Opisthorchiasis - a disease that causes the worms, called the cat fluke and affects the liver and pancreas.
- 1 Etiology
- 2 Epidemiology
- 3 cycle of helminth
- 4 Pathogenesis
- 5 Clinical signs opisthorchiasis
- 6 opistorhoz How to treat?
- 7 disease prevention
disease is caused by two species of flatworms: Opisthorchis felineus and Opisthorchis viverrini. in Russia is most common first type of agent.Helminths has a flat body and small size: a length of about 10 mm, shirinu- 3mm.
Opisthorchiasis - is the most common worm infestations in Russia. disease affects young and middle-aged people. Most often the disease is subject to the male sex.Infection generally occurs in summer and autumn.Helminthes are formed in the basins of such rivers as the Ob, Irtysh, Volga, Don, Dnieper and others. The highest incidence is recorded in the area of the Ob-Irtysh river basin, which is about five hundred people per 100 tho
cycle of helminth
source of infection are sick people, pets (cat, dog, pig) and the wild animals that feed on fish. person infected after eating fish that has not undergone processing, and includes live metacercariae .
Development O. felineus occurs with the change of the three hosts.The first will be the intermediate shellfish, second intermediate - fish, and the final host is a person.Among the hosts allocate human, cats, dogs, pigs and a variety of wild animals that eat fish (foxes, arctic foxes, sables, polecats, otters, mink and so on.).
adult worms, a parasite in the intestine, releases into the environment of mature eggs that can be maintained in a viable state for six months if it enters the pond.In the water they swallow mollusc of the genus Codiella, the body which exits miracidia, and then its transformation into sporocysts.The cyst develops rediae, go, get into the liver mollusk, formed where the next stage of development of the helminth-cercariae.A feature of the parasite is that all larval stages transformation occurs by parthenogenesis, and the number of worms in each stage increases.The time development of the parasite in the body of the mollusc from 2 months to years, depending on water temperature.
Upon reaching the invasion stage, the output of cercariae in the water and attach them to the skin of fish belonging to the family of carp (second additional owner).They then penetrate the skin and muscles, relieve the tail and covered in a day capsule form metacercariae.After 1.5 months, this form becomes capable of invasion, and fish, which carries them, begins to be a source of infection for the definitive host.When you hit him in the gut of the larvae is released from the shell and their migration to the liver through the common bile duct or pancreas.One month after entry into the body to the final master worms become sexually mature and start producing eggs.
The basis of the pathogenesis of the early stages of the disease is set to general and local toxic - allergic effects on the human body allocation helminth products.Due to these allergic reactions is an increase in vascular permeability, edema, and development of necrosis in various organs, primarily the liver.Food cells are worms, so as a result of destruction of helminths occurs epithelium lining the bile ducts, which is why small cysts formed in the liver tissue.With further progression of the process, it becomes chronic, occurs in the bile ducts proliferation of connective tissue.
In some cases, worms can cause blockage of small bile ducts, the formation of gallstones in them, which leads to the development of gallstones.As a result, damage to the ducts formed biliary dyskinesia.The end result of all the processes occurring in the liver can become liver cirrhosis and cancer.Damage to the pancreas from opisthorchiasis occurs due to take place in her allergic reactions and toxic products of vital activity of worms, resulting in the formation of edema in the organ and violation of outflow of pancreatic secretion.This in turn leads to the development of pancreatic fibrosis and cysts.
Clinical signs opisthorchiasis
variability and severity of clinical symptoms of the disease depends on the duration, number of worms in the body and the human immune status .
Opisthorchiasis human proceeds with the development of acute and chronic stages.Depending on the course also distinguish between erased and manifest forms, and on the severity of the disease - mild, moderate and severe disease.The progress of the erased form occurs without any clinical symptoms, characterized by an increase in eofinozilov clinical blood test to 40%.Discover this kind of disease is most often accidental.
In the classical course of the incubation period is about a month.In the case of lung disease progression occurs first appearance of fever up to 38 C and hold it for two weeks.Characteristic appearance of weakness, fatigue, abdominal pain without clear localization, the violation of a chair.
In moderate disease duration of fever increases to three weeks, the rise is above 39 C. It is also characterized by an increase of leukocytes and eosinophils in the blood test, the appearance of skin rashes, joint pain and muscle pain, vomiting, diarrhea and bronchitis with obstruction elements, changing the size of the liver and spleen.
In severe cases opisthorchiasis characterized by the appearance of high fever, various skin rash, headache, confusion, excitement, insomnia.The main symptoms of the disease in this form will be severe hepatitis symptoms: pains in the right hypochondrium, jaundice, an enlarged liver and increased amounts of enzymes and bilirubin in the serum.Some patients may develop stomach ulcers with severe paroxysmal pain in the epigastric region, nausea, vomiting and diarrhea.Also, you may receive a cough with symptoms of bronchial obstruction.
acute period of the disease lasts for about 2 months, and then there is a gradual disappearance of clinical symptoms, and the disease takes a chronic course with the appearance of signs of lesions of various organs and systems.The most common chronic diseases occur when symptoms of liver disease and gall bladder.The patients complained of the emergence of the feeling of heaviness and fullness in the stomach and in the right upper quadrant, which is given in the back and in the ribs on the left side.Also note the loss of appetite, cause nausea, vomiting, dyspepsia.In most patients there is an increase in volume of the liver, it becomes painful.The gall bladder is also increased and sore when pressed, often have bouts of biliary colic.Body temperature is usually not changed.
If the disease affects the pancreas, then there are pains that are surrounding the character and give the left side of the chest, back and left shoulder.It is also characterized by an increase in blood glucose and reduced production of pancreatic enzymes.
typical in chronic opistorhoze is a violation of the secretory and enzymatic functions of glands of the stomach and duodenum, which leads to the development of chronic gastritis, duodenitis, gastroduodenitis and ulcers.Due to changes in the central nervous system may cause headaches, dizziness, insomnia, emotional instability, depression, irritability, frequent mood swings, increased sweating.
Besides all of the above symptoms, the development of a chronic course of the disease may cause symptoms of defeat of the cardiovascular system, which will be shown the occurrence of pain or discomfort in the area of the sternum, increased heart rate, expansion of borders of heart, deafness its tone and decrease blood pressure.Often the flow opisthorchiasis complicated by secondary bacterial infection in the bile ducts, which is characterized by fever, abnormal liver function, increasing it in size, the appearance of a short jaundice.Also, long-term course of the disease can lead to chronic inflammation of the liver, cirrhosis or cancer.
As treat opistorhoz?
Treatment is carried out at home, require hospitalization, patients with severe clinical symptoms and the presence of decompensation of organ function. most optimal treatment for opisthorchiasis is praziquantel (or azinoks ).It is administered in a dose of 25 mg per 1 kg body weight, 3 times with an interval of 8 hours, over a day.This therapy is carried out only after normalization of body temperature and eliminate allergy symptoms.Also assigned symptomatic treatment: cholagogue drugs, antispasmodics, analgesics and anti-bacterial (with secondary bacterial flora), iron supplementation (in case of anemia).
main measure most effectively preventing infection by helminthiasis, is an exception to the food fish, not the last heat treatment, freezing or salting.In areas endemic for Opisthorchiasis, all fish belonging to the family of carp, are not recommended for use without prior decontamination.
Preventive measures also include a ban pet feeding raw fish (dogs, cats, pigs), to prevent falling into the sewage ponds, especially those inhabited by an intermediate host cat fluke - a clam.It is mandatory to conduct sanitary and educational activities among the population.