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Most often, the infection It occurs through direct contact with the carrier disease after ingestion of a man of mature eggs from developing inside the larvae. Pinworms secured to the intestinal wall via vesicle (located around the mouth of the worm) and feed the intestinal contents, and human blood. At this stage enterobiosis does not cause any discomfort, the presence of parasites is not felt. However, their presence is detected at a stage where female begins laying eggs.
In the evening and night hours parasite comes out of the anus, It lays eggs in the perineal area (Up to 150 thousand. pc), where the best conditions for their maturation -. 36 degrees of temperature and humidity. Pinworms crawling, cause itching, scratching the infected person and collects on the hands and under the fingernails and deferred mature eggs helminths, then transfers them into his mouth, and they are again in the intestine, where they grow up into adults within 2-4 weeks individuals. The cycle of infection thus continues.
Sometimes pinworms are females, moving around the perineum, women crawl into the vagina, then into the uterus, causing vulvovaginitis. They have been found even in the fallopian tubes and peritoneum.
The pathogenesis of inherent mechanical impact of helminths on the intestinal mucosa associated with stimulation of chemoreceptors and mechanoreceptors in their motion and fixation. Irritation in the ileocecal region causing reflex violation of the secretory and motor functions of the digestive tract, which is fraught with possible gastritis, enteritis, gastroduodenitis.
Individual specimens of worms are able to penetrate into the mucous on the two thirds of the length of its body. Around them develops inflammation, granulomas appearWhich consist of lymphocytes, eosinophils, macrophages. The degree of pathology severity depends on the duration and intensity of infection. Spread of the disease in many ways It depends on the sanitary condition of facilities and housingAs well as personal hygiene habits of man. Especially high is the infection of children in schools and preschool institutions. Pinworms pathogenic influence on the child's body is not in doubt, so enterobiosis has great medical and social importance. It is proved that by acting on the body immunosuppressive, pinworms contribute to the emergence of palpitations in patients with infectious and somatic diseases.
Causes
Among all helminthiasis enterobiasis up to 95%. Regardless of the climate zones and other factors it exists geographically wherever people live. Eggs with larvae are very tenacious and able to maintain full vitality of the human body is at a temperature of 23-40 ° C. At a temperature of 18-20 ° C survival rate of eggs is preserved up to three weeks, after which 70% remains viable individuals. At -15 ° C pinworms survive for one hour. Larvae is detrimental to high temperature - above 55 ° C, drying and sun.
Size pinworm eggs are so small that they can even transfer the flies. Getting on human hands as they are carried on a variety of everyday objects are transmitted in a handshake and even by airborne droplets.
The most common and expressed Enterobiasis symptoms in children. Pathogenic effects pinworms waste products on the child's body causing frequent infections, especially intestinal, due to weakened immune systems. They also adversely affect a child's intelligence, his behaviorIt causes confusion, irritability, remembering impairment and other disorders. Consequently, the fight against enterobiasis has a high social and medical significance.
Classification
In infested patients with different clinical picture may occur, depending on the degree of infestation with worms. There are several types of enterobiosis states that define Enterobiasis symptoms in adults and children.
Easy stage:
- invasion small amount pinworms individuals;
- significant manifestations of the disease are not observed;
- the appearance of a light itch in the evening or at night, which stops spontaneously after 2-3 days;
- repetition occurring itching to once every 2-3 weeks, in view of the cyclical turnover of generations of worms.
Middle stage:
- infecting organism many pinworms;
- massive re-re-infestation with strong, not passing itching;
- Regular brushing and scratching tissue surrounding the anus causes it to injury, thereby joins infection arise dermatitis;
- frequent sign is a bowel disorder, the rapid stool, watery, mushy, sometimes mucus detected therein;
- mucous walls inside and outside the sphincter reveal petechial hemorrhages, irritation, slight erosion ulcer, blood vascular pattern is reinforced;
- in some cases the destruction pinworms appendicitis.
Signs enterobiosis severe stage:
- intoxication waste products pinworms, in which the patient suffers from headaches, dizziness occur, there is fatigue, in rare cases neurasthenia, Psychasthenia;
- in contact with worms in the female genital organs arise vulvovaginitises in severe, sometimes simulating gonorrheal forms of inflammation;
- in patients with gonococcal infection enterobiosis difficult to cure, the illness more severe and long-lasting;
- endotermita appearance and various forms of peritoneal irritation;
- eosinophilia blood.
symptoms enterobiosis
The main symptom is Enterobiasis occurrence of itch in the anus and sometimes painful sensations in the abdomen. If the shape of the average intensity of infection, patients complain of constant itching, permanent abdominal pain, frequent tenesmus, increased frequency of defecation; stool diluted, increased flatulence. Strong, unbearable itching causes insomnia. In severe invasive stage in vzroslyhpriznaki enterobiosis - it headaches, general deterioration, depression, rapid fatigue. Women and girls parasites can cause vulvityPatients complain of redness of the genitals, itching, pain during urination, discharge.
Clinical manifestations of chronic-phase mixed. In some infected patients enterobiosis occurs in the absence of clinical symptoms.
Intensity of symptoms in this case is determined by the frequency and intensity of infection super- and re-invasion.
Since most of enterobioze are children, they become tearful, irritable, can not concentrate, attention is unstable. In some cases, even may experience fainting, occasionally seizures, Shaped like epileptic. Severe complications include appendicitis and appendikopatii, paraproctitis and proctitis, eczema and dermatitis with characteristic symptoms.
Diagnostics
Diagnostic tests, prescribed for adults and children at enterobioze, lie in the selection of a reliable method of identifying the eggs of pinworms.
Applied methods:
- Scatological laboratory tests - a fairly common method, however, when a low-efficiency enterobioze. In the test the stool contains a small amount of egg fails to detect them infrequently. This is due to the peculiarities of the process of laying eggs - a female helminths do not spend it in the gut. Sometimes in the stool can be detected movable females.
- Scraping of the skin in the perianal area - method is more informative. But to clarify the diagnosis should be carried out at least three times with an interval of seven days, due to the periodicity of oviposition pinworms as possible scrape in a low-intensity interval invasive.
- Graham's method - triple study content remaining in a special impression on the surface of the adhesive tape, placed in the perianal area. It is the procedure in the morning, before going to the toilet. The periodicity interval between taking material is seven to ten days. The informativeness of such a method reaches 93%, it is the most accurate in diagnosing Enterobiasis.
Treatment
As treatment enterobiosis invited to conduct a full set of measures to prevent re-infestation. Strict adherence to personal hygiene - a prerequisite not only for the sick but also for all family members and contact with him a group of persons. Deworming is carried out all infected people.
Appointed complex, taking into account Enterobiasis symptoms in adults and consisting of drug treatment, with strict observance of hygienic measures, including a number of conditions.
Key recommendations:
- hand washing with alkaline soap, always after toilet visits and before eating;
- every day should wear fresh underwear, bedding changed regularly, followed by washing and heat-treating iron;
- every day, at least twice, washing with soap preanal area - to sleep and in the morning;
- daily bathing, washing of the whole body in a shower;
- with a strong, unbearable itching recommended to do before going to bed the night enema with soda solution to flush irritants adults pinworms.
In the presence of infection in young children it is recommended after cleaning the latter (at bedtime) to lay a small swab of cotton wool, vaselined in the anus area. This prevents the spread of female pinworms (girls - zapolzaniya them into the vagina), saves the child from the itching.
By themselves, pinworms do not disappear, immunity to it is not produced. To completely get rid of them, it is necessary to spend treatment.
There is a fairly wide range of modern medicines to combat enterobiasis. The most common anthelmintic drugs They are Vermoxum, pyrantel, liperazin, Worm, medamin. Selecting a destination of a drug making the physician infectious disease.
complications
- inflammation of the mucous membranes of intestinal, proctitis;
- various types of skin inflammatory responses to scratching in the anal passage zone adjoining bacterial infections;
- patients girls and women - inflammation affecting the genitals. caused by pinworms vulvovaginitises girls up to 10 years in a severe form can cause infertility;
- soreness appendicitis. During surgery, are sometimes found in the appendix contained worms, however, their direct connection with organ inflammation has not yet been proved.
prevention
As a precaution to prevent the spread of enterobiosis developed a comprehensive series of measures implemented by the Ministry of Health. Identification invaded contingent conducted in areas where the epidemiological situation can be improved.
Subject to mandatory inspection by:
- children attending kindergartens, school children up to the fourth grade, as well as the staff of preschool institutions - once a year;
- personnel involved in the food industry, a person intending to use the pool - once at registration receipt;
- all children admitted to the hospital for treatment;
- the detection of a team of more than 15% of children infested - all receiving treatment.
The forecast for recovery
The forecast for recovery from enterobioze favorable in the case if it is not accompanied by the complications related diseases.
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