Clinical picture of ascariasis and enterobiasis in children at the present stage

Specialist: Gastroenterologist

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Description of the disease Symptoms Causes Diagnostics Treatment Prevention Pinworms are protocavity worms ranging in size from 2 to 12 mm, often living in the intestines of a child and causing significant harm to the child’s body. The diagnosis and treatment of this disease is carried out by a pediatrician, gastroenterologist and infectious disease specialist.

Content

• The causative agent of parasitic infection is pinworm
• Causes of pinworm infection
• What complications does the disease cause?
• Symptoms of the disease Acute period
• Chronic stage

Enterobiasis is an infection of the body with helminths - pinworms. Young children are at risk, but children of other ages can also be infected.

Folk remedies

You can get rid of pinworms not only with the help of traditional pharmaceuticals. Many people have long trusted products of natural origin. When used wisely, they can help with parasitic infections without producing toxic effects, like "chemistry".

Vegetables and seeds for the treatment of enterobiasis:

1. Pumpkin seeds. If pinworms are found in adults, treatment at home must include pumpkin seeds. This tasty, satisfying, and, most importantly, effective medicine will help you quickly get rid of helminths. In order for pumpkin seeds to have a proper effect on pinworms, you need to eat at least 300 grams of seeds in one day.
2. Seeds of watermelon. The seeds should be ground into powder. The resulting medicine should be added to a glass of water, 3 tablespoons each. and mix thoroughly. Take the drink for seven days, in the morning, one glass.
3. Beet. The juice is prepared immediately before consumption. It is enough to squeeze 100 ml of red beet juice. It is drunk twice a day, morning and evening.
4. Carrot. For treatment, use freshly squeezed juice (half a glass). To enhance the effect, add a few drops of vegetable oil. The juice is drunk in the morning, before meals.

Herbs to get rid of pinworms:

1. Wormwood. A tablespoon of raw material is poured with boiling water (500 ml), left to cool. Take one teaspoon three times a day before meals.
2. Oak and valerian. Valerian root and oak bark, taken in equal parts, are crushed, and the resulting raw material, in the amount of 1 tbsp. l., pour boiling water (250 ml). Leave for at least three hours. The drug is taken in the morning on an empty stomach. After one or two hours, eat a clove of garlic and drink three tablespoons of vegetable oil. The course of treatment is ten days.
3. Tansy, wormwood and chamomile. The raw materials are mixed in equal parts, take 1 tablespoon of the mixture, pour a glass of boiling water and leave. The infusion is drunk twice a day for five days.

Other means:

1. Some plant oils: pumpkin, hemp, flaxseed are excellent at fighting parasites. The oil should be drunk in the morning, on an empty stomach, in the amount of 1-2 tbsp. l.
2. A recipe called “drunk worms” has gained particular popularity. To combat pinworms, you need to drink 50 ml of cognac in the morning on an empty stomach, wash it down with very sweet tea, and twenty minutes later drink 50 ml of castor oil. Please note that castor oil has a pronounced laxative effect, so you must stay at home on the day of the procedure.
3. The anal area can be lubricated with zinc ointment. This drug has a viscous and sticky structure. The pinworms will simply stick to the ointment and will not be able to lay eggs.
4. Vaseline ointment with essential oils can become an obstacle to egg laying. To prepare the product, you need to add two drops of tea tree, thyme and lavender oils to the Vaseline. Mix everything thoroughly and apply the ointment to the anus every evening.

The causative agent of parasitic infection is pinworm

Enterobiasis is caused by the pinworm parasite. This helminth is a roundworm belonging to the class of nematodes. It has some features in appearance. Females grow to a length of 9-12 mm, they have a “tail” - a pointed end. It severely injures the intestinal mucosa when the worm is in the body. Males are 2-3 times smaller than females, and their “tails” are curved in a spiral. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2306321/ JP Caldwell Pinworms (Enterobius Vermicularis) Can Fam Physician. 1982 Feb; 28: 306–309.

Adult helminths live in the cecum and at the end of the small intestine. At night, females crawl out of the cecum through the anus. At this time, the person’s anal sphincter is relaxed, so nothing interferes with the worms. When the female pinworm emerges, she lays eggs in the perianal folds. There are a lot of eggs - up to 15 thousand. Having laid them, the female dies. The entire cycle of her life is about a month. The eggs are resistant to environmental factors and can remain viable for up to 3 weeks. They stain clothes and bedding.

After a few hours, the embryo from the egg becomes a larva, which itself begins to parasitize. This is how enterobiasis spreads. Pinworms can penetrate the thickness of the intestinal mucosa, causing the formation of granulomas. Sometimes worms crawl into the vagina, uterus and ovaries. Because of this, the female organs become inflamed.

Similarities

The main similarity between these parasites lies in their structure. Like pinworms, roundworms are also roundworms and nematodes. They have the same light color. There are also other similarities:

• Both types of parasites are localized in the intestines and affect other organs to a much lesser extent;
• Both parasites have the same transmission pattern - exclusively fecal-oral, that is, for the development of invasion, you need to ingest a certain number of parasite eggs;
• The transmission routes are the same. These are unwashed vegetables and fruits, raw meat, contaminated water, contact with pets or contaminated surfaces;
• They have some similarities in symptoms. Pinworms and roundworms cause mainly intestinal symptoms, intoxication and an allergic reaction;
• There are similarities in the parasite's life cycle. In particular, the peculiarity is that the invasion develops with constant repeated self-infection;
• In both species, males are much smaller than females;
• Both species are present in the intestines in entire colonies.

It is important to take into account that mixed invasions are currently widespread, when several types of parasites are present in the intestines at the same time. Roundworms and pinworms may well exist together in the body, causing the characteristic symptoms of both invasions.

What complications does the disease cause?

When the parasite attaches to the intestinal wall, it secretes a harmful secretion and damages the mucous membrane. In the latter case, poorly healing ulcers form and hemorrhages occur. If tissues are deeply damaged, inflamed granulomas appear. They consist of abnormally overgrown cells, lymph and blood. Due to the fact that pinworms injure the intestines, children experience abdominal pain. The microflora is disrupted and dysbacteriosis occurs.

When the female crawls out, she damages the soft tissue. The perianal area is irritated by the secretion of the worm - abrasions, cracks, eczematous rash, and neurodermatitis appear. If the helminth penetrates the genitals of girls, endometritis and other gynecological diseases may develop.

In the presence of pinworms the acidity of the stomach decreases , food is digested worse, and the course of intestinal diseases becomes more complicated . Parasites reduce immunity, because of them the effectiveness of vaccinations decreases and the number of side effects from them increases. Medicine knows of cases where pinworms pierced the rectum and entered the abdominal cavity, followed by peritonitis.

Being in the organs of the gastrointestinal tract, parasites cause the following complications:

• inflammation of the pelvis and peritoneum;
• acute skin lesions in the perirectal area;
• stagnation of feces in the cecum;
• pyoderma;
• anemia;
• developmental delay of the child;
• disturbance of appetite and sleep; Source: R.A. Fayzullina, E.A. Samorodnova, V.M. Dobrokvashina Helminth infections in childhood // Practical Medicine, 3(42) May 2010.
• in girls – cystitis, vulvitis;
• in boys - enuresis;
• anal fissures.

Diagnostics

To establish a diagnosis of enterobiasis, several diagnostic methods are used:

1. Identify key symptoms: itching at night, loss of appetite, weakness.
2. Analysis of stool for pinworm eggs. This method is not informative enough. Therefore, other methods are additionally used.
3. Scraping in the anal sphincter area. To do this, scrape off the contents of the area near the anus with a cotton swab.
4. Imprint of the anal sphincter area. This method uses adhesive tape, which is glued to this area, then glue the tape onto glass and look under a microscope.

Tests should be done at least 2 times for a more accurate result, with an interval of 2 weeks.

Symptoms of the disease

There are many signs that a child is infected with pinworms. However, not all of them are characteristic of this disease. Therefore, children are often treated for colitis or gastritis. If there are few parasites in the body, then there may be no symptoms at all. If the disease continues for a long time, anemia occurs , the condition of nails, hair, skin worsens, and the corners of the mouth crack.

Enterobiasis has an incubation period of 1-1.5 months . The “brightness” of the clinical picture depends on the strength of the immune system and the number of worms.

There are two types of disease - acute and chronic. Everyone has their own symptoms.

Acute period

Most often, nausea, abdominal discomfort, weakness in the morning, and frequent stools occur, although they are well formed.

Chronic stage

From the moment of infection to the chronic stage, 1-2 months pass. Symptoms may remain the same as in the acute form or worsen. The main manifestations of chronic enterobiasis:

• flatulence;
• itching in the anus, which becomes stronger at night, it lasts 4-5 days, then disappears and appears again after 2-3 weeks;
• heaviness and pain in the epigastric region;
• insomnia;
• enuresis at night;
• irritability;
• increased fatigue;
• neurological symptoms - problems communicating with peers, deterioration of memory, attention, isolation, headache.

Diagnostic methods

The diagnosis of enterobiasis is based on the examination of scrapings from the surface of the skin of the perianal zone to detect pinworm eggs. The material for research is collected with a spatula from the surface of the skin or an imprint is made on adhesive transparent tape (Graham method). Previously, a smear was taken with a cotton swab attached to a stick, but now the use of a spatula or adhesive tape is considered more effective. In severe cases of the disease, not only eggs, but also large numbers of adult pinworms are found in stool samples taken for analysis. To confirm the diagnosis, samples are taken three times at intervals of one to two days.

The doctor may order a clinical blood test to detect eosinophils, which is necessary in cases where not too much time has passed since the infection.

Treatment methods for detecting pinworms in a child

To treat enterobiasis, the doctor prescribes anthelmintic drugs. The dosage is determined according to the age and weight of the patient. It must be remembered that all these drugs are highly toxic and can cause adverse reactions. Pediatricians do not recommend choosing medications without consulting a specialist.

If a child is diagnosed with pinworms, then all family members need to undergo treatment. If there is a pet living in the house, it is also necessary to purchase anti-worm medication for it.

During treatment, it is also necessary to take sorbents, since anthelmintic drugs do not remove parasites from the body.

An effective regimen for taking medications and necessary procedures is prescribed by the doctor.

A number of hygiene procedures for the home are necessary:

• after the end of treatment, change the linen by ironing it with a hot iron;
• boil or wash the toys in hot water with added salt;
• Regularly carry out wet cleaning at home.

Nutrition

To increase the anthelmintic effect of medications and folk remedies, it is recommended to reduce the load on the digestive system as much as possible. To do this, follow a light diet. It is recommended to exclude sweet and flour products, fried and fatty foods from the diet. You can eat dairy products and drink freshly squeezed juices.

It is allowed to eat porridge and light soups with a small amount of potatoes. It should be remembered that following a diet during treatment for pinworms enhances therapy and improves the general well-being of the patient.

Disease prevention

To prevent a child from becoming infected with parasites, he needs to instill personal hygiene skills and ensure that:

• his nails were trimmed;
• he had no contact with street animals;
• did not put dirty objects into his mouth. Source: Clinical recommendations (treatment protocol) for providing medical care to children with enterobiasis, Federal State Budgetary Institution Scientific Research Institute of Infectious Diseases, Federal Medical and Biological Agency of Russia, Public organization "Eurasian Society for Infectious Diseases", Public organization "Association of Infectious Disease Doctors of St. Petersburg and the Leningrad Region" (AVISPO)

If you suspect enterobiasis in a child, you should consult a doctor as soon as possible and undergo a course of treatment. You can make an appointment with a medical pediatrician 24 hours a day by phone or leave a request to have a doctor come to your home.

Sources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2306321/JP Caldwell Pinworms (Enterobius Vermicularis) Can Fam Physician. 1982 Feb; 28: 306–309.
2. R.A. Fayzullina, E.A. Samorodnova, V.M. Dobrokvashina Helminth infections in childhood // Practical Medicine, 3(42) May 2010.
3. Clinical recommendations (treatment protocol) for the provision of medical care to children with enterobiasis FGBU NIIDI FMBA RUSSIA, Public organization "Eurasian Society for Infectious Diseases", Public organization "Association of Infectious Disease Doctors of St. Petersburg and the Leningrad Region" (AVISPO)

Markova Daria Olegovna Clinic

Author of the article

Markova Daria Olegovna

Specialty: pediatrician

Experience: 14 years

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Causes of infection

Most often, doctors detect enterobiasis in children, since they are much more likely than adults to:

• do not follow hygiene rules: do not wash their hands after contact with potentially contaminated surfaces, soil, visiting a public bathroom, before eating, etc.;
• eat on the street;
• lick or suck fingers, toys and other objects;
• They bite their fingernails.

The same actions cause helminthic infection in adults: enterobiasis is often called the disease of dirty hands.

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