Opisthorchiasis in adults, symptoms and treatment regimen

Opisthorchiasis - a disease that develops as a consequence of parasitism in the body trematodes or flukes, tapeworms. His pathogens - liver fluke, fluke and Siberian cat fluke. These parasites are small. Their flat body in the length of not more than 8-18 mm, in width - 1.2-2 mm. In the oral and ventral sucker at the worms have, they are attached to the internal organs of the human or animal.

Helminths that are opisthorchiasis pathogens, parasites primarily in the liver, gallbladder and pancreatic ducts. They feed on red blood cells, mucous secretions and the upper layer of the epithelium. To parasite in the human body, trematodes have to change 2 intermediate host.

What it is?

Opisthorchiasis - a disease of the group trematodozov caused by parasitic flatworms of the genus Opisthorchis - Opisthorchis felineus and Opisthorchis viverrini. Opisthorchiasis extended to the territory of Russia, Ukraine, Kazakhstan and the countries of Southeast Asia. Infection of susceptible people and fish-eating animals.

Infection occurs through ingestion of raw, salted or insufficiently cooked freshwater fish, according to 1893 - the carp family. The disease is characterized by lesions of liver ducts, gall bladder and pancreatic ducts.

exciter

Activators are opisthorchiasis liver fluke, including Opisthorchis felineus (Siberian cat or fluke), small parasite lanceolate 8-18 mm and a width of 1.2-2 mm. Parasite development occurs involving two intermediate hosts: shellfish and carp fish. End hosts are people and carnivores.

The first intermediate hosts - freshwater mollusks bitiniidy kind Codiella, inhabiting ephemeral shallow floodplain reservoirs. Their infection occurs by ingestion of eggs opisthorchis falling into the pond with the feces of final hosts, along with the sludge from the bottom of the pond. In the body of the mollusc parasite undergoes a metamorphosis. This stage of the parasite lasts for 2 months. The resulting cercariae leave the mollusk and actively introduced into the body of carp fish.

In the body of the fish parasite located in muscle and subcutaneous tissue. Here, it proceeds to the next step in the development and turns metacercariae, which lies in the round gray cyst size 0,17-0,21 mm. The larva inside is very mobile. In liberated metacercaria (0,44-1,36 mm length, width 0.15-0.30 mm) are clearly visible two sucker and excretory vial filled with black granules. After 6 weeks after infection the fish parasite becomes invasive, that is capable of infecting a host end. Of all life stages metacercariae Opisthorchis only able to take root and multiply in humans and carnivores. Potential carriers Opisthorchis larvae are ide, dace, roach, rudd, bream, chub, blue bream, white eye, sabrefish, asp, lin, gudgeon, bleak, minnow, verkhovka, studding. In the Ob basin largest infestation observed in ide, a little less - the dace and roach.

The final hosts of parasites (human, cat, dog, fox, foxes, ferrets and other carnivores) become infected after eating fish infested. In the stomach and small intestine initial final host metacercariae I am released from the cysts and then penetrate into the bile ducts and gallbladder bile liver moves. Here they are 10-12 days reach puberty and start producing eggs. Parasite eggs that fall on the ground, die within 8-10 days, if it enters into the water can survive up to a year. In the body of the final host the parasite can live for 10-20 years.

symptoms opisthorchiasis

In adults, the duration of the incubation period depends on the number of opisthorchiasis caught larvae, an average of 2-4 weeks. Further, depending on the state of immunity suddenly appear symptoms of acute parasitic losses. Acute opisthorchiasis in adults can occur in the following scenarios:

1. Mild course - lasts 1-2 weeks, the patient complains of fever up to 38 ° C, weakness, fatigue, headache.
2. Moderate course - the infected appear itchy urticaria, hives (Toxic effects on vascular bed), muscle and joint pain, vomiting, diarrhea, temperature to 39ºS. Decreased appetite, weight loss is possible. Symptoms last 2-3 weeks.
3. Severe course - against the backdrop of an extremely serious condition of the patient due to severe intoxication observed retardation or agitation, signs of defeat certain gastrointestinal, insomnia. Perhaps the development of acute epidermal necrolysis (Lyell's syndrome), acute myocarditis, Steven-Johnson syndrome, angioedema.

Forms of acute opisthorchiasis:

1. Pankreatopodobnaya - signs of pancreatitis is often associated with bile duct injury. There girdle pains, bloating, indigestion.
2. Gepatoholangiticheskaya - is associated with extensive lesions of the gallbladder and liver. The patient complains of spastic pain localized in the right upper quadrant and mimicking biliary colic. Fixed signs of stagnation of bile: yellowness of the skin and sclera.
3. Tifopodobnaya - to the fore in the symptomatic picture out skin rash, pyrexia, cough, sometimes appears.
4. Gastroenterokoliticheskaya - in opisthorchiasis symptoms predominate symptoms of inflammatory and ulcerative lesions of 12 duodenal ulcer, and often the stomach. At the same intoxication often poorly expressed.

The residents of disadvantaged in terms of epidemiology opisthorchiasis Western Siberia disease often occurs in a latent form, without giving a bright symptoms.

Chronic Phase opisthorchiasis

In chronic course of illness opisthorchiasis symptoms are very similar to symptoms of chronic cholecystitis, gastroduodenitis, pancreatitis, hepatitis B: The patient complains of persistent pain in the right upper quadrant, which are paroxysmal in nature and resemble in their intensity biliary colic, the pain may move to the right side of the chest cells. Also for the disease is characterized by: dyspeptic syndrome, pain during palpation of the gall bladder, the gall bladder dyskinesia. The disease process eventually involved the stomach and intestines, accompanied by symptoms inherent gastroduodenitis, pancreatitis and impaired bowel function well.

Infestation also causes disorders of the CNS, which results in frequent complaints of patients to decreased performance, irritability, sleep disturbances, headache, and dizziness. It is also noted trembling eyelids, tongue, fingers. Asthenic condition is usually accompanied by general weakness, rapid physical and mental fatigue. In some cases, the disorder of the nervous system can come to the fore, such patients are often diagnosed with "cardiopsychoneurosis" or "vegetative neurosis."

Chronic opisthorchiasis accompanied by allergic syndrome, manifested by itching of the skin, urticaria, angioedema, arthralgia, food allergies nature. Specificity of chronic opisthorchiasis is that after the complete disposal of parasites in the patient are irreversible changes in the internal organs. Patients have chronic hepatitis, cholangitis, cholecystitis, gastritis, disorders of the immune system. For these patients, great importance attaches to improving procedures after the full course of the treatment, to improve the functioning of the gallbladder, liver recovery, normalization processes digestion.

The disintegration agents, release their waste products, and as a result Necrosis of the organism's own tissues intoxication occurs, which is accompanied by allergic reaction. Moreover, helminths (young less mature individuals - more) injure biliary epithelium and pancreatic ducts, thus triggering process hyperplastic tissue regeneration. Among the consequences of the disease is also common mechanical disturbance of bile and pancreatic juice outflow due to congestion in the channels of parasites, pathogens of eggs, mucus, epithelial cells.

complications

If opisthorchiasis be severe, the experts say about the difficult prognosis and possible complications. Thus, as complications of the disease can develop cirrhosis, primary liver cancer and pancreatic cancer, bile peritonitis. There are also serious damage to the nervous system, as evidenced by the manifestation of headache, insomnia, irritability, depression.

In addition, opisthorchiasis infection can aggravate the condition of patients with other diseases, can badly affect the development of pregnancy, contribute to the formation of typhoid, paratyphoid carrier. If a person is re-infected opisthorchiasis, then for the disease is progressive in nature.

Diagnostics

In the diagnosis of the most widespread are opisthorchiasis radiographic techniques (cholecystocholangiography), ultrasound, computed tomography, and others.

Parasitological confirmation of the diagnosis is made possible at the 4 th week after infection, when the contents of the duodenum and feces appear helminth eggs. Currently available immunological diagnostic methods are not specific enough opisthorchiasis and sensitive, it is sometimes advisable to use only as a supplement to the parasitological methods.

Parasitological diagnosis, based on the study and identification of helminth eggs in feces and / or duodenal contents, is currently the only way to confirm diagnosis.

Opisthorchiasis than cure?

Opisthorchiasis proper treatment in adults involves a comprehensive approach, because the disease has a negative impact on the functioning of all internal organs.

To cure the disease in Domashov conditions, it is necessary to pass 3 stages:

1. Stage I - the preparatory. It includes appointment choleretic, anti-inflammatory, antispasmodic, anti-allergic agents, as well as hepatic and adsorbents. The duration of the preparatory phase, depending on the form of the disease and its severity, ranging from 10 to 20 days.
2. II stage - deworming. In this period appointed anthelmintics. Self-nomination of their unacceptable. Drugs are taken strictly courses. You can not interrupt the course of treatment or on their own to change the scheme of taking these medicines.
3. Stage III - recovery. The gall bladder and ducts, after deworming, has accumulated a large number of dead parasites, so it is necessary to create a good flow of bile for their removal. Therapy includes assigning choleretic drugs, and hepatic. For recuperation of the body, after undergoing disease appointed vitamin complexes and nutraceuticals reinforcing action.

To evaluate the efficacy of the treatment can not earlier than 6 months after its closure, since complete excretion of parasite eggs and restore normal operation of the digestive system is necessary time.

prevention

Those who are interested in what opisthorchis, and how to avoid infection with these parasites, it is necessary to get acquainted with the simple methods of prevention. This is especially true lovers of fish and seafood, as well as the true eastern gourmet cuisine.

The main precautions are:

• Observe rules heat treating fish: fry not less than 20 minutes to cook for at least 15 minutes, salt of at least 7 days, jerk about 3 weeks.
• Do not eat raw river fish, more attentive to the choice of oriental restaurants.
• After working with the fish be sure to wash your hands with antibacterial soap.
• After cutting the fish carefully handle kitchen tools, and pour over boiling water.
• Not buy river fish on natural markets, but only tested, specialized stores.

Opisthorchiasis represents a dangerous parasitic disease which is to be prolonged and careful treatment. In the presence of acute symptoms it is recommended to go directly to infectious diseases, so the patient can avoid the chronic form of the disease and its serious consequences.

Precautions against parasitic infestation are quite simple, and can help you avoid infection with various dangerous worms.