- Symptoms Diphyllobotriasis
- Reasons Diphyllobotriasis
- Treatment Diphyllobotriasis
Dirofilariasis - dangerous natural and focal helminthosis of dogs, cats and wild representatives of the Canidea and Felidea families. Also the person is ill a dirofilariasis. The disease is followed by severe defeat of all systems of an organism, including a brain and eyes. The person catch as a result of stings of the mosquitoes infected with microfilarias in an invasive stage. Mosquitoes of different types of the sort Culex and Anopheles are intermediate owners for dirofilyariya and transfer the activator (microfilaria) from an animal to an animal, and also from animals to the person. A part in circulation of dirofilyariya in the nature is played also by other blood-sicking insects - mites, fleas, louses, gadflies.
For the first time the dirofilariasis at the person was described in 1566 by the Portuguese doctor who allocated a parasite from tissues of an eye of the sick girl. The following case belongs to 1867 when in Italy the parasite in hypodermic cellulose of the adult man was found. In Russia the first case of the person is registered in 1915 in Krasnodar Krai by doctor A. P. Vladychensky. He took helminth at the patient from a tumor between an internal wall of an orbit and an eyeglobe. Then, after quite wide interval of time (in 1930) the second case of a dirofilariasis was in detail described by the founder of the Soviet helmintologic school academician K. I. Scriabin and his pupils - A. Ya. Altgauzen and E. S. Shulman. "The 27-year-old woman, the female resident of Kharkiv, on a lower eyelid of the right eye had a tumor size about a cherry stone. The surgeon removed it, and at a section of a tumor the nematode (worm) which appeared when studying a male of a ygotyap герепз was noticed". This message served as the beginning of systematic studying of these parasites in the USSR and a number of the countries of the world. Given V. V. Guskov and coauthors (2001), from 1915 to 1995 in the territory of the Russian Federation 110 cases of a dirofilariasis were diagnosed for people. The Italian parasitologist V. Tarello (2002) provides such data in the works: by 2002 in Italy 298 human cases by a dirofilariasis, in Sri Lanka ~ 131, in France - 75, in the Russian Federation - 69 are registered. On a dirofilariasis today Greece and Iran also are unsuccessful. In the territory of these states, according to its data, the high percent of infectiousness is noted by helminthosis of dogs (from 25 to 60%). At the same time the author notes that there is a direct dependence between the level of prevalence of infection of dogs and people.
A. Murashko and coauthors (2005) described a case of a dirofilariasis of the right eye at the patient who is constantly living in Republic of Belarus. They specify that in the beginning the diagnosis "a Quincke's disease of Quincke" in this connection the patient received treatment steroid and non-steroidal anti-inflammatory drugs was exposed. However the being available symptomatology - hypostasis of an upper and lower eyelid of the right eye, and also the right side of the person, a hyperemia of a conjunctiva and an exophthalmos of the right eye, morbidity at turns of an eyeglobe, a febricula and a headache - as a result of therapy completely did not disappear. Clinical signs became aggravated with frequency approximately in 2 weeks. As a result of surgical intervention from the inflammatory center the worm was taken. The laboratory of parasitology of the Minsk city center of hygiene and epidemiology established that helminth is an immature female of D. repens
The diphyllobotriasis can have the latent and clinically expressed current. The disease begins gradually - nausea, a loss of appetite, abdominal pains, an unstable chair, sometimes subfebrile temperature. A characteristic sign is В^-дефицитная anemia. In cases of its development in patients there are a weakness, an indisposition, tachycardia, there are pains and paresthesias in language. On it bright red spots, cracks (Hunter's glossitis) appear. Further owing to an atrophy of nipples of language it becomes smooth, brilliant (the "varnished" language).
Several types of dirofilyariya are described. Puberal dirofilyariya have in length of 20-30 cm and width of 1,2-1,5 mm. The type of D. immidis is most widespread in Ukraine among animals. Parasites of this look found favorable conditions for the existence in a cavity of a right ventricle of heart. With a considerable number they are localized also in the right auricle and pulmonary arteries. American parasitologist of GF. Otto found puberal parasites in a vena cava, a chest cavity and bronchial tubes. Puberal герепз develop and breed in hypodermic cellulose of animals. Between species of parasites the person in available literature has no data on a typical percentage ratio. However, judging by messages from the different countries of the world, at people the skin form of a dirofilariasis caused by D. repens meets more often.
Dirofilyary - viviparous and very prolific parasites. In days they allocate in blood a large number of larvae (microfilaria) 300-320 microns in size in length and 6,8 microns width. Microfilarias circulate on circulatory and absorbent vessels therefore can get into any bodies and fabrics, causing various pathology. They can be also given vnutriutrobno from mother to a fruit.
As the international practice shows, treatment of a hypodermic dirofilariasis at people comes down generally to extraction of adult parasites in the surgical way that presents certain difficulties in connection with their mobility. In case of infection of the person of D. immitis use the same drugs, as for treatment of animals - ivermectin (стромектол) and диэтилкарбамазин (hetrazane and DEC). It should be noted the expressed side effect of means of this group, especially on a liver and kidneys. The disease in general will badly respond to treatment both at people, and at animals. Treatment is very expensive, however quite real. At the same time the doctor is faced by three stubborn tasks:
* extermination of the puberal parasites who are in cavities of a right ventricle, auricle, pulmonary arteries or in hypodermic cellulose;
* destruction of a microfilaria, thousands circulating on an organism;
* reduction of expressiveness of intoxication of an organism caused, on the one hand, by side effects химио, the adult helminths and their larvae applied to destruction with another - decomposition products of parasites;
* restriction of effects of the heavy complications arising at treatment.
Usually for extermination of puberal parasites use arsenic drugs.