Ascariasis

Ascariasis is a common parasitosis inatlnita the child regardless of age. Incriminated in producing disease parasite to cause disease in people known as the roundworms.The host is human or other animal intestine.
Etilogie:
Causative agent of disease is a parasite called Ascaris lumbricoides (limbricul). This is a nematode, a worm round a smooth body, white-pink, with a length of 15-35 cm, with extreme heads, the female is always larger than the male.
Parasite life cycle help in understanding the symptoms present in cases of infestation.Adult lives in the small intestine of the host, where females deposit about 200 daily.000 eggs. Neembrionate eggs are being removed simultaneously with the faeces, no self-infestation occurs. The egg becomes infected when the embryo formation in the external environment, within a period of 30-40 days. Contamination children will take about digestive. Embryonated ascarid eggs at ground level will be ingested along with unwashed foods (fruits, vegetables). Once in the digestive tract, the larvae will be released in the small intestine. They cross the intestinal mucosa and reach the liver through the port. After an interval of 3-4 days will migrate through the veins and inferior vena cava suprahepatice, reaching the right heart. From here go to the lungs and pulmonary capillary leave to enter the alveoli and bronsiole. After crossing the respiratory tree reaches repatrund epiglottis and in the digestive tract. It is set in the small intestine, turning into adult form.
Signs and symptoms:
In asymptomatic parasites will be diagnosed during an examination conducted for other purposes coproparazitologic (for example to cause a hipereozinofilii enteritis).
Clinical manifestations in larval stage of the parasite are known as Loffler syndrome. In a short, decateva days after ingestion of eggs is accompanied by expectoration irritating cough with chest pain and exceptionally hemoptysis (blood in sputum elimination, print use), and fever.On physical examination no pathological signs noted. By performing X-ray lung opacities will highlight the systematic or nesistematizate very labile disappear spontaneously after a few days.Hypereosinophilic is typical in the same period (30-60% of cases), the parasite being in a stadium tissue evolution.
Clinical manifestations in the adult stage of the parasite are varied.Digestive disorders are often reagsesc: abdominal pain, nausea,, flatulence (bloating), vomiting (sometimes entailing removal ascariazi by mouth), diarrhea which can eliminate ascarizi.Allergic manifestations are found: pruritus (itching), urticaria (an allergic reaction of the body protrudes through the skin, red slabs, raised - as signboards caused by nettle, itching - itching giving), Quincke edema, spasmodic cough, Loffler syndrome late.Psychiatric disorders appear as tics, nasal itching, irritability.
There are cases that may have severe complications that occur in heavy infestations and require surgery. In the category "Surgical ascariasis" include: bowel obstruction caused by obstruction of ascariazi package, a chance volvus hampered by many parasites, intestinal intussusception and intestinal perforation. Ascarizilor penetration into the lumen apendicular cause acute appendicitis, obstructive jaundice in bile ducts and pancreatic ducts result in acute pancreatitis.
Positive diagnosis:
This clinical manifestations can not positive diagnosis of ascariasis.In the larval stage of the parasite is distinguished by laboratory tests hypereosinophilic (15-30%) and exam coproparazitologic not have efficient.
In the adult stage of the parasite is moderate eosinophilia (5-10%) or absent. The exam will emphasize coproparazitologic egg parasites, where infestation has been done with female.
Treatment:
To treat the parasites to drug therapy is used most often. Are frequently used these regimens: Levotetramisol (Decaris) - 3-4 mg / kg single dose or mebendazole (Vermox) 100 mg 2 times daily for 2-3 days.
In severe infestations cases resorting to surgery, as appropriate.