Helminthiases / / August 12, 2017
Diphyllobothriasis most widespread in the areas of fisheries in the freshwater environment.
Pathogens diphyllobothriasis - tape worms tapeworm.The greatest value in human pathology has a tapeworm (Diphyllobothrium latum).His body reaches a length of 2-10 m, sometimes more.It consists of a head with two slits, neck, and a plurality of segments.In the womb of the helminth eggs from a plurality of dual-shell, cap at one pole and bumps on the opposite end.The size of eggs 0,068- 0,071 x 0,045 mm.
in puberty stage of a parasitic tapeworm in the small intestine of man, dogs, cats and other mammals.With the feces of the definitive (final) hosts tapeworm into the environment highlighted his balls.After contact with the eggs into the water after 2-5 weeks.therein forms a germ that go into the water.Here they ingest tapeworm intermediate hosts - freshwater crustaceans (Cyclops) and others crustaceans larvae develop in procercoids..Fish - additional home tapeworm eating Cyclops, the lar
Infection of humans and animals diphyllobothriasis mammals occurs by eating raw, slightly salty, not enough heat-treated as pike, burbot, perch, ruffe, some other fish and their eggs from the tapeworm larvae.
Pathological anatomy and pathogenesis
With the death of patients from tapeworm anemia at autopsy found anemizatsiya organ and tissue hyperplasia erythroblastic bone marrow tissue hemosiderosis of the liver, kidney, spleen, bone marrow, adipose degeneration infarction, bleeding in the pericardium, endocardium, at the bottomeyes in the esophagus.
When considering the pathogenesis diphyllobothriasis should take into account a number of factors: toxic-allergic reactions, mechanical action of worms, neuro-reflex influence, the possibility of hypo-and avitaminosis.Tapeworm cause damage to the intestinal wall, attaching to it.Sensitization of the body of the patient metabolic products of worms leads to the development of allergies.The pathogenesis tapeworm anemia is an endogenous vitamin deficiency - deficiency of vitamin B12 in the body of the patient and, perhaps, folic acid.
diphyllobothriasis often occur with mild clinical phenomena.Patients point of nausea, sometimes vomiting, epigastric pain, or throughout the abdomen, arising out of touch with the time eating, fall, rarely increased appetite, unstable chair.Sometimes the skin rash pours.For some patients had epileptic seizures, dynamic and obstructive ileus.
In developing tapeworm anemia appear weakness, drowsiness, dizziness, falling disability, enhanced dyspepsia, paresthesia sometimes occur.Quite frequently reported complaints of a burning sensation in the tongue, especially when taking medication, sour and salty foods.Occasionally there is pain during the passage of food through the esophagus.In severe anemia, pale skin with a yellowish tinge, his face puffy, sometimes there are swelling in the legs and lower back.Subcutaneous fat layer is usually stored.The temperature is usually low-grade, rarely rises to 33-39 °.Often develops glossitis Hunter - bright red painful spots and cracks on the tongue.Sometimes these changes are propagated to the gums, buccal mucosa, palate, pharynx, esophagus.Over time, the acute effects subside, papillae atrophy language, it becomes smooth, shiny, "varnished".The abdomen is often distended, stool often liquid, abundant.The liver and spleen are enlarged.The vast majority of patients have Akhil, but meets and gastric hyperacidity.Often there are signs funicular myelosis.
number of red blood cells in some patients 500 000 in 1 mm3 of blood, and even lower.The amount of hemoglobin decreases to 2-2.5 g / l.Color indicator is usually high, sometimes less than one.ESR increased.Serum bilirubin content increased, which gives an indirect reaction.In a blood smear megaloblasts scanty, sometimes normoblasts and erythrocytes with calves Joly and rings Kebota.Characterized by a hyperchromatic macrocytes and megalocytes.The number of leukocytes is typically reduced.Often found thrombocytopenia.The content of vitamin B12 in the blood is reduced dramatically.
Recognition diphyllobothriasis after 2-3 weeks after infection, when tapeworm reach sexual maturity, is not difficult in the study of feces patients helminth eggs.Patients often report on the allocation of their defecation ribbon-shaped scraps of tapeworms.
- tapeworm bovine (beef tapeworm infection)
Treatment and prognosis
Deworming at diphyllobothriasis spend extract fern, quinacrine, fenasalom, pumpkin seeds, as in teniarinhoze.
the presence of tapeworm anemia purpose anthelmintics combined with pathogenetic therapy.In severe forms of anemia, vitamin B12 is administered prior to de-worming.Surgical treatment is carried out in the event the patient bowel obstruction.
In the absence of severe anemia favorable prognosis.Specific therapy usually leads to the elimination of tapeworms and clinical recovery.
Fighting diphyllobothriasis driven by a planned detection and treatment of patients, the protection of rivers from pollution faeces, health education, aimed at the elimination of the population of habit to eat raw, salted and insufficiently cooked fish and fresh, the so-called livingeggs.
tapeworm larvae are killed by salting the fish in strong salt solution, depending on its size in 2-7 days.