Hospital pediatrics. Helminthiases in children. Ascariasis (most important)

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Hospital pediatrics. Helminthiases in children. Ascariasis (most important)

Lecture notes, cheat sheets

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40. Helminthiases in children. Ascariasis

Helminthiasis - diseases that develop when parasitic helminth worms and their larvae are localized in the body.

Classification of helminthiases:

1) according to the biological principle: nematodes (roundworms), cestodoses (tape), trematodes (flukes);

2) epidemiologically: geohelminthiasis, biohelminthiasis, bon-contact.

Ascaridosis

The causative agent is a roundworm that parasitizes in the adult stage in the small intestine. The life span of Ascaris is about a year. In the migration stage (the first 6-8 weeks after infection), Ascaris larvae have a mechanical and sensitizing effect, causing eosinophilic infiltrates in the tissues of various organs and causing hemorrhages. In the intestinal phase (8 weeks after the lesion), adult roundworms cause toxic-allergic and neuro-reflex reactions of the body, a variety of local mechanical effects.

Clinic. The migration phase often occurs under the guise of acute respiratory infections, bronchitis (malaise, dry cough or scanty sputum, low-grade fever, dry and moist rales in the lungs).

Urticaria, vesicular rash on the hands and feet are possible, volatile infiltrates in the lungs may occur.

In the intestinal phase, the gastrointestinal form is distinguished, manifested by salivation, nausea, loss of appetite, cramping pains around the navel, sometimes disorder of the stool and gastric secretion; hypotonic form, manifested by a decrease in blood pressure, weakness; neurological form, manifested by dizziness, headache, fatigue, sleep disturbance, vegetative-vascular disorders.

Complications.

Ascariasis ileus, ascariasis appendicitis; perforative peritonitis; ascariasis of the liver with the occurrence of jaundice, subdiaphragmatic abscess; ascariasis of the pancreas with clinical manifestations of acute pancreatitis, creeping of ascaris into the respiratory tract with the development of asphyxia.

Diagnosis- Based on laboratory data, it is based on the detection of nematode larvae in sputum, antibodies in the blood, late intestinal phase of roundworm eggs in feces.

Treatment- Piperazine, levamisole, and combantrin are used to expel young and adult roundworms. Piperazine is prescribed after meals 2 times a day, the interval between taking the drug is 2-3 hours, for 2 days, the recommended dose is 1,5-2 g per dose (3-4 g/day). Effectiveness increases when piperazine is taken after dinner before bed. Decaris (levamisole) is prescribed after meals at a dose of 150 mg once, Pyrantel is prescribed once after meals at a dose of 10 mg/kg body weight.

Oxygen treatment is carried out on an empty stomach or 3-4 hours after a meal, preferably in the morning, 2-3 days in a row.

Prognosis and prevention.

The prognosis in the absence of complications that require surgical treatment is favorable.

Prevention: mass examination of the population and treatment of all persons infested with ascariasis. Protection of the soil of kitchen gardens, orchards, berry fields from contamination with feces. Thorough washing and scalding vegetables and fruits with boiling water.

Author: Pavlova N.V.

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