a dry cough with scanty sputum production. The body temperature is either normal - 36.60, or subfebrile - 37.10 - 37.40.
• Sometimes small bubbles appear on the skin of the feet and hands, inside of which are transparent contents.
• The appearance of papillomas and warts on the skin
• Profuse drooling, nausea and flatulence after eating, decreased appetite
• Night gritting or grinding of teeth
• Unreasonable irritability.

Ascaris. Complications

The most important complications are decreased immunity and intestinal obstruction.

• Intestinal obstruction occurs due to the formed lump, consisting of a large number of adult sexually mature ascaris, which completely closes the intestinal passage.
• Blockage of blood vessels in organs by ascaris larvae
• Helminths weaken the body's defenses and can be an indirect cause of various diseases, including oncological ones.

In support of this, watch the video about the surgical intervention for eliminating intestinal obstruction due to proliferating roundworms.

As a result of ascariasis, the following are manifested:

• chronic lung diseases, bronchitis
• sluggish chronic infections
• chronic fatigue syndrome
• heart attacks
• sepsis
• liver disease
• cholecystitis
• pancreatitis
• peritonitis
• allergies
• various diseases of the legs: from a constant feeling of fatigue to large swelling and swelling
• tumors
• dermatitis

Therefore, it is very important to carry out helment diagnostics in the event of a disease in order to exclude the presence of worms. Before talking about high-quality treatment of any disease, you need to cure the patient from worms, since with weak immunity, treatment of other diseases is almost impossible.

Indications for examination

• Inpatients, outpatients (according to clinical indications);
• children in preschool institutions, orphanages, orphanages, primary school students,
• adults, by the nature of their occupation, belonging to risk groups (workers of treatment facilities, agricultural irrigation fields, greenhouses, greenhouses, gardeners, etc.)

Diagnosis of ascariasis

The basis for the diagnosis of the early phase of ascaris is clinical and epidemiological data. Acute clinical symptoms of broncho-pulmonary pathology (fever, cough, chest pains, blood eosinophilia, volatiles and filtrates in the lungs, etc.) in the season of the year, not typical for colds, stay in foci of ascariasis, participation (especially children) in picking berries strawberries, early vegetables - are the basis for a presumptive diagnosis.

The unconditional confirmation of the diagnosis is the detection of larvae in sputum, however, these are very rare findings, therefore, are of little practical importance.

Serological diagnostic methods are proposed: the reaction of precipitation on live larvae of ascaris (E. S. Leikina), the reaction of indirect hemagglutination, latexagglutination, the reaction of accelerated erythrocyte sedimentation (according to Krotov). The methods based on the detection of volatile fatty acids in saliva and urine according to N. Ya. Soprunova were encouraging.

However, having a very important scientific value (the study of immunity, epidemiology, pathogenesis), serological methods have not entered widespread practice. Therefore, if there is a presumptive diagnosis, it is necessary after 3 months (when roundworms reach puberty and begin to release eggs) to conduct a scatological study using the methods of a thick smear according to Kato or the enrichment method (Fulleborn, Kalantaryan, etc.).

Considering the possibility of parasitizing only males, which indicates a non-intensive invasion, when coproovoscopy is negative, diagnostic deworming is recommended.

Research material

• Sputum, fecal samples - microscopic examination, DNA detection;
• blood serum - determination of AT.

Etiological laboratory diagnostics of ascariasis includes in the migration phase - microscopic examination of sputum samples to detect larvae, detection of parasite DNA in sputum or feces; in the intestinal phase - microscopic examinations to identify ascaris eggs in fecal samples, detection of parasite DNA in feces, antibodies to ascaris in the blood - identification of specific antibodies to the parasite's AG.

Comparative characteristics of laboratory diagnostic methods

Confirmation of the diagnosis in the migratory phase of ascariasis is the detection of ascaris larvae in sputum samples during microscopic examination. A negative study result cannot serve as a basis for excluding ascariasis. In such cases, a repeated microscopic examination of fecal samples is recommended to detect ascaris eggs (usually after 3 months).

In the intestinal phase of the disease, the main diagnostic methods are aimed at identifying ascaris eggs in feces (analysis of feces for ascaris). The most commonly used microscopy of a thick smear according to Kato and an enriched preparation obtained using one of the concentration methods (Fulleborn, Kalantaryan, etc.).

DNA detection by PCR is a promising method for detecting both migratory ascaris larvae in sputum and helminth eggs in enriched feces samples.

Currently, there are a large number of reagent kits for detecting AT in the diagnosis of ascariasis. However, many of them have a manufacturer's recommendation to use confirmatory direct tests when positive test results are obtained.

Under these conditions, direct methods for detecting a pathogen (microscopy, DNA detection) are the most accessible method for laboratory diagnosis of ascariasis.

Indications for the use of various laboratory tests

The effectiveness of diagnostics is achieved by the combined use of laboratory and instrumental methods corresponding to the phase of the disease: in the migration phase of ascariasis - sputum examination using direct methods for detecting ascaris larvae, in the intestinal phase - the study of enriched fecal samples by microscopy using, with negative results of the study, methods of radiation diagnostics and diagnostic deworming.

Laboratory diagnostics

Laboratory diagnostics of the intestinal stage of ascariasis is based on the detection of ascaris eggs in the analysis of feces for eggs of the worm or adult ascaris in feces after diagnostic deworming.

But already at an early (migratory or larval) stage, ascariasis can be diagnosed using an immunological study - the determination of specific antibodies to ascaris.

Although the diagnosis cannot be made on the basis of serologic testing alone, results should be considered in conjunction with history and clinical symptoms, early serologic diagnosis allows therapy to be initiated before complications of the disease develop. In immunocompromised patients and neonates, serologic data are of limited value.

A complete blood count shows:

1. 

   Complete blood count is one of the methods for diagnosing ascariasis

   Anemia - a decrease in the number of red blood cells, such as red blood cells with hemoglobin. It arises due to the harmful effects of toxins entering the bloodstream during the life of ascaris, as well as due to a lack of nutrients.

• Hemoglobin norm 120-140 g / l
• Erythrocytes norm 3.5-5.5 million / ml

Eosinophilia - an increase in one of the white blood cell fractions (i.e. leukocytes) called eosinophils. Eosinophils neutralize histamine, a biologically active substance that is released in excess when parasites enter the body. The rate is 0-5%

With prolonged carriage of ascaris, the number of eosinophils in the blood continues to grow steadily and can reach quite significant values up to 15-25%.

However, it must be remembered that an increase in the number of eosinophils and anemia are not strictly specific signs of ascariasis, since they can appear in the presence of any other parasite in the body or other allergic conditions.

It should be borne in mind that with a single study of feces, the absence of helminth eggs does not mean that there are no roundworms, and does not give a reason for a final negative diagnosis. The absence of eggs occurs in the following cases:

1. One female or only one male lives in the intestine. Therefore, the breeding cycle of ascaris is disrupted, and there is no emergence of new offspring.
2. When parasitizing too young and not fully formed individuals, or vice versa, the life cycle of ascaris comes to an end, and they lose the ability to reproduce
3. In some cases, in the treatment of other diseases with various drugs, the reproduction of ascaris is also disrupted at the same time.

X-ray examinations for ascariasis

A simple X-ray of the lungs, along with eosinophilia, can indirectly suggest the presence of ascariasis.

When passing through the pulmonary system, roundworms cause small focal inflammatory changes in the lungs, which remain visible for a long time on radiographic images. The above pathological processes in the lung tissue allow us to assume, together with other diagnostic signs, the presence of ascaris in the body, namely, in the phase when the parasites are just migrating in the lungs on their way to the permanent place of parasitism - the intestine.

Diagnostics of the intestinal phase of the development of parasites is not very difficult, since along with the clinical gastrointestinal syndrome, when analyzing feces for the presence of helminth eggs, it is easy to detect traces of the presence of one or another parasite in the intestine.

Features of the interpretation of laboratory test results

The identification of ascaris larvae or their eggs in any type of test material in the analysis for ascaris serves as an unconditional confirmation of the diagnosis of ascariasis.

Negative results of stool analysis for roundworms can be associated with invasion by males, immature or old females. In such cases, other methods of diagnosing ascariasis are used (X-ray studies with contrast, diagnostic deworming).

Negative results from the detection of ascaris eggs in feces may be associated with invasion by males, immature or old females. In such cases, other methods of diagnosing ascariasis are used (X-ray studies with contrast, diagnostic deworming).

Find out more:

• Worms in humans - symptoms, diagnosis, treatment
• A child has worms - causes, signs, symptoms and treatment
• Helminth worms. What worms live in a person. Types of parasites