Opisthorchiasis - a parasitic disease of the liver and biliary tract caused flatworms-flukes.
Infection occurs by eating contaminated fish.
Trematodes or flukes - flatworms 5-20 mm long, 1-4 mm wide. Eggs allocated Opisthorchis, small, to 0.026 x 0.01 mm.
Parasitic flukes in the bile ducts of the liver and the ducts of the human pancreas, pets (cats, dogs) and some wild mammals (fox, mink, muskrat, etc.). helminth eggs already formed larvae released into the environment, and further development takes place in fresh reservoirs in shellfish and fish then carps - roach (roach, chebak) ide, dace, Rudd, bream, carp, and lin et al.
After eating contaminated fish larvae flukes are released in the duodenum, where penetrate into the bile ducts, where they for 3-4 weeks reach sexual maturity and begin to lay eggs. In 20-40% of infected parasites are also found in the ducts of the pancreas and gallbladder.
manifestations opisthorchiasis
Opisthorchiasis severe symptoms usually develop in people who came into the center of the other areas where opisthorchiasis not found. The local population has the disease, usually hidden within. In particular, acute opistorhoz practically not observed in indigenous North (hanty, Mansis) infestation which in some chronic opisthorchiasis foci reaches 100%.
The average incubation period of 2-3 weeks. Embodiments flow varied early stage - from erased to common forms of allergic reactions with multiple lesions. Worn form is limited to a small rise in temperature, a slight increase eosinophils in the general analysis of blood. The disease begins suddenly. The main manifestations in the acute stage - fever and pain in the right upper quadrant. The fever lasts 1-3 weeks with a maximum of up to 39C or higher.
Chronic phase fugacity opisthorchiasis with vital activity of parasites in the bile ducts of the liver and pancreas. Among these bodies there is a close relationship. The basic process is the painful inflammation of them.
Opisthorchiasis occurs mainly signs of chronic inflammation of the gall bladder, duodenum and pancreas. Leading symptoms are pain in the upper abdomen, especially in the right hypochondrium, nausea, poor tolerability of fatty foods, dry mouth and the bitterness and others. Often, in the long course developed depression with anxious-hypochondriac syndrome.
In some cases, the disease can be severe and accompanied by a blockage of the bile ducts, the development of jaundice, Abscesses of the liver, gall peritonitis.
The symptoms of the chronic phase opisthorchiasis
- pain in the epigastric region,
- pain in the right upper quadrant,
- intolerance to fatty foods,
- loss of appetite,
- nausea,
- fatigue.
complications
- nonfunctioning gallbladder,
- cholecystitis,
- cholangitis,
- liver abscess,
- gallstones.
Diagnostics
In the diagnosis of the most widespread are opisthorchiasis radiographic techniques (cholecystocholangiography), ultrasound, CT scan and etc.
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 treatment
opisthorchiasis treatment should be complex.
Chemotherapy is carried out with praziquantel. Praziquantel - antivermicular broad-spectrum drugs. The mechanism of action is associated with reduced muscle parasites, passing into paralysis. The drug is rapidly absorbed by ingestion. In small quantities enters breast milk. In patients with impaired renal function may slow excretion of the drug.
Treatment is carried opisthorchiasis praziquantel at a daily dose of 40-75 mg per 1 kg of body weight, 2-3 assignable reception. Monitoring the effectiveness of chemotherapy is carried out by the study of feces and / or examining the contents of the duodenum within 3-6 months after treatment. Praziquantel should not be administered if it affects the eyes, as if the death of helminth blindness may develop. In the treatment of patients in the acute stage of helminthiasis possible reactions associated with allergenic action parasites decomposition products, which in some cases requires additional purpose hormones.
Praziquantel should not be administered within the first 3 months of pregnancy. But it can be used during breastfeeding, but the days of treatment and for a further 48 hours after the end of treatment should abandon breastfeeding.
In connection with the possible emergence of dizziness on the day of treatment, and the next day after taking praziquantel are not allowed to drive or maintain the machinery. Patients whose activities are related to the need to fast concentration and high reactivity, caution should be exercised when applying praziquantel. Praziquantel is not recommended for children under 2 years. Side effects of praziquantel: headache, dizziness, weakness, fever, hives. Generally, side reactions are mild and do not require special treatment.
prevention
The basis of personal prevention opisthorchiasis is the exclusion of food neobezzarazhennoy fish. Disinfection achieved by heat treatment, freezing, smoking, salting according to established guidelines.
Some methods of processing fish, in which fish occurs disinfection of parasites:
- freezing; freezing time 7 hours at a temperature in the body of fish -40 ° C; 32 hours - at -28 ° C.
- salting - ambassador in a salt solution having a density from day brine salting 1.20 at 2 ° C; duration of salting from 10 to 40 days depending on the weight of the fish.
- heating (cooking); not less than 20 minutes after boiling.
With regard to the sensitivity of the larvae of the parasite to treatment in a microwave oven, this issue needs further study.
