Enterobiosis
Description:
Enterobiosis - the eurysynusic invasion caused by parasitizing in a human body of nematodes from the sort Enterobius, the Oxyuridae family (Cobbold, 1864).
Enterobiosis symptoms:
Clinical manifestations of an enterobiosis are various and depend on intensity of infection, frequency of reinfestations and individual reaction of infested. Besides, numerous observations confirm value of age, namely, heavier, quite often complicated reaction of an organism of the child.
At primary invasion, according to these data, the clinical incubation makes two days, an acute phase 5-7. The parasitological incubation - the beginning of allocation of females which determines actually duration of a chronic phase of one infection makes 35 - 75 days.
The main clinical symptoms of an acute phase of an enterobiosis are abdominal pains, morning intestinal discomfort, nausea, the speeded-up issued chair to 4 times a day. These phenomena proceed up to 5 - 7 days, the chair remains speeded up until the end of an invasion. The nature of clinical manifestations in a chronic phase is ambiguous. At a part infested an enterobiosis proceeds without complaints, in the absence of clinical symptoms. Tension of symptomatology in a chronic phase of an enterobiosis depends first of all on intensity of an invasion and frequency super - and reinfestations.
At a weak invasion the main complaint is the perianal itch arising more often in the evening before going to bed when backfilling, sometimes an abdominal pain. In 2 - 3 days all these symptoms pass and, as a rule, each 3-4 weeks repeat. This frequency is connected with completion of development of new generation of helminths as a result of a reinfestation.
At more intensive and long invasion the perianal itch disturbs infested not only in evening and night hours, but also in the afternoon. The reminding pains at appendicitis amplify to an abdominal pain, a thicket in the right ileocecal area, there are tenesmus, a meteorism, the liquid speeded-up chair. The intolerable itch interrupts a sleep, becomes the reason of a nocturia, masturbation. From a gemogramma the moderate leukocytosis, an eosinophilia of peripheral blood which gradually accrues in an early phase is noted, reaches a maximum (23%) by 16th day, then gradually decreases by the end of an invasion to 4 - 5%.
As a rule, neurologic symptoms, such as a headache, dizziness, decrease in memory are expressed. To a bowl children suffer, they become whimsical, whining, quickly get tired, badly perceive useful skills. Instability of attention, inability to concentrate reduces progress, adults have a working capacity.
The enterobiosis exerts authentically negative impact on povendenchesky reactions and psychological development of children of preschool age. Cases of faints and epileptiform attacks at the children prichinno connected with an enterobiosis are described.
It is necessary to carry appendicopathias and appenditsita, proctites and paraproctites, dermatitis and eczemas of perianal area with symptoms, characteristic of them, to heavy complications of an enterobiosis.
The indisputable reason of painful vulvit and vulvovaginitis at girls quite often is the chronic enterobiosis.
To M. G. Makarova it is established that the enterobiosis causes reliable decrease in nonspecific immunity: activity of a lysozyme of saliva (by 1,5 times) and the content of alpha interferon (to level less than 2 units/ml), at the same time does not exert impact on the content of gamma interferon. These data are of special interest in respect of establishment of the reasons of the immunosuppression which is especially often found at children.
The forecast in the absence of complications at an enterobiosis favorable.
In conclusion it is necessary to pay attention to polymorphism of the clinical manifestations prichinno connected with an enterobiosis, but characteristic of the most different organ pathology. It leads to the inevitable address infested to doctors of different specialties: to gastroenterologists, obstetricians-gynecologists, neuropathologists, allergists, dermatologists, urologists, surgeons, etc. And only the correct orientation of such specialist to need of an exception of an enterobiozny invasion provides the qualified help to the patient.
Enterobiosis reasons:
The activator of an enterobiosis is the pinworm - Enterobius vermicularus (Linnaeus, 1758; Leach, 1853).
The name Enterobius comes from the Greek enteron - intestines and bios - life, vermicularis - reduced from Latin - the worm living in intestines a worm.
Pinworm - a small nematode of a spindle-shaped form молоч) white color which cuticle has cross ischerchenny
Length of an adult female reaches 9-12 mm, a male of 3 - 5 mm, at a female the tail end is pointed, at a male is rather stupid and is kryuchkovidno twirled. Acute side Kiel passing on helminth body length on the front end forms head vesicles. The alimentary system of helminth is presented by the actinostome limited to three lips, a cylindrical gullet with the expansion in the form of a bulbus passing into intestines and which is coming to an end with an anus in a back part of a body.
Bulbus of a gullet and a vesicle form the prisasyvatelny device which provides fixing of adult helminths to an intestines wall.
The reproductive system of a female consists of a pair ovary, the uterus passing into a vagina and comes to an end with a vulva. The vagina has a muscular press which in the oxygen-free environment of intestines of the person is in a spazmirovanny state. Therefore parasitic females, being in a gleam of intestines, do not allocate some eggs. The reproductive system of a male is presented by a seed plant which comes to an end with a long spicule.
Eggs of pinworms have oblong, a little asymmetric form, one party more flat. The size of eggs - 50 - 60 x x 20 - 30 microns. They are covered with a thin double-circuit colourless smooth cover.
Treatment of the Enterobiosis:
Necessary condition of successful treatment of the patient with an enterobiosis is simultaneous carrying out all complex of the preventive measures preventing a reinfestation. This, first of all, strict observance of the personal hygienic mode not only the patient, but also all contact in the center. Considering high contageousness of an invasion before the treatment revealed infested on an enterobiosis all contact - children by a scraping method, adults - poll are surveyed. All revealed infested in the center, a family are subject to simultaneous deworming.
The following belongs to the main recommendations about the sanitary and hygienic mode in the family centers of an enterebioz:
1.enterobioz - a disease of dirty hands therefore purity of hands and nails, fight against an addiction to gnaw nails, to take fingers in a mouth, washing of hands with soap before food - a basis of successful treatment;
2.invazirovannye have to sleep in the closed pants, i.e. with elastic bands not only around a belt, but also around legs, daily change them;
3.obyazatelnoye a podmyvaniye of perianal area water with soap for the night and in the morning after a dream;
4.pri existence of an itch in perianal area the soda cleansing enema is before going to bed recommended; it is counted only on mechanical removal of helminths from a rectum; calculation of baking soda - for an enema: 1/2 teaspoons on 1 glass of boiled room temperature of water (garlick, milk and garlick, acetic enemas are not recommended to be applied since they irritate mucous a rectum);
5.ezhednevnoye washing of a body, bathing under a shower;
6.ezhednevnaya change of bed linen and its proglazhivaniye by the hot iron effectively, but it is difficult feasible and at observance of all above-mentioned recommendations it is optional.
In the presence of an invasion at small children it is recommended after an evening podmyvaniye for the night to put the small wadded tamponchik greased with vaseline ointment to the area of an anus. It prevents creeping of females of pinworms, saves the child from an itch, at women and girls the zapolzaniye of pinworms in a vagina warns.
At unconditional and high-quality implementation of these recommendations of the patient it can be exempted from an invasion without drug treatment.
However improvement of infested is carried out quicker and more reliably at observance of a complex: drug treatment against the background of the sanitary and hygienic mode.
