25.10.2020

Treatment of ascariasis in children

Ascariasis in children with a small number of parasites can occur in erased form. Sometimes pronounced manifestations of intoxication and allergies can occur in a child already in the first weeks after infection with ascariasis (in the early migration stage).

There is a general malaise, fever up to 38 ° C, chest pain, an allergic rash and itching of the skin, dry cough or mucous sputum, and sometimes pleurisy. When ascariasis in children there is an increase in the liver, spleen, lymph nodes.

In the intestinal stage of ascariasis in children, symptoms of indigestion are associated with a decrease in gastric acidity and enzyme activity, deterioration of food digestion and absorption of nutrients. When ascariasis, children begin to be disturbed by recurrent abdominal pains (abdominal syndrome), lack of appetite, and sometimes – aversion to food, excessive salivation, nausea, intolerance to certain foods, flatulence and unstable stools, weight loss, frequent colds.

Ascariasis is characterized by disorders of the nervous system (asteno vegetative syndrome): children have fatigue, memory loss, confusion, irritability, restless sleep, the appearance of vestibular disorders, hyperkinesis and epileptiform seizures.

Complications of ascariasis in children

Ascariasis in children is dangerous for its complications. Ascaris larvae cause mechanical damage to the walls of various organs and blood vessels, accompanied by limited or significant hemorrhages, inflammatory infiltrates, micronecrosis and ulceration (sometimes – perforation) of the tissues of the liver, small intestine, lungs.

The waste products secreted by the larvae and adult ascaris have a strong toxic and allergic effect on the body. Ascariasis in children leads to sensitization of the whole body and the development of pronounced general and local allergic reactions in the form of asthmatic suffocation and urticaria.

Ascariasis in children contributes to the development of dysbacteriosis; depressing the immune system, increases susceptibility to various infections. In pediatrics, ascariasis in children is a contraindication for preventive vaccination because of its low efficacy.

With massive invasion, ascariasis in children can be complicated by mechanical or spastic obturation of the intestinal lumen, appendix and bile ducts, which leads to intestinal obstruction, attacks of acute appendicitis, cholangitis, cholecystitis, pancreatitis, the development of obstructive jaundice. In the endemic foci of ascariasis in weakened young children can develop severe pneumonia with a fatal outcome.

Diagnosis of ascariasis in children

Diagnosis of early ascariasis in children is based on clinical and epidemiological data and the presence of additional signs: leukocytosis and eosinophilia – in the general blood test, the larvae in a microscopic sputum smear, eosinophilic infiltrates in radiography of the lungs. The proposed serological methods for the diagnosis of ascariasis in children (precipitation reaction on live ascarid larvae, the reaction of indirect hemagglutination with ascariasis antigen, etc.) are not widely used.

A more accurate diagnosis of ascariasis in children is possible 3 months after infection, during the chronic intestinal stage of the disease, when the worms become sexually mature. For this, a laboratory test of feces on helminth eggs is carried out.

In some cases, adult roundworm can be detected by chest and chest x-rays, as well as endoscopic examinations or surgical interventions in pediatric gastroenterology.

Treatment of ascariasis in children

Children with an established diagnosis of ascariasis are given anthelmintic drug therapy; the type of drugs and the duration of the course of treatment are selected by a pediatrician depending on the severity of the disease.

In the early migratory stage of ascariasis in children, desensitizing and anti-helminth drugs are prescribed – thiabendazole or mebendazole, which have a wide spectrum of anti-nematode activity. Pulmonary manifestations are stopped by taking bronchodilators and corticosteroid drugs.

For the treatment of intestinal stage ascariasis in children is used for choice: levamisole – once; Pyrantel – once; piperazine, mebendazole – for children over 2 years old, especially in case of polyinvasion.

The effectiveness of treatment of ascariasis in children with these drugs is 80-100%. One month after the treatment, a control examination of the child is carried out.

In uncomplicated cases of ascariasis, anthelmintic treatment usually leads to the complete recovery of children without any consequences; in complicated cases, the prognosis depends on the severity of the developed complications.

Primary prevention of ascariasis in children consists in observing personal hygiene measures, secondary – in carrying out sanitary-hygienic measures (protecting the soil and water from faecal contamination, active detection and treatment of patients with ascariasis, informing the population).

Ascariasis in children is a parasitic disease that develops when a child is infected with round worms – ascaris. Ascariasis in children can manifest as malaise, fever, local allergic reactions, cough, abdominal and asteno vegetative syndromes, digestive disorders, weight loss. Diagnosis of ascariasis in children includes the analysis of clinical and epidemiological data, the results of a general blood test, serological tests, an analysis of feces on helminth eggs. When ascariasis in children prescribed anthelmintic drugs.

Ascariasis is one of the most common helminth infections (helminths) caused by the parasitic roundworm Ascaris lumbricoides. The main contingent of patients are young children. The causative agent of ascariasis in a child – human ascaris has a fusiform shape, white and pink color and rather large sizes (females up to 40 cm, males up to 25 cm). Roundworm can parasitize in various organs of the child, but their main habitat is the thin intestine. Ascariasis in children belongs to anthroponotic geohelminthiasis: the only biological host of helminth is man, and the maturation of eggs occurs in the soil.

Causes of Ascariasis in Children

The source of soil contamination with helminth eggs is a person suffering from ascariasis. The ascarids themselves in the environment are not viable, and their eggs can be stored in the soil for many years. Infection with ascariasis in children is carried out by the fecal-oral route when ingesting ascaris eggs with larvae that have ripened to the invasive stage.

Children have the greatest risk of infection with ascariasis in the summer and autumn due to inadequate compliance with the rules of personal hygiene after contact with soil and grass (during a walk on the playground, in the sandbox); when used unwashed vegetables, fruits, herbs, boiled water.

The life cycle of roundworm includes several phases of development. Mature eggs of Ascaris released into the intestines release the larvae, which penetrate the mucous membrane into the portal vein and circulate through the bloodstream, spread to the liver, gall bladder, right ventricle of the heart, lungs and bronchi. When coughing with bronchial secretions, the larvae enter the oral cavity and, when ingested with saliva, re-enter the small intestine, where they reach the mature state.

The period from the moment of infection to the development of an adult roundworm takes 2.5-3 months, which corresponds to the early migration stage of the disease. During the late intestinal stage of ascariasis in children, adult worms parasitize the body. Per day, the female roundworm lays up to a quarter of a million immature eggs, which are excreted with the patient’s feces. The life expectancy of adult Ascaris is no more than 12 months, after which they die. A new generation of larvae in the same organism cannot appear, and even in the absence of treatment, ascariasis in children completely stops in about a year, if during this time no re-infection has occurred (including auto-invasion)

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