A parasite can appear in the human body that feeds at the expense of the host while doing harm to it. On its presence may indicate anemia, allergic reactions, decreased immunity, indigestion, lack of appetite.
One of these parasites is ascaris, which can cause a number of complications due to the fact that its life cycle requires movement through the bloodstream. Diagnosis of ascaridosis in children is effective at any stage of the development of the worm.
You can swallow the larva with unwashed fruits, greens, contaminated water. They can be transferred to products by flies or ants. As studies show, eggs are often found on door handles, money, in reservoirs, on handrails in public places.
Therefore, even if you think that hygiene is at the proper level, and the symptoms of ascariasis are evident, it is nevertheless highly recommended to carry out a diagnosis.
What are the symptoms of ascariasis
If a little bit of ascaris is parasitized in the human body, then the disease can proceed without a pronounced symptomatology. Signs of the presence of helminth( allergies, symptoms of poisoning) can be observed a few days after infection.
Weakness, lethargy, low-grade fever, chest pain, skin rash, itching, coughing( unproductive or with phlegm) are noted. With infection, lymph nodes, the liver and the spleen are markedly enlarged.
The adult specimen provokes the following symptoms:
- indigestion( due to reduced acidity and lack of enzymes);
- abdominal pain( occurs intermittently);
- decreased appetite;
- increased production of saliva;
- intolerance of individual products;
- nausea;
- bloating, rumbling;
- stool disorder;
- weight loss;
- decreased immunity( leading to frequent colds);
- asthenovegetative syndrome( fatigue, poor memory, irritability, inattention, sleep disturbance, coordination problems, involuntary muscle contractions and epileptiform convulsions are possible).
In the process of life ascarid produces toxins that lead to symptoms of poisoning and provoke allergic reactions
But even if there is no bright clinical picture, this does not mean that ascaridosis does not require treatment. Larvae of helminth damage the walls of organs and vessels, which is accompanied by bleeding( limited or significant), inflammation followed by exudation, necrosis and ulcers. Most of the damage occurs in the liver, small intestine, lungs.
The body of the carrier becomes extremely sensitive to the irritating effect of foreign substances, this results in the appearance of an excessive immune response to minor irritations( the allergy may be general and local).If a nematode is present, preventive vaccinations are not recommended, since their effectiveness is greatly reduced.
Diagnosis
The method of diagnosing ascariasis depends on the expected stage of the development of the worm. The life cycle of the worm includes two stages:
- migration;
- intestinal.
When a mature egg enters the intestine, the larval membrane is destroyed by enzymes of the digestive tract( molt).Through the wall of the intestine, the individuals enter the portal vein and are transported to the liver, the right ventricle of the heart, the gallbladder, and into the airways through the bloodstream.
At first, ascaris feeds on blood serum, as it develops, oxygen needs it and it consumes red blood cells. It is because the larva is required for development and migrates to the lungs. When coughing, the larva with phlegm is in the mouth and is swallowed again. Now the worm in the large intestine is able to reach the sexually mature state.
Depending on the intended stage of the parasite development, the physician may prescribe the following studies:
- general clinical( urine, blood test).Indirectly indicate a helminthic invasion;
- specific( PCR stool and phlegm).They help to detect and identify the parasite;
- serological( antibody test).These include the indirect hemagglutination reaction( RNGA), immunofluorescence( RIF), and enzyme immunoassay( ELISA);
- additional( ultrasound, CT, endoscopy, x-ray, anthropometry).They do not allow to see the parasite, but they can exclude pathologies with such a symptomatology and reveal complications of ascaridosis.
Ascaridosis causes dysbiosis and immunosuppression, which causes frequent colds.
. Diagnosis at an early stage.
. You can confirm infection with ascarids at the stage of migration of the larva by establishing clinical and epidemiological information and conducting an additional laboratory study.
General blood test
The patient must take a blood test from the finger or from the vein. The increase in leukocytes and eosinophils will indicate the presence of an infection, to which the body responds with increased production of histamine( allergy).Normally, the blood contains up to 5% of eosinophils, while helminthic invasion, this figure is increased by 5 times.
Sometimes anemia occurs because the helminth feeds on cells carrying oxygen. The presence of worm in the body can be indicated by an increase in ESR to 15-20 mm / h. In the chronic course of ascariasis, the number of leukocytes decreases, which affects the immune system.
Thus, indirectly on developing ascariasis indicates a decrease in the level of hemoglobin, an increase in eosinophils and leukocytes. Blood is shed on an empty stomach. Three days before the analysis should stop taking medication, not to drink alcohol, to exclude heavy food.
If it is expected that the infection occurred within the last three months, then blood, urine, and sputum tests are prescribed.
Biochemical urine test
The analysis is aimed at finding fatty volatile acids. Their high concentration indicates the infection with worms. This method is nonspecific, since acids can be a sign of other pathologies. This analysis allows one to assume helminthic invasion at the stage of repeated penetration of the larva into the intestine, when the individual is not yet sexually mature.
Examination of sputum
If a patient is suffering from a wet cough, sputum analysis is assigned. In it, larvae can be found. The analysis is not always able to confirm the presence of the parasite, since the study may not coincide in time with the moment of exit of the larvae from the lungs. If the larvae were not found, then it is recommended to conduct a second analysis 2-3 days later.
If the cough in a patient is unproductive, then lavage is used, which is taken with bronchoscopy. This method is prescribed if there is no other way to confirm the diagnosis( the symptomatology is pronounced and the patient can not wait).
Radiography
X-ray photographs of the lungs show focal inflammations that occur when the ascarids pass through the pulmonary system. These changes are visible for a long period, but when they are detected, ascariasis can not be confirmed.
Radiography of the lungs will show the presence of an eosinophilic infiltrate, that is, the accumulation of cells in a certain area of the lung( a shadow is seen on the X-ray, after a while there is no seal on the re-image of the seal).The reason for the appointment of radiographs are complaints of weakness, fever, cough, in which the mucous or muco-purulent bronchial secretion is separated with an admixture of blood or metallic taste.
If the infiltrate is accompanied by an increase in the blood of eosinophils, and a picture taken in a week does not show a shadow, the doctor suspects the presence of an allergic disease. It could arise as a result of taking medications, vaccinating, worm or bacterial infection, launched by a plant agent.
Radiography is effective only during the migration stage, when the larva passes through the lungs. Several pictures are taken from intervals of several days, when compared, one can trace the movement of the larva.
An x-ray of the abdominal cavity shows intestinal obstruction, accumulated fecal masses and air, an enlarged small intestine. If you drink a contrast agent( barium) before the procedure, then the worm will be seen in the picture.
Ascarids reproduce sexually; therefore, for the isolation of eggs, heterozygous individuals are required.
Analysis of feces for ascariasis
After the migratory stage, intestinal infection occurs( in the intestine an adult lives).For 24 hours a female produces up to 240 thousand eggs, which leave the body of a person with calves. The worm is able to parasitize in different organs, but more often it is found in the small intestine.
Stool analysis is informative only when a mature individual lives in the body, that is, three months after infection with helminth eggs. Laboratory research discovers helminth eggs, which the female secretes in huge quantities.
This method allows you to accurately establish the diagnosis and type of worm. But eggs are not allocated with each emptying of the intestine, so the analysis can be carried out more than once. In addition, one worm or same-sex can parasitize in the small intestine, so eggs are not excreted.
No special training is required before material is collected for analysis. Please note that the material must be placed in a sterile container. It is not recommended to take the feces of a child from a pot. For analysis, 8-10 cm3 of material( about two teaspoons) is sufficient.
Analysis of blood for helminths
At any stage of the life cycle of the worm, blood tests for the detection of worms are informative. Serological, immunological and nonspecific methods may be used. During the study, the specialist is not looking for ascarid larvae, but for antibodies to them.
If the analysis showed the presence of specific antibodies, and in the stool eggs were not found, then with absolute certainty one can speak of helminthic invasion. It should also be taken into account that the immune response does not appear immediately after infection with ascaris. Immunity produces antibodies only on the 18-20 day after infection, the maximum number of them is registered on 30-40 days.
The most common diagnosis of ascariasis does not cause difficulties
The serological method helps to detect specific antibodies that are produced by the immune system in response to the toxins released by the worm. In helminthic invasion, immunoglobulin E is synthesized. During the study, specific antibodies M and G are also detected. The titer above 1: 100 indicates infection with ascaris.
The presence of an immunoglobulin can also reveal the stage of the disease. So, IgG appears 20-40 days after infection, and IgM is on the fifth day. For analysis, the adult takes venous blood, and the child has a capillary blood.
The PCR method is aimed at detecting helminth DNA.It allows you not only to detect the worm, but also to determine what kind of worm it belongs to. And although a laboratory test for the detection of helminths is accurate, it is not always prescribed.
Additional study of
If the larvae penetrate the liver, causing difficulty in the outflow of bile, they can be excised during ultrasound. In the liver, noticeable anechogenic foci, having a round shape and even margins.
Patients with clinical symptoms of ascariasis may be assigned ultrasound of the abdominal cavity to detect pathological changes in the liver, gall bladder, pancreas, which are provoked by the parasite. For the same purpose endoscopy, laparoscopy, CT, MRI can be prescribed.
Since in young children as a result of ascariasis physical development can be disrupted( due to anemia, nutritional deficiencies and vitamins), anthropometry may be required to confirm a lag behind the age norm.
Askaridosis in young children can cause somatic diseases, an allergic reaction, a delay in development. Therefore, as soon as the first signs of infection have appeared, you need to consult an infectious disease specialist or pediatrician. It is necessary to teach the children to observe the rules of hygiene and to ensure that they do not suck their fingers and do not gnaw on their nails.
The nematode parasitizes up to a year, then the worm dies. In view of the fact that the larva can only ripen in the soil, the new generation is not capable of infecting the host. It turns out that if only one worm lives in the body, then even without therapy it will die, and the symptoms of the disease will pass. But there is no guarantee that the child does not "eat" eggs of the larvae several times a year.