Miscellaneous

Diphyllobothriasis: symptoms in humans, treatment and prognosis

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Diphyllobothriasis - a helminth disease, with infection and lesions of the digestive tract of humans and animals. The disease leads to megaloblastic anemia.

Parasite is fairly large tapeworm - a tapeworm (D.latum), it grows in length up to 10 m, in nature there are more than 10 kinds of little-studied type of tapeworms Diphyllobothrium.

What it is?

Diphyllobothriasis - intestinal helminth infections, arising from invazirovannosti human parasitic worms, tapeworms. Pathogens diphyllobothriasis parasites in the small intestine, causing dyspeptic symptoms, and megaloblastic anemia.

Causes of

More prone to diphyllobothriasis those who live in regions with temperate, cold climate (mainly in the northern hemisphere), and development of fisheries in the freshwater ponds. Definitive hosts of the parasite: fish-eating animals and humans. Intermediate hosts - Cyclops crustaceans and freshwater fish (salmon, perch, pike, ruff, burbot and others).

Pathogen diphyllobothriosis at maturity stage parasitize the small intestine of man or animals predisposed to it after their feces are allocated to the external environment of helminth eggs. Eggs into the water and after 2-5 weeks embryos appear that swallowed freshwater crustaceans. Further development of the embryos in the form procercoids occurs in muscle tissue, liver tissue of fish, crustaceans which feed. Here the worms move to the next shape development, dangerous to humans.

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Infection diphyllobothriasis is due to ingestion of raw, poorly processed, salted contaminated fish and its roe. You can also get infected through diphyllobothriasis knives, utensils, boards, with which butchered infected fish.

Pathogenesis

one, at least some tapeworms, but described the cases of parasitism 100 or more species normally lives in the human gut. The lifespan of the parasite is calculated in years 10, 20 or more years. In this part of the end section periodically strobila rejected and the web-like excreted faeces during defecation.

  1. The following factors underlie the pathogenic action of the broad tapeworm: mechanical action helminth, neuro-reflex effect, toxic and allergic reactions, the development of B12 and folic beriberi acid. The role of mechanical factor increases with intensive invasion. Attaching to the intestinal mucosa, it violates the tapeworm that causes local damage, mikroizyazvleniyu atrophy. When the accumulation of intense infestation of parasites can cause intestinal obstruction.
  2. One indicator of sensitization of the organism, which is the result of exposure to toxic and allergic products vital helminth its antigens, blood eosinophilia is most pronounced in the early stages of the disease. Neuro-reflex influences as a result of irritation of the nerve endings of the intestinal wall contribute to disruption of the function of the stomach and other organs of the digestive tract.

The severe manifestations of infection is the development difillobotrioznoy megaloblastic anemia, the pathogenesis of which is endogenous vitamin deficiency B12 and folic acid. Diphyllobothriasis etiologic role in the development of anemia was established in 1884 by S. P. Botkin. Of dietary vitamin B12 - antianemichesky external factor - is not digested and absorbed strobila parasite.

symptoms diphyllobothriasis

Causes of clinical signs of disease in humans - mechanical damage to the intestinal wall in the site of attachment of worms, tapeworms release of metabolic products, the absorption of important parasite to humans substances.

Due to the mechanical action tapeworm the following symptoms develop diphyllobothriasis mucosa of the small intestine:

  • neuro-trophic disorders;
  • atrophy and necrosis at the site of attachment of the parasite;
  • vistsero-visceral reflex reactions (in the background interoceptors irritation).

Because the poisoning of the human body helminth metabolic products bothriocephaliasis accompanied by allergic reactions. Against the backdrop of the absorption and synthesis of useful elements are formed by symptoms such as:

  • hypovitaminosis B12 and folic acid;
  • shortage of vitamin C, B1 and B6;
  • deterioration immunity;
  • megaloblastic anemia (internal gastric factor is not associated with vitamin B12, which is why the latter is not digested and absorbed by the parasite).

Diphyllobothriasis develops gradually: from the moment of infection until the first complaints about the state of health may take up to three months. Start infection is gradual. Most often, patients are referred to such symptoms:

  • a slight increase in temperature;
  • increased or decreased appetite;
  • nausea;
  • vomiting (rarely);
  • intestinal obstruction (sometimes);
  • unstable chair;
  • It hurts the entire abdomen

Due to deficiency of vitamin B12 appear the following symptoms:

  • weakness or dizziness;
  • pale skin;
  • swelling;
  • tachycardia;
  • fast fatigue;
  • glossitis, accompanied by painful sensations when eating (rare).

Clinical severity of anemia depends on the degree of infection, comorbidities, quality of human nutrition. there may be "nervous" symptoms on a background of the invasion:

  • numbness in various parts of the body;
  • the sensitivity of the violation;
  • paresthesia;
  • periodically appearing unsteady gait.

Sometimes bothriocephaliasis proceeds latent (asymptomatic).

Diagnostics

Because to make a diagnosis without diphyllobothriasis analysis is not possible, given the manifestation of symptoms is recommended immediately contact the medical facility. The first thing the doctor must carry out a detailed survey, since it is necessary to determine:

  • Do people live near bodies of water;
  • Whether consumed as food fish of dubious cooking;
  • Are there fish cleaning in the past few months.

The main test to determine diphyllobothriasis - fecal (excreted eggs can be found broad tapeworm). Under the microscope, they are easily distinguished by particular oval shape, length and yellowish-gray color. Sometimes patients can tell the allocation with the feces of some parts of the worm. After detection in stool eggs, all doubts disappear the disease, and the doctor confidently diagnose bothriocephaliasis.

Also blood test to refine the size and composition of red blood cells. Diphyllobothriasis when they are enlarged and full of hemoglobin. Also, this analysis is necessary to determine the level of vitamin B12 in the blood. After determining the final diagnosis of the patient, it is necessary to conduct a survey of all his family and the local environment.

diphyllobothriasis treatment

If there are no signs of extensive invasion, and the person feels more or less normal, treatment diphyllobothriasis does not require a hospital inpatient. Complicated cases where the infection has caused severe reactions of the body or has an extensive character, the patient is hospitalized for a few days.

Regimen diphyllobothriosis starts with recovery of vitamin B12 in the blood.

medication

Prior to the medical treatment the patient is assigned to vitamin B12. Reduction of iron level in the blood can take up to 30 days. Next, prescribed to treat diphyllobothriosis of such preparations:

  • "Azinoks";
  • "Biltricid";
  • "Praziquantel";
  • "Niclosamide";
  • "Albendazole".

Today bothriocephaliasis often treated "biltricid", its efficiency is nearly 100%. Drug "Niclosamide" cures invasion of reception at a dose - 2 grams orally. But the cost of the drug is more expensive than that of counterparts, and it is banned in some countries. After getting rid of parasites patient should undergo rehabilitation course, which includes a healthy diet and taking vitamins.

Folk remedies

For the expulsion of worms in traditional folk medicine, an extract of male fern, as well as pumpkin seeds and a decoction of them.

Pumpkin seeds should be consumed every day for 1 hour on an empty stomach in the morning.

At one time taking 300 grams of raw or pre-dried seed. It is desirable to pre-grind, adding a small amount of boiling water and natural honey.

prevention

When fishing, and the use of river and lake fish to prevent her raw food diet, carefully monitor its thermal treatment. Plerocercoids quite stable. Die at minus 15 ° for one day (24 hours) at minus 10 ° in tchenie 3 days at minus 4-6 ° for 9-10 days.

High temperatures are harmful to plerocercoid more - they are killed at a temperature of 55-60 °, in other words: roast thoroughly recommend the fish for at least 20 minutes, and large pieces of fish - at least 30-40 minutes. The salt products are allowed to eat at a salt content in the end product is not less than 9%, in this case plerocercoids die.

Timely detection of symptoms and treatment diphyllobothriasis. Regular screening for helminthiasis fishermen before and after navigation, employees of fish processing plants.

Forecast

Diphyllobothriasis flowing without complications can be easily treated using specific anthelmintic means. Upon detection of complications, they are eliminated by specific methods, depending on their nature. Poor outcome (bowel gap, anorexia, fatal) is possible in extreme cases, no proper treatment. Transferred disease not to induce immunity.

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