Tenidozy belong to the category of parasitic infections, the causative agents of which are ribbon helminths - tienides, belonging to the class of cestodes( lentets).In the medical literature, they are also called staples or tapeworms.
Types of
Depending on which type of tapeworm became the culprit of the disease, the doses are divided into two types:
- shadows, triggered by a pork chain;
- is a teniarhynchiasis caused by a bull chain.
Some sources refer to cyanosis as a cysticercosis, a disease caused by the ingestion of pigs into the stomach of eggs, but this classification seems deeply mistaken for most specialists.
Cysticercosis - in spite of the fact that its causative agent is porcine tapeworm( as in the case of tetanus) - the type of shadowing is not a dosis: it is a completely different disease.
The causative agent of the human doses
- The causative agent of the shadowosis is the pig papaya ( in the medical literature it is also called the pork tapeworm and the armed chain).The length of an adult helminth can range from two to four meters. In front of his body is a head( scolex), equipped with four perfectly developed muscular suckers and a halo of two rows of chitinous hooks.
With the help of these devices, pig tartan, parasitic in the human small intestine, reliably attaches itself to the mucous membranes of the intestinal walls. Its flat body( strobila), reminiscent of the ribbon, consists of numerous quadrangular segments-proglottids.
As a hermaphrodite( an organism that has both female and male genital organs), the pork solitaire is the owner of a triple-ovary and the uterus with 7-12 branches on each side. Each mature segment contains between thirty and fifty thousand eggs.
Inside the eggs are invasive oncospheres - embryos provided with six hooks. Ripened proletottids, separated from the body of the helminth, are excreted from the human body into the external environment( usually into the soil) along with the calves.
Video shows the way of transferring the pork chain to the person:
- The bullshit of ( also called bovine tapeworm and unarmed chain) is the culprit of the appearance of the shadowarhynchus. It is a tapeworm, the length of which can reach ten to twelve meters. The flat ribbon-like body of this helminth consists of a head equipped with a rudimentary proboscis and four powerful suckers, a short neck and a large number of proglottid segments.
Like pork tapeworm, bovine tapeworm is a hermaphrodite with a well-developed female and male reproductive system. His genitals are located in the middle third of the trunk. Helmint has a closed uterus characterized by maturation and accumulation of eggs inside it.
As the number of eggs increases, the uterus is stretched, resulting in a large number( from 16 to 30) of protrusions forming on each side of it. Since the maturation of eggs is not uniform, end-proglottids can contain from fifty to one hundred and fifty thousand invasive larvae that do not need ripening.
Researchers have found that bovine tapeworm can produce about six hundred million eggs within one year, and at least eleven billion eggs throughout life.
Rounded eggs of bovine tapeworm, having a transparent thin shell, contain an embryo( oncosphere), equipped with three sharp hooks.
The mature segments, located at the very end of the torso of the bull's chain, first stretch, then narrow, then move forward from the strobila. Once in the intestine, the separated segments leave the human body through the anal canal along with the feces.
An interesting fact has been established, according to which most of the segments move along the intestines passively, along with digested food masses, but some of them quite independently and quite actively advance to the anus. When they get out of it, they can crawl along the body for a while, giving them unpleasant sensations.
Each sick person can daily give out to the environment from one to twenty-three segments. Despite this, the helminth does not become shorter, as new proglottids grow continuously from the cervical side. Consistently developing and maturing, they advance to the tail of the helminth, in order to separate from it in time.
Both the bovine and the pork chain do not have a digestive system, since the helminths, immersed in the partially digested contents of the intestine of their host, can only assimilate the nutrients.
Video about the mechanism of transfer of a bull chain:
Source of infection
- In order for the pork chain to develop, it must change two hosts. As its intermediate host, wild boars or domestic pigs( more rarely dogs and other mammals) most often act. In their organisms, the eggs of the tapeworm are together with the earth or food.
Once in the digestive tract of pigs, invasive oncospheres, released from the eggs, along with blood flow are carried throughout the body and after a while settle in the structures of muscle tissues.
Eight to ten weeks later, the embryos are transformed into Finns( or cysticerci) - special larval vesicles containing a head provided with hooks. In the muscle tissues of pigs, Finns can exist for three to six years;at the end of this period, their calcination and death occurs.
Sometimes in the role of an intermediate host of a pig chain, a person can act: in this case, the larvae of tapeworm( cysticerci) provoke the development of a dangerous disease - cysticercosis.
The most frequent places for the localization of cysticerci are the brain and eyes, although cases of their introduction into the structures of muscles, internal organs and tissues are not uncommon. The symptomatology of cysticercosis is determined by the place of parasitization of the larvae.
Subsequent development, as well as helminth parasites, occurs in the body of a person who has eaten wild boar or domestic pig meat, infected by Finns. Once in the small intestine of a human, the scolex of the tapeworm leaves the larval vesicle and, using suckers and hooks, tightens itself to the intestinal wall.
After 8-10 weeks, having increased a huge number of segments, the pork thistle turns into a matured individual.
The main causes of infection with the shadows:
- Eating pork that has not undergone veterinary control and has not received sufficient heat treatment.
- Non-compliance with hygiene rules( cysticerci can enter the body from contaminated hands).
- Drinking raw water containing larvae of pork chopsticks.
Thus, infection with a shadyosis occurs either by water or food. Adult pork tartar can parasitize in the body of its regular host for two decades.
- The final owner of a bull tie is always human. Cattle( cows, yaks, buffaloes, zebu) play the role of an intermediate host. The main source of environmental contamination with eggs of this helminth is a man whose small intestine is parasitized by his adult.
A special risk group is made up of workers( represented by shepherds, milkmaids, livestock keepers, calves) of livestock breeding complexes that care for cattle.
Given that the end proglottids of bovine tapeworm are passively withdrawn from the body of an infected person with feces or actively selected from its anus, mass seeding of forage, cattle and pasture areas with helminth eggs containing oncospheres ready for immediate invasion occurs.
In the absence of sanitary treatment, tapeworm eggs( killed a few hours after exposure to a solution of carbolic acid or bleach) in the external environment remain in danger for one to two months.
Thus, animals can become infected with tenierhinchosis by eating hay, grass or other food contaminated with feces of sick people. Eggs of bovine tapeworm can get into the calf's body from the dirty hands of the calf, which appears as milk.
In the Russian Federation, the cases of this disease are most often recorded in the territory of Dagestan, Tuva, Buryatia, Sakha Republic, Perm, Altai and Krasnoyarsk Territories, Novosibirsk, Tyumen and Irkutsk regions.
Infection with tenierhynchiasis, as a rule, reaches peak values at the time of mass slaughter of cattle, occurring during the autumn-winter period.
A person can become infected with a shadeiarhoz:
- Using raw food( most often this happens when taking a sample from raw minced meat), dried, slightly salted or under-processed meat stuffed with viable cysticerci containing a protocalex( a head of larval form of thiidids) of a mature tapeworm.
- Disregarding the sanitary and hygienic and household skills during the cutting of raw meat or in the conduct of economic activities.
Under the influence of bile and gastric juice, the protoscoole leaves the larval bladder and, with the help of suckers, is fixed to the intestinal wall, marking the onset of the development of the helminth, reaching sexual maturity 2-3 months after introduction into the body.
As a rule, teniarinhoz is characterized by parasitism in the intestine of the only specimen of bovine tapeworm, although in medical practice there have been cases of parasitization in the human intestine of several dozens of tapeworms at once.
Symptoms of
Clinical manifestations of dosis in some patients may be practically absent, while in others, manifesting themselves very clearly, they often cause severe health disorders.
In some cases for a number of years the only evidence of infection of the body with tapeworms is either the presence in the stool masses of proglottids separated from them, or the independent creeping of segments clearly visible with the naked eye from the anus of the infected person.
Accompanied by extremely unpleasant sensations( the patient feels that foreign bodies are crawling inside the anal canal causing intolerable itching), this process can cause a number of neurotic disorders.
The characteristic signs of an astheno-neurotic syndrome are: headaches, dizziness, fainting, increased fatigue, extreme irritability, all kinds of sleep disorders, weakness in the upper and lower extremities.
As a rule, a sick person does not even guess that the cause of this syndrome is a strong intoxication of his body with the products of the vital activity of parasitic tapeworms. In exceptional cases, parasitic infestation can trigger the onset of convulsive seizures.
Because the clinical picture for both types of dosis( shadowy and tenierhinhose) has many identical manifestations, we combined them in one list. The symptomatic symptomatology of doses is:
- Feeling of heaviness and pain in the abdomen. In some patients, they may be aching and not too strong, while in others they are very pronounced and have a cramping character.
- A belching and heartburn arising regardless of food intake.
- The violation of intestinal motility and excretory function of the digestive tract.
- Intensive salivation.
- Constant nausea, periodic calls for vomiting.
- Catarrh of the small intestine, arising from the traumatic effect of the helminth on the mucous membranes of its walls.
- Increased flatulence.
- Unstable character of the stool, characterized by a constant change of constipation and diarrhea.
- Intestinal obstruction, which occurs when the helminth is knocked down in a tight lump, which prevents the movement of feces.
- Strengthening of allergic reactions to toxic substances formed during the life of tape worms and poisoning the human body.
- Dry skin, deterioration of hair and nail plates due to an acute shortage of vitamins and minerals provoked by parasitizing helminth in the body.
- Increased appetite and a constant sense of hunger experienced by the patient. Despite the large amount of absorbed food, the patient not only does not gain weight, but also significantly loses weight.
- Strengthening of the heartbeat, lowering of arterial pressure. The patient may complain of tachycardia, pain in the heart muscle, tinnitus and flies before the eyes. Some patients experience nasal bleeding.
- The appearance of urticaria rash( exanthema), covered with dry crusts, which occurs in weakened patients.
- Appearance of anemia( low content of red blood cells - erythrocytes - in the blood).
- Pronounced soreness of the tongue, the appearance of cracks on it and the increase in its size.
- By falling of the moving segments of the bovine tapeworm into the middle ear( through the Eustachian tube), into the respiratory tract and into the vomit.
Bear bovine tapeworm during pregnancy is fraught with the emergence of severe toxicosis, miscarriage and premature birth.
The above manifestations of dosis in full are very rare. It is established that for them a tendency to a gradual increase is characteristic, depending on how long the parasite remains in the patient's body.
Diagnosis
Given the small number of specific manifestations that allow one to suspect a parasitic infection, the diagnosis of dizziness is often associated with a number of difficulties.
If a doctor suspects of being infected with a bulbar chain, he should ask the patient delicately if there were any instances of cysticerci crawling out of his anus, because this is the symptom of uncontested parasitic infestation.
An equally indisputable symptom that confirms the presence of dosis is the detection of segments of tapeworms in the stool after the act of defecation( they are clearly discernible to the naked eye and the patient can notice it).
If helminth cysticerci are not detected visually, they can be triggered by taking a salt laxative, using garlic or pumpkin seeds.
The second stage in the diagnosis of doses is the whole complex of laboratory studies:
- Macroscopic examination of feces, consisting in examination of pre-prepared material either with the naked eye, or using a magnifying glass. This diagnostic technique, which helps to control the effectiveness of the prescribed treatment and to carry out a differential diagnosis when parts of helminths belonging to the cestode class are detected, always precedes the microscopy of the studied substrate.
- Performing coprovooscopy( the term is formed by the fusion of three Greek words: "scopéo" - look, "kopros" - feces, "ovos" - egg) - a laboratory technique for studying feces samples under a microscope, helping to detect the eggs of tapeworms in them. In bacteriological laboratories of Russia, coprocopy( analysis of eggs by the worm) is carried out by different methods. The most commonly used methods are:
- Kato-Miura, which involves the study of a thick swab of stool under cellophane;
- Enrichment( the method of precipitation of Füllbörn and the more perfect flotation method of E. V. Kalatranian, which involves the use of a saturated solution of sodium nitrate as a flotation solution);
- Acetic ester and formalin-ether precipitation.
- Study of perianal-rectal scrapings taken from the skin surrounding the anus. Biomaterials for enterobiasis are selected in the morning hours: it is necessary before urination, caloric discharge and hygienic procedures. There are different methods of taking perianal scrapings:
- Perianal scraping according to Torgushin is performed using a cotton swab, wound on a glass or wooden spatula. After moistening the tampon with glycerol solution, take a smear from the folds located in the anus. Putting a drop of glycerin on a slide, wash the swab in it, lightly striking it on the glass. The resulting preparation( without the use of a cover glass) is studied under a microscope.
- Perianal scraping according to Kevorkova is performed with a cotton swab moistened with distilled or boiled water. Wiping her perianal folds, put the wand in a centrifuge tube and shake the contents carefully. After removing the cotton swab, the contents of the tube are centrifuged for three minutes( centrifuge rotation speed is 1500 rpm).
- Extremely popular is the technique of perianal scraping according to Rabinovich, which involves the use of eye glass sticks. Wide spatula sterilized and dried eye sticks dipped in a special glue and, giving them a vertical position, dried for several hours until a uniform adhesive film( given that the stickiness of the film is maintained throughout the week, laboratory technicians prepare sticks in advance).Scraping is performed by applying both sides of the spatula to the skin of the perianal folds. After fixing the wand in a special holder, the two sides of the spatula are microscopically successively.
- Another popular method is perianal scraping by Graham's adhesive tape. To perform this procedure, use either an operating film or a conventional transparent tape. Cutting a strip of adhesive tape( length 8-10 cm), pre-attach it to the slide. Before taking the scraping, the film is removed from the glass and, holding it by the ends, tightly press the adhesive side against the anus and perianal folds, trying not to touch them with hands. Undressing the tape from the skin, transfer it to the slide with an adhesive side down and evenly, avoiding the formation of air bubbles, glue to the glass. The finished product is examined under a microscope.
To get reliable results, perianal scraping should be taken at least three times, doing this every other day or every day.
Since the larvae( oncospheres) of bovine and pork tapeworms have an identical morphological structure, it is possible to distinguish between shadow arthrosis and shadowosis by careful macroscopic examination of their mature proglottids( joints) having different number of branches of the uterus. Pork tapeworm has eight to twelve of them, and a bull one - from eighteen to thirty-two.
- Differential diagnosis of the disease of doses requires not to be confused with diseases of the gastrointestinal tract( cholecystitis, gastroenteritis, Crohn's disease) and a variety of intestinal helminthiases.
- Pig and bovine chains can be detected during contrast radiography of the small intestine. On the roentgenogram tape tapeworms look like wide light strips.
- A general blood test, sometimes indicating the presence of leukopenia, anemia and an increase in the number of eosinophils( a variety of leukocytes that protect the body from the toxic effects of pathological microorganisms), is of little diagnostic significance, since all these indicators are transient.
Treatment of
It is recommended that treatment of doses is carried out in a medical hospital under the supervision of an experienced specialist.
The de-worming of patients these days is carried out with low-toxic drugs capable of paralyzing the nervous system of tenid and, eliminating adhesion( adhesion) to the walls of the small intestine, removing them from the body along with feces.
- The first stage of therapy is a single administration of phenasal, niclosamide, albendazole or praziquantel, after which the helminth spontaneously exits through the anus. In case of complication, in which the parasite is excreted from the patient's body only partially( its head continues to be firmly attached to the intestinal wall and can easily restore the helminth's strobil) the treatment course is repeated. In the treatment of the above drugs, side effects, consisting of dizziness and digestive disorders, are possible.
- In the second stage of treatment( 1.5-2 hours after taking the medicine), the patient is given a salt laxative , which helps to remove feces containing segments with solitary eggs.
- To prevent autologous invasion( self-infection), carefully ensure that the patient does not experience vomiting.
- Before the beginning of treatment and during it the patient should observe a special slag-free diet , which provides frequent( at least five times a day) consumption of small portions of food. The basis of the therapeutic diet should be lean soups, viscous cereal, lean fish, sour-milk products. The best drinks are teas, compotes and kissels. The patient should completely abandon the use of pickles, smoked products, fatty, sweet and fried foods. It is absolutely unacceptable to use chocolate, coffee, legumes, dishes from spinach, cabbage and beets, grapes, apricots, peaches, gooseberries, raspberries.
- The main therapeutic regimen can be supplemented with phytotherapy , in which case the physician can prescribe capsules with essential extract of male fern. To small children the preparation is given, having mixed it with honey, jam or fruit jelly. Duration of treatment is one day. The maximum daily dose for a 1-year-old child is 0.5 g, for an adult patient is 4 g.
- . Good results in the treatment of dzenia give the use of pumpkin seeds. After cleansing from a hard peel and finely grinding in a mortar, they are mixed with a small amount of honey, sugar or jam. Ready drug in small portions is given to the patient on an empty stomach( it is advisable to feed him within one hour).Three or four hours later the patient should take a laxative, and after another 30 minutes he is given an enema. The daily dose of pumpkin seeds( without skin) for babies aged 2-3 years - 75 g, 6-7 years - 100 g, for adult patients - 300 g.
- No less effective is the use of decoction of pumpkin seeds. For its preparation, the dried pumpkin seeds, together with the outer white peel, are ground in a meat grinder and, with a double volume of water, put on a water bath for two hours. Ready broth filtered through gauze, and then remove the oil film from its surface. The cooled broth should be drunk to the sick for half an hour. After a couple of hours the patient takes a laxative, and after half an hour he is given an enema. For children under five years old, a decoction of 150 g of raw sunflower seeds is prepared, six to seven from 200 grams, ten years from 300 grams, and adults from 500 g.
Prevention of
The prevention of doses is in:
- Timely detection of people exposed to parasitic infestation. First of all, employees of meat-packing plants and cattle-breeding complexes( calves, shepherds, milkmaids, zootechnicians, etc.) and all members of their families are subject to mandatory examination.
- Protecting the environment from contamination by tapeworm eggs. To this end, state services carry out thorough monitoring of compliance with sanitary and hygienic standards on livestock farms and farms. Particular attention is paid to the installation of toilets for staff.
- Identification of animals infected with helminths in the course of veterinary and sanitary examination of meat. When a Finn is detected as a bull tangerine, the meat is disinfected before being sold by careful digestion in compliance with a number of standards.
- Thorough inspection of the purchased meat. Larvae of helminths are sometimes noticeable even to the unaided glance, especially if parasitic invasion is massive.
- Purchasing meat only in markets or in shops that carry out a permanent veterinary and sanitary examination of all meat products.
- Completely refusing to eat raw or undercooled meat of pigs and cows. All meat dishes should be well baked, cooked or roasted. To make the beef completely safe, small pieces of it must be boiled for two to three hours.
- Immediate contact with a qualified physician if symptoms are identified that indicate a possible infection with helminths.
- Education of the population , consisting in its informing about possible ways of parasitic invasion.