Enterobiosis: symptoms, treatment and prevention
Mar 27, 2018
Enterobiasis is a widespread parasitic disease in the world, related to helminthiasis.Its pathogen are worms from the group of nematodes, known as pinworms.Table of contents: Pinworms Helminth development path Paths of infection with pinworms Symptoms of enterobiosis Complications of enterobiasis Enterobiasis tests Enterobiasis treatment
The causative agent of this helminthiasis is a small round worm of whitish color.The length of the spindle-shaped body of the female is up to 1 cm, and the male is usually half as large.In females, the posterior end of the body is pointed, which gave the name to the parasite.The helminth is fixed to the intestinal wall of the host by means of a vesicle around the oral opening.Worms feed on blood and intestinal contents.The most favorable conditions for the growth and development of adult pinworms - in the caecum, including - its appendix - appendix.In a person infected with enterobiasis, as a rule, there are no painful sensations due to the presence of parasites in the digestive tract.
Enterobiasis is one of the most common parasitic diseases in the world.You can get sick with this helminthiosis at any age, since the susceptibility to invasion does not change at all with the years.
At risk, there are mainly young children who are not familiar with the basic rules of personal hygiene.
The source of the disease can only be a person infected with pinworms.
Helminth development cycle
When the patient goes to bed and his anal sphincter relaxes as much as possible, the helminth females creep out through the anus and lay eggs on the skin in the perianal area.The female can lay off from 5 to 17 thousand eggs for 1 time!After that, she dies.
As the patient feels unbearable itching, he combs the affected area.Eggs fall under the fingernails and on the skin of hands, which, if there is insufficient level of personal hygiene, causes repeated infection( auto- or re-invasion) and spread of the parasite through household items.
Note: , fertilized females are not able to lay eggs directly in the intestine, because in this anoxic environment their reproductive organs are in a spasmodic state.
Average age of adult pinworms is slightly more than 5 weeks.They parasitize on the walls of the intestine, mainly the female, and the functions of the males are only in fertilization, after which the male dies.
Eggs of pinworms can be carried by house insects and even with dust particles.For successful development, a temperature of 34 ° C-36 ° C and a high humidity level( up to 90%) are required from the egg of the larva.Ripening time - only 4-6 hours.Larvae from eggs are released into the human gastrointestinal tract under the action of digestive enzymes.
In the small intestine of a human, they grow in mature individuals in 10-20 days¸ after which mating takes place.The males that fulfill their intended purpose are brought out, and the female migrates to the lower parts of the small intestine, attaches there to the wall and continues to live and feed until the eggs that have increased in size inside her body begin to press on the esophagus.Having detached from the wall of the small intestine, the female descends into the large intestine and rectum, and then leaves it for laying eggs, thereby starting a new cycle of development of the next generation of helminths.
Oysters are characterized by a rather high degree of stability in the external environment.Under favorable conditions, eggs can remain invasive outside the human body for up to 3 weeks!
Destructive for eggs of this parasite are dry environment and solar ultraviolet.
Paths of infection with pinworms
The main source of infection are dirty hands and seeded items.With a low level of hygiene, pinworm eggs enter the body of the new host through the mouth, and parasitize and multiply in the intestine.The most often enterobiosis affects children, especially - attending pre-school children's institutions.Outbreaks of enterobiosis in kindergartens are by no means a rarity.
Symptoms of Enterobiasis
The main sign of enterobiasis in adults and children is a strong itching in the perianal area, which develops in the evening before bedtime and at night.If the parents noticed that the child strenuously combs this area in a dream, then it is required to immediately take the necessary measures to degelment the organism of the baby.
From infection to the first clinical manifestations usually runs from 3 to 6 weeks.With a mild form of this helminthiasis for 1 to 3 days, the patient has an itch, which disappears for some time.It re-emerges after 2-3 weeks due to repeated self-infection.If pinworms are many, the itching becomes intolerable and persecutes the patient almost constantly.
Important: the total number of parasites in the body of the carrier can reach tens, and in the case of re-invasion, the count can go to thousands of individuals( we are talking only about adult pinworms)!
The most important symptoms of enterobiasis include:
- itching near the anus;
- abdominal pain( not always);
- rumbling in the abdomen;
- frequent tenesmus;
- a rapid stool of a pulpy consistency;
- admixture of blood in the stool( relatively rare).
Note: is most clearly symptomatic in the acute phase( within the first week).In the chronic phase of enterobiasis( 35-70 days), the main symptom of helminthiosis is pruritus in the area.
Neurological symptoms may develop in children with enterobiasis:
- sharp mood swings;
- decreased appetite;
- increased fatigue;
- poor sleep;
Complications of enterobiasis
Combing often causes abrasions, resulting in the development of secondary bacterial complications.Dermatitis and eczema can also complicate the course of the disease.
In case of particularly severe and prolonged course of enterobiasis the following complications are possible:
- irritation of the peritoneum;
- Enterobiosis endometritis( with the ingress of female worms into the female genital tract).
Important: describes the formation of granules around pinworms, deeply submerged in the thickness of the intestinal mucosa, as well as the development of peritonitis due to perforation of the muscular wall layer and the exit of helminths into the abdominal cavity!
Helminthes irritation of the intestinal wall leads to reflex disturbances of peristalsis and activity of the secretory glands.The consequence of the negative impact of pinworms can be the development of gastroduodenitis and enteritis.
It is noted that pinworms significantly change the microbiocenosis of the intestine, as a result of which the majority of infected people develop dysbacteriosis.
In female patients, regardless of age, inflammatory pathologies of the urinary tract( cystitis) and inflammation of the reproductive system( vulvovaginitis) can develop as complications of enterobiasis.
Important: enterobiosis favors transmission of some other contact parasitic diseases - hymenolepiasis and giardiasis.
Helminths in the process of vital activity release a huge amount of toxic metabolic products, which causes a general poisoning of the carrier's body.In this connection, enterobiosis in children is especially difficult.
During pregnancy, enterobiosis can become one of the causes of severe toxemia.
Pinworms can reduce overall immunity, so people infected with helminths are more susceptible to infectious diseases.
Important: studies have shown that pinworms can exert an immunosuppressive effect on the children's body by suppressing the development of immunity after vaccinations( in particular after the introduction of an antidiphtheria vaccine).In 18% of cases, antibodies do not form after DTP, and in 14% of cases, their number is very small.
Analyzes for enterobiasis
Analyzes for enterobiasis and egg worms are fundamentally different.To hand over a feces on an enterobiosis practically it is senseless.It is only known that after the end of the cycle of fertilization, the masculine specimens of helminths can leave the fecal masses.Single eggs of parasites can be detected only by chance, since parasites lay them outside the rectum.To detect pinworms around the anus, a smear or scraping is done on enterobiasis.
Analysis for enterobiasis: how to take in order to get reliable data?
For diagnostic purposes, scraping is performed from perianal folds, for which a special sterile adhesive tape is used.
Analysis is given three times - either daily or every other day.The most informative are scrapings taken in the morning before defecation and hygiene procedures( washing).
In the course of a laboratory blood test, moderate leukocytosis and eosinophilia are fixed( the peak occurs on day 16 of the onset of the disease).
Treatment of enterobiasis
As a medicament, the patient is prescribed anthelmintic drugs. The most effective drugs of this group in the treatment of enterobiasis are:
- Mebendazole( Vermox) - 10 mg once;
- Combantrin( pyrantel pamoate) - at the rate of 5-10 mg per 1 kg of the patient's weight once after a morning meal;
- Piperazine( 3 g per day for 3 admission, course - 5 days);
- Albendazole( 400 mg) once;
- Carbendacim( 10 mg per day in 3 divided doses).
To prevent nighttime itch that interferes with normal sleep, the pinworm can be removed from the intestine with a cleansing enema( 0.5 tsp baking soda for 200 ml of warm boiled water).
As an external agent, it is advisable to apply topically anesthetic ointment( overnight) in the anal area.
For the treatment and prevention of enterobiasis, a number of elementary rules must be observed.The patient must thoroughly wash his hands after each visit to the toilet - hot water with soap and, preferably, with a brush.
It is better to cut your nails as short as possible.Underwear to an infected person should be changed at least twice a day, and bedding - every day.In the evening and morning after awakening, the perianal area needs to be thoroughly washed with warm water and soap.
The washed bed linen and bed linen must be thoroughly ironed with a hot iron to ensure the destruction of helminth eggs.Eggs of pinworms can be transmitted through linen, toilet bowl and bathroom furnishings.In the room where the patient is located, as well as throughout the apartment, it is advisable to carry out daily wet cleaning, adding soap and disinfectants to the water( for example - a usual soap solution and sodium bicarbonate).
It is necessary to observe a special hygienic regimen for at least 2-3 weeks after the first symptoms are detected and treatment is started.The patient is recommended to use special cotton swabs, which are administered rectally, or wear panties with elastic bands on the hips.These measures make it possible to exclude the scattering of pinworm eggs.Even if the family has symptoms of enterobiasis only in one of the members, treatment must go through all.
With the outbreak of enterobiasis in a preschool, all children and staff are treated.
Fifteen days after the completion of the course treatment, it is imperative to monitor its effectiveness.
Vladimir Plisov, medical reviewer