Paragonimiasis
Description:
The paragonimiasis (paragonimosis) is a zooantroponozny natural and focal biohelminthosis from group of trematodoz with the fecal and oral mechanism of transfer of the activator. The paragonimiasis is characterized by preferential defeat of a respiratory organs with a recurrent current.
Abdominal paragonimiasis. This paragonimiasis is caused by migration of larvae from intestines in an abdominal cavity. Note symptoms of enteritis, hepatitis, sometimes benign aseptic peritonitis.
Pleuropulmonary paragonimiasis. This paragonimiasis is caused by parasitizing of young helminths.
The inflammation and sclerosis of tissue of lungs (sometimes - other bodies) under the influence of helminths are the cornerstone of a pathogeny of a paragonimiasis. Clinical manifestations of a paragonimiasis depend on prescription of a disease and, perhaps, on intensity of an invasion of a paragonimiasis though it and is not proved. At first around adult parasites and their eggs acute inflammatory reaction develops, at the same time in infiltrate eosinophils prevail. Further around the center of a paragonimiasis the fibrous capsule forms. The cysts located in a pulmonary parenchyma break in bronchioles. Their contents are presented by blood, eggs of helminths and inflammatory exudate. If the cyst is located subplevralno, the pleura empyema containing a large number of eosinophils can be created. Over time in the defeat centers a paragonimiasis sclerous processes amplify, and the inflammation abates. Some centers of a paragonimiasis obyzvestvlyatsya. Pulmonary flukes in addition to a parenchyma of lungs quite often get into other fabrics - a pleura, an abdominal wall, abdominal organs, a brain, causing inflammatory changes and a sclerosis there. Damage of a brain is especially dangerous. It was reported about frequent development against the background of a paragonimiasis of very heavy bacterial infections. Defeat of an abdominal wall and a liver is characteristic of the invasion caused by Paragonimus skrjabini paragonimiasis.
Symptoms Paragonimiasis:
Paragonimiasis incubation interval duration 2 - 3 weeks, at a massive invasion can be reduced to several days. During migration of larvae of a paragonimiasis specific manifestations are absent. Enteritis, hepatitis, benign aseptic peritonitis, allergy symptoms, including myocarditis and a skin itch are possible. Already in an early stage of a paragonimiasis there are symptoms of damage of lungs in the form of flying infiltrates, pneumonias, exudative pleurisy.
At an acute pleuropulmonary paragonimiasis there are fever with a temperature of 39 - 40 °C, stethalgias, short wind, cough with a purulent phlegm which sometimes contains blood impurity. In 2 - 3 months there comes the chronic stage with change of the periods of aggravations and simplification which can last within 2 - 4 years.
In a chronic phase of a paragonimiasis the focal pneumosclerosis develops; radiological reveal the blackout centers with enlightenments in the center. The diffusion pneumosclerosis, a pulmonary heart, pulmonary bleeding, lung cancer are possible. The drift of parasites in a brain leads to encephalitis and an encephalomeningitis, volume process, phymatoid. At dissimination of eggs the polyserositis is possible. Damage of lungs at a paragonimiasis seldom leads to death, however at extra pulmonary localization of helminths the frequency of complications and a lethality are high. According to one research, the extra pulmonary centers of defeat were noted at 30,7% of the hospitalized patients with a paragonimiasis, damage of a brain - at 8,4%.
Distinguish acute and chronic damage of a brain at a paragonimiasis. Sudden development of neurologic symptomatology, usually against the background of pulmonary pathology is characteristic of acute. At chronic epileptic seizures and permanent neurologic disturbances are frequent; at a X-ray analysis of a skull find calcificats in the form of "soap bubbles".
At infection with larval forms of paragonimus (P. westermani ichunensis, P. miyazakii, P. huatungensis, etc.) the acute stage of a paragonimiasis does not differ from a usual pulmonary paragonimiasis. In a chronic stage the paragonimiasis also proceeds with the aggravations which are followed by an eosinophilia of blood and remissions. Radiological find the migrating pneumonic centers, exudative pleurisy against the background of strengthening of the vascular drawing. The exudate in a pleural cavity can also be right-, left-side, the polyserositis is possible. At a long current of a paragonimiasis pleural commissures with restriction of mobility of a lung and a diaphragm can develop. Complications of a larval paragonimiasis are pheumothorax, pulmonary bleeding, sometimes suppurative process with formation of abscess pulmonary or empyemas of a pleura.
The heaviest complication of a pulmonary paragonimiasis is the hematogenous drift of eggs of helminths in a brain with the subsequent development of encephalitis, encephalomeningitis, a syndrome of damage of a brain (a cerebral paragonimiasis). Complications of a pulmonary form of a paragonimiasis are pheumothorax, pulmonary bleeding, sometimes suppurative process with formation of abscess of a lung or an empyema of a pleura. At timely treatment and lack of complications the forecast of a larval paragonimiasis rather favorable; pulmonary without treatment leads to exhaustion and pulmonary insufficiency, at defeat by a brain paragonimiasis – the forecast adverse!
Reasons Paragonimiasis:
Final owners of a parasite a paragonimiasis are: pigs, dogs, cats, rats, muskrats, many wild carnivorous, including person; in an organism of the final owner the puberal paragonimiasis is localized preferential in small bronchial tubes, forming fibriozny capsules. With urine and excrements of egg of a paragonim are allocated in external environment. At hit in water in egg the larva - meratsidiya which is implemented into the intermediate owner - a fresh-water mollusk forms. In 5 months, after development and asexual reproduction of larvae in water there are cercariae who are implemented into a body of additional owners - fresh-water crayfish and crabs where the larva, invasive for final owners, - metacercarias forms. In intestines of the final owner of a metacercaria are exempted from covers and move ahead in lungs, sometimes in a brain and other bodies where in the range from 0,5 up to 3 months reach puberty. Metacercarias at 56 °C perish in 20 min., at 70 °C - in 5 min.
Treatment Paragonimiasis:
Treatment of a paragonimiasis is carried out with an impolzovaniye of the special protivogelmintny drugs appointed лечещьм by the doctor. Duration of treatment of a paragonimiasis makes 4-5 days. The forecast at timely treatment of a paragonimiasis and lack of complications rather favorable; the pulmonary paragonimiasis without treatment results in pulmonary insufficiency, exhaustion. At damage of a brain the forecast fatal.
