Opisthorchiasis children

February 16, 2013

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Opisthorchiasis   - A disease in its essence is a chronic helminthiasis In which mainly affects the bile ducts of the liver and pancreas. According to medical statistics, in the world there are about 21 million. Man Infected opisthorchis . Opisthorchiasis very widespread among animals that feed mainly on fish. However, in endemic areas the main source of infection is people. The causative organism is found in dogs . cats . wild animals . Pathogen opisthorchiasis - parasite, whose name Siberian fluke Or cat .

The disease is detected in the Europe But the most widely distributed in opistorhoz Western Siberia   and East Kazakhstan   (pool Obi   and Irtysh ), And the basin other rivers in particular Dnipro Basin .

How is infection

A person infected with the parasite during the ingestion of raw, dried, salted fish, which belongs to the carp family . It bream . chebak . ide . roach . carp   et al. parasites can also be transmitted to humans from animals. But more often the source of infection is people.

In some regions, indigenous people are infected in opisthorchiasis 80-100% of cases . This situation arises from tradition - eating fish is not treated thermally. In such regions as early as the age of eight disease affects almost all children. The mechanism is similar to the process of contracting the infection ascaridiasis .

The infected fish during digestion in the stomach and duodenum human is freed metacercaria   from their shells. Over several hours, they are moved to intrahepatic bile passages . During the movement of the parasite releases metabolites Which are toxic to the body. Children opistorhoz   clinically manifested depending on how massive invasion was, how old the child, as well as the level of its immunity .

Symptoms

In the development of the disease occurs in the body products antibodies Which in turn provokes allergic reaction . AT liver   and myocardium   an infected person come degenerative processes .

Opisthorchiasis in children who live in highly foci of infection, as a rule, has primary chronic . Where there is a intermediate endemicity, opisthorchiasis symptoms in children appear serious. It is more typical for children aged 1 to 3 years . The acute form of the disease manifested by pain in the epigastric, in the right upper quadrant, sometimes a rash on the skin, upset his chair, catarrh of the upper respiratory tract. Temperature rises to 38 ° C ., The acute form of the disease, and it can grow up 39 - 39, 5 ° C . Increased liver appears lymphadenopathy . hypoalbuminemia . Blood picture changes. As a result, these children observed developmental delays . Therefore, treatment opisthorchiasis children is paramount.

For children 4-7 letnrem age   allergic symptoms when infected opisthorchiasis manifested more clearly. Expressions are also signs of disease in older children: approximately Two to three weeks   after a massive infestation they may appear fever . skin rash . pulmonary syndrome   or pneumonia . There are also expressed myocardial changes . If the disease is difficult, children can develop allergic hepatitis   from jaundice . The development of acute symptoms is gradual, their highest manifestations observed through 1-2 weeks .

With the chronic stage of the disease   children a marked holepatiya Rarely observed gastroenteropatichesky syndrome And a third of children have asthenic syndrome . As a result, children in primary school age slower to develop physically, malnourished, they have regularly observed frustration of a chair. They have often noted a moderate increase in liver without pain. At the same time there heaviness . pain in the right upper quadrant . nausea . poor appetite , so how hypertonic dyskinesia of the gallbladder   becomes hypotonic . By about 15 years   is compensated clinical manifestations of infection, the adolescent laboratory parameters are normalized. Normalization provides state immunity, which by this time is generated by the parasite antigens.

As a complication of the disease can develop choleperitonitis . cirrhosis of the liver . primary cancer of the liver and pancreas . Also, the presence of opisthorchiasis complicates the treatment of opportunistic diseases.

Classification

With the development of acute opisthorchiasis children to distinguish between asymptomatic . erased   and Clinical disease Which can be holangiticheskie . tifopodobnaya . gepatoholangiticheskie . bronchopulmonary   availability. In chronic opistorhoze stand symptomatic   and latent form of the disease . In such a state can be observed holepatiya   and gastroduodenopatiya . After a viral infection in children can develop opisthorchosis cirrhosis of the liver .

With tifopodobnaya version acute illness begins abruptly with fever, chills. There is also cardialgia . lymphadenopathy . skin rash . Often ECG   It notes the presence of diffuse myocardial changes. Patients complain of headaches. From the first days of illness there is a sharp weakness . cough . myalgia And other manifestations of allergy. The duration of acute symptoms - about two weeks.

With gepatoholangiticheskom version there is a strong fever . eosinophilia As well as symptoms that indicate liver damage: jaundice . an increase of bilirubin in the blood . Also exhibit symptoms golangioholetsistita . Basically, it's a pain, similar to biliary colic. In severe cases, the condition is exacerbated by signs pancreatitis .

With   gastroenterokoliticheskom version   Clinical symptoms resemble   catarrhal   and erosive gastritis . enterocolitis . ulcer . At the same time concerned pain in the right upper quadrant . epigastric . nausea . decreased appetite .

With bronchopulmonary version   in the pathological process involved the respiratory system. At the same time there is a person asthenic-vegetative syndrome Which manifests irritability, severe fatigue, sleep disturbances.

Diagnostics

Diagnosis of acute opisthorchiasis   It carried out taking into account the epidemiological history (it is important to know whether there has been eating raw fish of the carp family). Also, the doctor takes into account the characteristic clinical picture and the presence of positive serological reactions. It is important to consider that finding eggs opistorhisov   in the bile and feces may not be earlier than Six weeks after infection .

Diagnosis of chronic opisthorchiasis   It performed similarly on the basis of epidemiological history and characteristic clinical picture. In this case, confirmation of the diagnosis is also revealing in feces and duodenal contents baby parasite eggs. Additionally, ultrasound is performed, in which children in primary school age revealed biliary dyskinesia hypertensive type, and the older children there is a hypotonic dyskinesia type.

Treatment

Child opistorhoz acute stage must be treated so as to primarily remove manifestations of high fever . Initially held detoxification therapy During which appointed antihistamines, calcium salt. If the disease runs hard, then practice techniques glucocorticoids . Also appointed cardiovascular drugs.

The second stage treatment is practiced praziquantel   ( biltricid ). This drug is effective anthelmintic   broad spectrum that affects the majority of trematodes   and cestode . Note, however, that the drug is toxic effect on the internal organs, particularly the liver, the pancreas, which have already been subjected to shock opisthorchiasis. Therefore, after reception can occur nausea . vomiting . diarrhea   and others allergic reactions .

In the process of treatment and recovery period the patient is a diet that reduces the amount consumed fat . roughage . Children are also encouraged to receive ascorbic acid .

During the treatment it is important to carefully monitor how it is effective. To this end three and six-month study performed feces and duodenal contents. If later six months   parasite eggs are found, the therapy practice azinoksom . At the dispensary observation of children staying for three years after the last treatment. Appointed as anti-inflammatory drugs salicylates . Ascorutinum . phenylbutazone . This takes into account the likelihood of developing vasculitis .

After the liberation of the body from being infected children need rehabilitation treatment Which is appointed by taking into account the individual characteristics of the patient. This restorative drugs, holding physiotherapy , Nutrition. Forecast opisthorchiasis children provided timely diagnosis and proper treatment is favorable.

Prevention

The main method prevention of child opisthorchiasis   - Eating fish of the carp family only after heat treatment . In regions where infestation is fixed, it should lead an active health education of adults, aimed at complying with their rules of supply. In no event should not be given to young children raw fish . It is important to avoid contact with sewage in the river basins, to control whether the fish are not infected, which falls on the production or trading network parasites. It requires properly fish processing , Producing hot smoking after salting fish. In a properly processed fish and canned fish metacercaria   It is not contained.