Helminthiases / / August 12, 2017
The clinical course opisthorchiasis distinguish two phases - early (acute) and late (chronic).After 2-4 weeks after infection, the patient has a headache, malaise, weakness, pain in muscles and joints, sometimes severe jaundice, nausea, vomiting, diarrhea.The temperature rises to 39-40 ° C.The duration of febrile period from 2-3 days to 2 months.In some patients, the skin lesions appear.From the side of respiratory marked cough, sometimes asthmatic suffocation, lung wet and dry rales.When X-ray revealed infiltrates.In all patients, the liver is increased, in some - the spleen and lymph nodes.The blood eosinophilic leukemoid reaction with an increase in the number of leukocytes and eosinophils to 70000 to 26000.
Distinguishes three options bolezni- tifopodobnaya, gepatoholangitichesky, gastroenterokolitichesky.In obliterated in the early phase of the disease is a low grade fever, which is kept 3-6 days in the blood eosinophilia and up to 20%.
Many patients in this phase of the disease in the appointme
Thus opistorhoz in the early phase occurs as an acute allergic allergosis holangiogepatitom.This acute early phase of the disease sometimes lasts up to 3 months, gradually moving in late chronic phase.In the late phase opisthorchiasis main complaints of patients to reduce pain in the epigastric and right upper quadrant.Many pain radiating to the back, and sometimes in the left upper quadrant.Often, pain aggravated periodically in the form of attacks of biliary colic.Often there are dizziness, headache, dyspepsia.Some patients indicate insomnia, frequent changes of mood, increased irritability.
skin color is usually normal or pale.Sometimes there subikterichnost sclera and sky.Severe jaundice in the later phase of the disease is extremely rare.In these cases, usually combined with opistorhoz disease Botkin.Low-grade or normal temperature.The liver is often enlarged and sealed.All patients opisthorchiasis impaired excretory function of the liver, which is associated with lesions of the bile ducts.Other functions of the body when not complicated form of the disease in its later phase, usually normal, but violated in the case of additional bacterial or viral infection of the bile ducts and gall bladder and other hepatotropic factors.
gallbladder is often enlarged and tight.In many patients, it is possible to achieve the reduction only after repeated duodenal intubation.
emergence of a number of patients girdling pain in the upper abdomen radiating to the left along the costal arch to the spleen, pain on deep palpation of the pancreas, a violation of its features suggest frequent presence at opisthorchosis chronic pancreatitis.
From the gastric secretion half of the patients observed reduction of gastric acidity and Akhil.When X-ray duodenum study found a violation of passage of contrast material and changes of the mucous membrane of the relief, mostly atrophic character.Eosinophils in the blood, often mild anemia.
symptomatology opisthorchiasis analysis shows that, when there is always a cholangitis varying degrees of severity.Often there biliary dyskinesia, rarely holangioholetsistit.Common chronic hepatitis with changes mainly in the interstitial tissue of the liver and chronic pancreatitis.For some patients develop the so-called zooparazitarny holangitichesky cirrhosis.Sometimes opistorhoz were obliterated.
- treatment, prevention and prognosis of opistorhoze
After 1 month.after infection can detect opistorhisov eggs in the feces and duodenal contents of the patient.
main and most frequent complication opisthorchiasis - suppurative cholangitis.Some, though rare, cases purulent cholangitis can lead to the formation of abscesses in the liver.Cases of perforation opistorhoznoj liver abscesses in the free abdominal cavity, as well as through the diaphragm into the pleural cavity.The pus in such cases are usually detected opistorhisov eggs.