Diagnosis of ascaridosis

video Ascarids in the human body can be present simultaneously in several stages of development, from eggs and ending with matureindividuals, due to which it is difficult to diagnose helminthic invasion. For each stage of infection, there is a typical symptomatology, and, nevertheless, the doctor needs to observe the patient for some time to detect ascaris.

How to identify the infection? Diagnosis of the disease depends on the staging of the pathology. Physicians can use the following tests for ascaridosis:

• biochemistry and a general blood test;
• blood test for the presence of antibodies - immuno-enzyme;
• sputum examination;
• stool analysis;
• urine analysis;
• X-ray;
• ultrasound examination;
• anthropometry.

Symptoms of ascaridosis

Most often, the first signs of infection are manifested by the respiratory system and the gastrointestinal tract. The strength of the symptoms depends on the degree of invasion. So, with a small number of parasites, the infection in its beginning can, generally speaking, not manifest itself at all or the person will feel slight weakness and increased fatigue.

In the case of moderate / massive infection, certain pathological symptoms are observed at the very onset of infection. The patient can complain:

• for a cough of different intensity, accompanied by the discharge of mucous sputum with blood impurities( in some cases).A similar symptom is caused by damage to the tissues of capillaries during the migration of larvae into the pulmonary alveoli;
• slight chest pain;
• the appearance of dyspnea during even a slight physical exertion;
• increase in body temperature to subfebrile indicators: 37-37.9 ° C;
• increased sweating;
• abdominal discomfort;
• tachycardia;
• abrupt change in blood pressure indicators. Most often, hypotension is observed, ie, the drop in blood pressure is lower than 90/60 mm Hg. Art.

Symptoms of ascaridosis depend on the current stage of infection of

. During moult larval the symptoms can be as follows: skin itch and rash, rapidly forming swelling, enlarged lymph nodes. In later stages, the existing symptomatology is due to the presence of parasites in the small intestine.

The patient may complain of nausea, vomiting, worsening of appetite and bloating. There may be rumbling in the abdomen, soreness in the navel and epigastric region, disorder of the stool - most often it is diarrhea, weight loss.

Blood test

If a suspicion of infection with ascarids is suspected, the doctor can prescribe the patient a complete blood test, ie, not only a general study, but also extended biochemistry. The analysis can be carried out both in the usual polyclinic and in the laboratory Invitro.

In the presence of infection, the analysis will show specific changes:

• anemia - a decrease in the number of hemoglobin and red blood cells. The reason for its decrease is the influence of toxins that penetrate into the general bloodstream as a result of the life of ascaris. Anemia also develops as a result of a deficiency of nutrients. The norm of hemoglobin is 120-140 g / l, erythrocytes - 3.5-5.5 million / ml;
• eosinophilia - an increase in the number of eosinophils( normal 0-5%).Eosinophils act as neutralizers of histamines, which are produced in large quantities in the case of the presence of parasites in the human body.

In the absence of therapy and prolonged carriage of helminths, the level of eosinophils continues to increase and can reach a level of 15-25%.But the increase in the level of eosinophils in the development of anemia can not be regarded as a clear sign of the presence of ascarids. Similar symptoms are formed in other parasitic infections.

Immunoenzyme assay method( ELISA)

An enzyme-linked immunosorbent assay for ascariasis is recognized as the most effective way to confirm a diagnosis, which allows to identify the infection at the very beginning of its development. After penetration of ascarids into the human body, the immune system starts active production of specific antibodies - immunoglobulins.

They are necessary to eliminate the effects of toxic effects of helminths. It is the concentration and type of antibodies that makes it possible to establish an accurate diagnosis, as well as the degree of helminthic invasion.

Venous blood

is used to analyze ascaridosis in the adult category of patients. Several types of antibodies to Ascarid antigens corresponding to different infection periods - A, G, M, have been used. Depending on the type of immunoglobulin detected, the doctor can obtain information about the timing of the infection. Thus, IgG is detected from 3-6 weeks, and IgM is detected already from the 5th day of infection.

A blood test is only administered if simpler studies have indirectly confirmed the pathology. An essential condition is the presence of a pronounced pathological symptomatology.

Blood donation to immunoglobulins is recommended in the following cases:

• with mixed infections, when it becomes necessary to identify all pathogens;
• if the general blood test is as close to the critical data as possible;
• for the purpose of observing the results of previously prescribed therapy in dynamics.

For the study of blood in an adult a venous blood sample is taken, in children - capillary. Preparation in both cases is standard. The analysis is carried out strictly on an empty stomach, in the morning hours. Before taking the test, a 12-hour hunger is recommended.

For two days before blood donation, you must refuse to take any medications. One day before visiting the laboratory, you should not take alcohol and smoke. It is worth noting that IFA is a rather expensive analysis, but it has undoubted advantages. The study identifies parasites in about 90% of all cases.

Analysis is used as an early diagnosis, characterized by informativeness. It allows the doctor to evaluate the results of drug therapy. There is an opportunity to get a quick result.

The decoding of the study is based on the received data.

Sputum analysis for ascarids

Sputum examination can detect the disease only at the stage of lung injury. It is typical for her to develop a cough with a lot of sputum, which is taken for research. During the microscopy of the material, the lab technician identifies the parasites in the stage of the larvae.

In case of impossibility of obtaining sputum, the flushing obtained during the bronchoscopy procedure is used. It is assigned in exceptional cases, since it refers to expensive research.

Stool analysis

Analysis of feces for the presence of ascaris in them is the most common method for diagnosing helminthic invasion. Sexually mature females lay a huge number of eggs. The fertilized egg is clearly visible when enlarged: it has the shape of an ellipse, up to 60 microns in diameter, with a dense outer shell of yellow color.

In some cases, stool analysis is unsuccessful, because only one-sexed

live in the intestine. One of the laboratory methods can be used to determine the presence / absence of ascarids:

• Füllebörn;
• Kalantaryan;
• Krasilnikova.

It should be noted that a negative result may be erroneous. Especially in the event that the patient has a typical symptomatic pathology. The reason for this can be the finding of all ascarids in the stage of larvae. Laying eggs mature sex females begin only a few months after entering the body of the carrier.

Therefore, signs of a parasitic infection can already be observed, but eggs in feces will not be identified. In such cases, a second test of the stool test is recommended. There is a possibility that all the roundworms will be of the same sex. In this case, females will lay off unfertilized eggs. If the gastrointestinal tract is inhabited only by males, then eggs, in general, will not.

During collection of faeces, certain rules must be observed:

• feces must be collected on the day of transfer to the study - in exceptional cases, the biological material can be stored in the refrigerator on the side shelf for not more than a day;
• to collect feces during menstruation is prohibited;
• feces need to be harvested without using enema;
• in the beginning it is necessary to urinate and only then to empty the intestine - it is extremely undesirable to allow mixing of feces and urine;
• for two days before collection of material, it is necessary to exclude from the diet all gas-producing products, and also to stop using rectal suppositories and any medications;
• before emptying the intestine it is necessary to conduct hygienic washing of the perineum.

From putting the feces on a study on helminthic invasion with acarids, patients with hemorrhoidal bleeding should be discarded.

Urinalysis

Urine biochemical examination may be used to detect ascariasis in adults. In the course of the study, the fatty acids are determined in the urine composition, which confirms the diagnosis. Determine the infection of ascarids by analyzing it can be already at the earliest stage.

Before taking the test, it is forbidden to take medicines, drink alcohol, eat spicy and spicy foods / meals. Before collecting urine, you need to wash your genitals. The first part of urine is not collected.

Radiography

Diagnosis of ascaridosis in adults and children includes X-ray examination. The technique is used to identify the characteristic symptomatology typical for each stage, either pulmonary or intestinal.

Since the X-ray room is available in every clinic, doctors often use this method of diagnosing

helminthiosis. When infecting ascarids on a roentgenogram, characteristic changes will be seen. During the chest X-ray, the doctor can observe the larvae in the human lungs. The average duration of the pulmonary stage is not more than 10 days.

The image shows blackouts that can be mistaken for tuberculosis or pneumonia. But when a repeated picture is taken, the existing blackout either disappears or is found in another part of the lung. This indicates a high mobility of parasites.

When examining X-ray rays of the abdominal cavity, it is impossible to consider helminths. But the sign of their presence is the unnatural expansion of the small intestine. It causes stagnation of fecal masses and formed gases, which can not move in the physiological rhythm from a large number of helminths present in the lumen of the intestine.

Ultrasound diagnosis

The technique is based on the passage of sound waves through living tissues of the body. Consider the helminths on the monitor screen the doctor can not, which is due to the small size of the parasites. In addition, the density of the body of ascarids is almost completely equal to the density of the surrounding tissues.

Ultrasound is one of the most accessible techniques, therefore, it is also used quite often as a diagnosis of ascaridosis. When pathological symptoms of infection with ascarids appear, ultrasound is assigned to exclude other diseases accompanied by such signs - colitis, ulcer pathology, Crohn's disease, etc.

If the diagnosis of "ascariasis" is confirmed, then ultrasound diagnostics will reveal the formed complications, in particular, pancreatitis, cholangitis, gastrointestinal obstruction and others.

Anthropometry

The technique is based on measuring the main parameters of growth and is practiced most often in childhood. In an adult it is not very informative.

Anthropometry, as a preliminary diagnosis of ascaridosis, is used in preschool institutions

Parasitic infection can not be claimed for quite some time, but all this time the helminth feeds on the contents of the gastrointestinal tract, taking a certain amount of vitamins and nutrients.

The lag in physical development will be hardly noticeable with moderate invasion, when no more than 20 parasites live in the intestine of the child. But in case of severe infection - the number of helminths can reach several hundred - there is a significant delay in growth.

In kindergartens, the following measurements are performed:

• growth;
• weight;
• head circumference;
• circumference of the thorax.

Anthropometry allows only to assume the presence of helminthic invasion, but it is impossible to diagnose it with 100% confidence. Confirm or refute ascariasis will only be the result of a serological test of blood. Deviations on the roentgenogram or in the blood and urine can be provoked by other pathologies, therefore these methods are only preliminary.