Opisthorchiasis

March 6, 2012

Related Articles:

• Biltricid, reviews about the drug
• Viral Hepatitis B
• Tablets Worm
• Pediculosis

Tweet

Opisthorchiasis   - A disease which is part of a group helminthiasis . The illness affects the pancreas and liver. The causative agent is a parasite opisthorchiasis called   Siberian fluke   or cat . This parasitic worms not only in humans but also in animals - dogs, cats, and wild animals. In the body it lives in a gall bladder, pancreas, liver, biliary tract.

Prevalence opisthorchiasis

Outbreaks opisthorchiasis formed due to the influence of different factors: the presence of water bodies, their sewage pollution, population dietary habits (eating raw fish). In today's world, the bulk of the area opisthorchiasis located on the territory of Russia and Ukraine.

Experts have concluded that over the past ten years the number of cases decreased markedly invazirovannosti citizens. Yet the dynamics of the disease suggests that surveillance should be carried out without fail.

Infection opisthorchiasis comes from an infected person or animal. Parasite eggs in the faeces fall into the water. They then ingested by snails, where the larvae and grow. Thereafter, the water into larvae cercariae . In turn, they penetrate into fish, preferably carps.

As a result, people and animals infected opisthorchiasis in fish consumption. It is especially dangerous to eat raw, dried, heat-treated bad fish that may contain infective larvae of the parasite. The most common infection of the disease occurs in endemic foci.

Metacercariae   They have very high vitality, Thus, even at temperatures of about - 40 ° C they may be stored for up to six hours. They have a lower resistance to high temperatures and salt.

After ingestion occurs digestion capsules metacercariae . In turn, the thin shell gealinovuyu larva breaks in the duodenum. Of colon parasite larvae penetrate into the gallbladder bile duct, as well as in the ducts of the pancreas. After about 3-4 weeks metacercaria already lay eggs. That is the whole cycle of the parasite lasts about four months. Infestation occurs in the body of an infected person solely as a result of repeated infections. Opistorhisov can live for 20 to 25 years.

Symptoms opisthorchiasis

If a person holds opistorhoz, symptoms begin to appear between the fifth and the forty-second day after infection disease. The disease can be mild, moderate and severe. The incubation period for this last approximately 21 days. As a rule, opistrohoz begins abruptly, in more rare cases, the disease develops gradually. At the same time the patient complains of severe fatigue, periodic sweating, malaise. The further course of the disease goes largely subclinical, the symptoms expressed little. The patient may have a fever, however, recovery is generally small - 38 ° C. If a person appears opistorhoz, symptoms may be expressed eosinophilia   Modest leukocytosis .

However, if there is an acute form of the disease, when opistorhoze moderate severity in a patient observed hyperthermia , Increase in body temperature, which can reach 39 - 39, 5 ° C. These symptoms also complement the catarrhal phenomena upper respiratory tract. Eosinophilia, and leukocytosis is growing, there is a moderate   increased erythrocyte sedimentation rate .

Patients opisthorchiasis mild to moderate forms of severity noted that after one or two weeks significantly improved their condition. In this case, there is a latent phase of the disease, which continues to have a chronic course of the disease.

If acute opistorhoz manifested in severe (about 10 - 20% of people says it is the course of the disease), the disease can have a number of variations. Thus diagnosed tifopodobnaya . gastro-enterokolitichesky gepatoholangitichesky options, as well as a variant of the disease that affects Airways . In the latter case it manifests opistorhoz bronchitis . pneumonia .

At typhoid form Which often manifests itself opistorhoz, most pronounced symptoms indicate an allergic nature of the acute phase of illness. In this case, the disease begins acutely, the patient is suffering from a sharp increase in body temperature, he manifested fever, rashes on the skin. Quite often observed cardialgia In which the ECG noticeable diffuse myocardial changes, as is the case intoxication   organism. Acute onset of the disease, in addition, in the first days is accompanied by severe headache, malaise, myalgia, dyspepsia. The man thus may suffer from cough and other symptoms characteristic allergies . Opisthorchiasis acute manifestations usually lasts about two weeks.

To gepatoholangiticheskoy form   disease characterized by high fever, eosinophilia. In addition, there are signs of diffuse liver disease: patients seen hepatosplenomegaly . jaundice , Increased levels bilirubin   in the blood increases the protein level. Patients concerned about pain sometimes they resemble colic in some cases appear as dull and aching. If the disease takes a severe form, may be a manifestation pancreatitis   and malfunction of the pancreas. In this case, there are dyspeptic symptoms, the pain of herpes character.

If opistorhoz manifested in gastroenterokoliticheskom version , The disease takes the form of erosive katarralnogo gastritis . duodenal and gastric . enterocolitis . In this case, the characteristic symptoms occurs in the right upper quadrant pain, epigastric. Man very concerned about nausea, vomiting, decreased appetite, broken chair. When fibroskopicheskom study observed erosive and hemorrhagic gastroduodenitis And in some cases - ulcerative niche. Weaker expressed intoxication and fever.

Approximately one third of patients suffering from involvement in disease Respiratory That manifest inflammatory processes in the upper airways, pleurisy, pneumonia, bronchitis, wheeze. The man at this present form opisthorchiasis asthenic-vegetative syndrome, which is manifested by weakness, sleep disturbances, fatigue, irritability.

Sometimes the acute stage of the disease has a protracted course: in this case, the fever can last for about two months or even longer. In this case the patient does not pass pulmonary syndrome, and are signs of liver damage. In the process of reducing the manifestations of acute stage of the disease gradually overall normalized, modified form of the disease, turning into a chronic phase. Very often this is manifested biliary dyskinesia . chronic pancreatitis . Chronic holangioholetsistit . Such conditions, in turn, become a factor contributing to secondary bacterial infections. As a result, the patient may develop loss of the hepatobiliary system holangiogepatita the type in which there is severe pain, jaundice, enlarged liver. If the pancreas is affected, the infected person appears opisthorchiasis pancreatitis.

As a result of shock syndrome often arises gastritis chronic nature , and duodenitis .

Sometimes patients complain of pain in the heart, irregular heartbeat. These phenomena are associated with the presence of degenerative changes in the myocardium. In the process of developing the disease is suppressed and exhausted pituitary .

Opisthorchiasis children   expressed usually mild, with an acute form of the disease appears much less frequently than in adults. Children aged one to three years in chronic phase of the disease manifests itself lagging behind in physical development, signs of biliary dyskinesia, the baby does not eat. When the child grows up, he had a pronounced sensitization, when the adolescent patient is already taking place of the pathology characteristic of adult patients.

Complications opisthorchiasis

If opistorhoz be severe, the experts say about the difficult prognosis and possible complications. Thus, as complications of the disease can develop cirrhosis of the liver . primary liver cancer   and pancreas . choleperitonitis .

There are also serious damage to the nervous system, as evidenced by the manifestation of a headache, insomnia, irritability, depression.

In addition, infection opisthorchiasis can aggravate the condition of patients with other diseases, can badly affect the development of pregnancy , Contribute to the formation of typhoid-paratyphoid carriers. If a person is re-infected opisthorchiasis, then for the disease is progressive in nature.

Diagnosis opisthorchiasis

At an early stage it is very difficult to diagnose, because the parasite eggs and bile And feces can be detected only after four to six weeks. Therefore, the diagnosis of "acute opistorhoz" expert puts guided these epidemiological history, as well as a manifestation of the relevant symptoms. Thus, the presence of the disease can be assumed if the patient for some time resided in the outbreak spread and consumed opisthorchiasis not thermally treated fish. The presence of leukocytosis and eosinophilia in conjunction with the symptoms described above, as a prerequisite to the formulation of such a diagnosis.

Also, due to the high concentration of serum specific immunoglobulins   sometimes used serological diagnostic methods. The diagnosis is confirmed after about a month in the case of eggs opisthorchis.

In the process of diagnosis of chronic phase opisthorchiasis parasitological method is used: it is based on the detection of parasite eggs in the feces of the patient or in the duodenal contents.

Treatment opisthorchiasis

It is important that treatment opistorhoza as chronic and acute phases were integrated. In this case it is necessary to combine the methods etiotropic   and pathogenetic   therapy.

Treatment opisthorchiasis goes in stages: initial doctor conducts the necessary preparations for the treatment, followed by the reception of anthelmintic drugs parallel pathogenetic treatment. The next stage - rehabilitation of the patient, then it must leave at a dispensary and monitor how effective the treatment was carried out.

Patients who have an acute phase opisthorchiasis, the therapy must be directed primarily at the elimination of allergic reactions, as well as for the treatment of diseases associated with them. In this case, the prescribers with antihistaminic action ( suprastin . diphenhydramine . tavegil ) And sedatives (drugs bromine, Valerian ). Also, an expert assigned to receive funds from the anti-inflammatory action.

However, even after liberation from the invasion all the functions of the hepatobiliary system is completely restored not always. Thus, there may be irregularities in the gastrointestinal tract, and the microcirculation in the functioning of the immune system. Therefore it is very important to quality rehabilitation therapy. In this case, specific medications and treatments the doctor prescribes, guided solely by the individual patient's condition. Particular emphasis should be placed on strengthening therapy, should also undergo treatment opisthorchiasis drugs which improve the condition of biliary system, treatment with physiotherapy. It is also important to eat a diet that recommend treating physician.

For two months after the patient was discharged from the hospital, it is recommended once a week to do tyubazh sorbitol using magnesium sulfate.

The duration of the clinical examination after treatment is determined, guided by how difficult it was for ailment. Typically, clinical examination period is two to three years, and about one half-yearly examination of the patient is carried out.

Prevention opisthorchiasis

To high-quality disease prevention must be applied opisthorchiasis A complex approach . First of all, it is important to timely detection of infested and holding their deworming followed by the control condition. As the sanitary and epidemiological measures, it is important to prevent contamination of fecal contamination of water bodies and carefully monitor the processing of fish to be eaten.

For information on the precautions necessary to distribute among the population, it is particularly important in the centers, where there is a high level of contamination opisthorchiasis.

Everyone should necessarily comply with all rules for the preparation of fish dishes . So, cook the fish should be no less than 20 minutes to roast in a pan - at least 15 minutes. Salted fish can be cleaned in hot smoked.

Salted fish should be at a temperature of 16 - 20 ° C for two weeks. Thus it is necessary to use a salt with a consumption of not less than 14% by weight of the fish. Canned smoked fish, and can not be viable metacercariae.