Ascariasis In Children - Symptoms, Complications, How To Remove?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Ascariasis in children

Ascariasis is the defeat of the body of children and adults with helminths (human ascaris Ascaris lumbricoides). Man is both intermediate and final host of this parasite. The disease is seasonal in nature, with the greatest prevalence during the warm season. Symptoms of ascariasis in children are associated with the migration of this parasite in the body. Most often, the symptoms of ascariasis appear in the gastrointestinal tract, less often in the respiratory system.

Content:

• Where do roundworms come from in children?
• What happens after the eggs of the parasite enter the child's body?
• Symptoms of ascariasis in children
• What do roundworms and their eggs look like?
• What if the ascaris came out?
• What is ascariasis?
• Consequences and complications of ascariasis
• Diagnosis of ascariasis in children
• How to remove roundworm from a child?
• Can ascariasis recur after treatment?
• How to prevent ascariasis?

Where do roundworms come from in children?

Infection of children with ascariasis occurs by the fecal-oral route. A person in whose body sexually mature individuals produce fertilized eggs excretes them along with feces. Children become infected with such eggs through soil, contaminated water, food, dirty hands.

Infection routes:

• Contact with infected children in the children's team;
• Toys;
• Door handles in public places, in transport;
• Banknotes and coins;
• Vegetables and fruits with soil microparticles;
• Transfer of Ascaris eggs by insects.

What happens after the eggs of the parasite enter the child's body?

Once in the intestines, roundworm eggs from the duodenum are carried through the body with the blood stream. They penetrate the lungs, liver, and the right side of the heart. Once in the lungs through the small circle of blood circulation, the larvae enter the alveoli. Then the larvae rise into the larynx, into the pharynx, are swallowed again and enter the intestines a second time. Such a cycle of roundworms pass in 2-3 weeks.

In the small intestine, roundworms go through the stage of growth and maturation to sexually mature individuals. If there is a sexual partner for them, soon the female secretes about 200 thousand eggs with feces. These eggs must mature in the soil within 1-2 weeks under favorable conditions (temperatures from +16 to + 32 ° C). Then they find a new owner and the development cycle repeats again.

Symptoms of ascariasis in children

In infants, ascariasis practically does not occur, since they are protected by the mother's specific antibodies through breast milk. Accidental ingestion of parasites into the body of children under one year ends with their removal. From 2-3 to 10 years old, children become active, their diet expands, and they most often get helminthic infestation.

Symptoms of ascariasis in children:

• Staying tall, underweight,
• Delayed physical development
• Remaining in mental and mental development during mass invasion;
• Weakness, lethargy, frequent headaches;
• Allergy symptoms;
• In case of complications - pneumonia, hyperthermia, cough with phlegm;

Occasionally, symptoms such as restless sleep, photophobia, and abdominal pain may appear.

What do roundworms and their eggs look like?

The human roundworm belongs to roundworms. It is pink in color, up to 25 cm long in males and 40 cm in females. The thickness of the roundworm is 3-5 mm, the sexually mature individual is covered with a cuticle. This shell protects the helminth from gastric juice and enzymes that process protein. The main habitat of roundworm is the small intestine. The parasite does not attach to its walls, it does not have scolexes for fixing in the mucous membrane. In the lumen of the intestine, the helminth is retained by constant movement against the movement of food.

The lifespan of the roundworm is 2 years, then the parasite dies. If re-infection does not occur, ascariasis in rare cases ends spontaneously. The eggs of mature individuals are yellow or yellow-brown in color, ranging in size from 50 to 70 microns. They can only be seen with microscopic examination.

What if the ascaris came out?

The released instance of the helminth must be placed in a container with a lid and shown to a specialist. If it is impossible to transfer the ascaris, you need to photograph it. Accurate data on the presence of a parasite in a child's body will help to make an emergency diagnosis and timely start treatment.

What is ascariasis?

Classification of ascariasis by its localization:

• With intestinal complications;
• With complications in other organs;
• Ascariasis of not specified etiology.

Classification of helminthiasis depending on the stage of development of the disease:

• Acute stage;
• Intestinal stage;
• Stage of complications.

Consequences and complications of ascariasis

If for the majority of adults this type of helminthiasis does not pose a threat to life or health, then the helminthic invasion has serious consequences for the child's body.

Complications of ascariasis:

• Bowel obstruction. It is accompanied by abdominal pain, constipation, bloating, vomiting with the smell of feces. It occurs due to the fact that the lumen of the small intestine is closed with a ball of ascaris, it can be complicated by perforation of the intestinal wall and peritonitis.
• Appendicitis. It occurs with the accumulation of ascaris in the cecum, manifested by pain and fever.
• Pneumonia. It appears after the larvae have been in the lungs for 10 days. Damaged capillaries and alveoli are affected by a secondary bacterial infection.
• Asphyxia. It occurs when the mucous membrane of the respiratory tract is irritated by larvae or with reflex spasm of smooth muscles.
• Atypical arrangement of Ascaris. It occurs during the migration of larvae with blood flow to the sinuses, middle ear, lacrimal canal, genitals.
• Liver abscess. It occurs as a result of ingestion of larvae and adults with venous blood flow, damaging the mucous membrane.
• Obstructive jaundice. Bile stasis appears when the bile ducts are blocked by large helminths during migration from the duodenum.

The chronic course of the disease, which is not manifested by serious complications, aggravates the course of bacterial infections in children, leads to growth retardation and mental development.

Diagnosis of ascariasis in children

It is possible to differentiate ascariasis in children from diseases similar in symptoms when conducting an accurate diagnosis. The doctor tries to collect a preliminary history, determine the stage of development of helminthiasis.

Methods for diagnosing ascariasis in children:

• Complete blood count - with the migration of larvae into the lungs, an increase in the concentration of leukocytes in the blood is noted;
• Analysis for blood biochemistry - the fraction of eosinophils that react first to helminthic invasions increases;
• A blood test for antibodies to ascaris is an accurate serological diagnostic method, specific antibodies to the Ascaris lumbricoides parasite are formed almost immediately after the ascaris larvae enter the body;
• Sputum analysis - is carried out for the pulmonary form of ascariasis in children, with an intense cough, ascaris larvae and a large number of eosinophils are found in the sputum;
• Analysis of feces - during microscopic examination, yellow-brown fertilized eggs of ascaris are found in excrement, at the larval stage of development of the parasite, the analysis of feces may be false-negative;
• Urinalysis - the release of volatile fatty acids may indirectly indicate the presence of ascaris, even in its larval form.
• Chest X-ray - within 10 days with the pulmonary form of the development of the invasion, it can show characteristic changes, volatile infiltration of the lung;
• X-ray of the abdominal cavity - used in differential diagnosis with gastrointestinal diseases, can reveal intestinal obstruction from a large number of ascaris in the intestinal lumen;
• Anthropometry - is used in children, since in the chronic form of ascariasis, especially in case of mass invasion, the parasite takes away nutrients and vitamins from the child's body.

Treatment of ascaris in children

Treatment of ascaris in children is reduced to taking anthelmintic drugs. In no case should you independently select this or that remedy, only a doctor can do this.

First, not every drug can be used to treat children. Secondly, the dose for them is selected on an individual basis. Thirdly, all anthelmintic drugs have a toxic effect on the body, so self-medication can bring significant harm to health.

If roundworm is diagnosed in a child in the migration phase, then desensitizing drugs and anthelmintics are shown to him. Thiabendazole (Mintezol) or mebendazole (Vermox) are most often prescribed in childhood. They have a wide spectrum of activity and have a detrimental effect on ascaris larvae. If the child has severe pulmonary symptoms, then a dose of bronchodilators and corticosteroids is selected for him.

When roundworms are detected in children in the intestinal stage, the following drugs are prescribed for him to choose from:

• Vermox (Mebendazole).
• Decaris (Levamisole).
• Pirantel (Combantrine).
• Piperazine.

These drugs are highly effective and often one course of treatment is enough to save the child from the invasion. Re-diagnosis of the disease is required 30 days after treatment.

If a child suffers from acute ascariasis, regardless of the purpose of the drug, antihistamines are a mandatory component of treatment. They stop allergic reactions resulting from the release of toxins by helminths. For sensitization, calcium gluconate, calcium chloride, ascorbic acid, glucocorticosteroids are used.

Drugs for the treatment of ascariasis:

• Mintezol. The daily dose is 25 mg / kg / day, it is divided into 3 doses, the course of treatment is 5 days.
• Medamin. The daily dose is 10 mg / kg / day, it is divided into 3 doses, taken during the day, with a massive invasion, the course takes 2-3 days.
• Decaris (Levamisole). The daily dose is 2.5 mg / kg / day, it is divided into 2-3 doses, taken during the day.
• Combantrine. Used in pill form according to age and body weight.
• Vermox (Mebendazole). The daily dose is 25-50-100 g / day, it is divided into 2 doses, the course of treatment is 3-4 days. It is not used in children under 2 years of age, as well as in case of mass invasion, as it can provoke ascaris into the lungs, into the pharynx, stopping intestinal motility, vomiting, and acute pain.

During the treatment of the child, it is advisable to transfer to a dietary diet, with meals rich in vitamins and proteins of animal origin. It is necessary to give up simple carbohydrates (sweets, flour and confectionery products), from fatty foods.

To correct the intestinal microflora, patients are recommended to take Bifiform, Linex and other prebiotics and probiotics. Enterosorbents prescribed after a course of anthelmintic therapy. They are aimed at reducing the desensitization of the body. These can be drugs such as Polyphepan, White activated carbon, Polysorb, etc. In addition to specific drugs, enzymes, multivitamins, iron supplements are prescribed (if there is anemia).

Monitoring the effectiveness of treatment is carried out 3 weeks after its completion. In laboratory conditions, feces are examined three times. The prognosis for the treatment of ascariasis is favorable, special care should be taken when treating helminthic infestation in infants. Asphyxia after the migration of ascaris into the airways can be fatal; it is stopped during urgent surgical intervention. As a rule, the prognosis for recovery is favorable. Complications are infrequent, but surgery may be required in an emergency.

Can ascariasis recur after treatment?

Once transferred ascariasis in children cannot be a guarantee against re-infection. When eggs enter the digestive tract, a new cycle of development of the parasite begins and the appearance of symptoms of the disease. Specific immunity to ascariasis is not formed either in children or adults.

How to prevent ascariasis in a child?

It is very important to carry out the prevention of ascariasis in children, since after treatment it is easy to get helminthic invasion again. Even after thorough disinfection, the eggs of the parasite could remain in the child's environment. Consequently, in order to protect family members and the child himself, eggs and ascaris larvae should not be allowed to enter the body.

Preventive measures against ascariasis:

• Early diagnosis and treatment of patients. At the slightest suspicion of helminthiasis, you should take a feces test, make a test sample to detect antibodies to roundworms in the blood, undergo treatment under the guidance of a helminthologist or infectious disease specialist.
• Thorough hand washing after contact with sand and soil, before eating, after using the toilet. This route of infection is most common among children.
• Eating only carefully processed foods: fruits, vegetables, berries, herbs, or appropriate heat treatment of dishes for baby food (at least 50 ° C), drinking exclusively boiled water.
• Change of sand in children's sandpits, its processing, regular digging and loosening for solar sanitation.
• Engineering protection of soil from contamination with faeces during the construction of child care facilities, filtration and disposal of sewage, cleaning of cesspools.
• Compost feces for 4 years before using as fertilizer.
• Fight against insects - carriers of roundworm eggs.

The doctor draws attention:

• The main source of ascariasis is contact with soil contaminated with helminth eggs. Contact with pets, fish or meat consumption cannot cause this infestation.
• When expelling ascaris, you need to monitor the condition of children after taking the medicine. Dead parasites can accumulate in the intestinal lumen in large tangles, cause intestinal obstruction, accompanied by pain, nausea, and vomiting.
• The use of folk remedies for the treatment of ascariasis (spices, pumpkin seeds, garlic) is not effective enough to completely expel worms. Discomfort makes the roundworm move to other organs, where their presence is not typical for this species.
• Spontaneous death of roundworm in a child's body after 2 years of stay does not guarantee a complete cure. The constant ingestion of the parasite's eggs constantly renews the helminth colony.

Pathologies of the intestines, skin, lungs, the appearance of an allergic reaction in children are the reason for examination for ascariasis and other helminthiasis. The clinical picture of these pathologies does not have its own specificity, it can be disguised as other diseases. The earlier an accurate diagnosis is made, the faster recovery will come.

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.