February 16, 2013
- Polydex, ear drops, and instructions
- Child nutrition for the prevention of iron deficiency anemia
- Moderate amounts of alcohol may be beneficial
- Hystoglobulin
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 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 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 .
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.
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