Opisthorchiasis

The disease is frequently recorded among the population living in the basins of the rivers: the Ob, the Irtish, the Dnieper, the Southern Bug, the Dnister, the Danube, the Nemen, the Northern Dvina, the Pechora, the Enisei, the Lena, the Amur and others. If a man eats raw or inadequately cooked freshwater fish, invasion takes place.

DIAGNOSTICS

Incubation period - 2-4 weeks.

Weakness, fever.

Headaches, muscle pains, arthralgia.

Various dermal eraption, itch.

Pains in the right hypochondrium, disorders infringement of liver functions.

Icterus, hepatomegalia, splenomegaly.

Eosinophilia is note 90 %, hyperleukocytosis is up to 50000-70000 in mkl, increase of BSR is up to 70 mm / h.

Diagnostics is based on the detection of ova in the bile and IFA.

CHRONIC OPISTHORCHISIS

Opisthorchiasis in the chronic stage proceeds at the phenomena of a dyskinesia of cholic paths, chronic cholangitis, cholangioholecictitis, chronic pancreatitis, the development of the liver cirrhosis is possible.

Opisthorchiasis is frequently complicated by addition of the secondary bacterial infection. In these cases the temperature rises periodically a marked pain, sharp enlargment and induration of the liver and icterus appear. At bacteriological bile research pathologic bacteria “Coli” and streptococcuses are often found.

TREATMENT

PRASICVANTEL is prescribed in a single dose of 25 mg/kg body weight.

Desintoxication and antibacterial therapy are indicated.

PARAGONIMIASIS (ENDEMIC HAEMOPTYSIS)

Human invasions are most frequent in the Far East but there are endemic foci in South America, Cameroons, Somalia and India. There are several species of Paragonimus which may affect the man, the commonest being — P. westermani. If a man or certain other mammals eat raw or inadequately cooked freshwater crabs or crayfish, invasion takes place.

DIAGNOSTICS

Slight fever, cough and the expectorations of sputum streaked with blood are usually ferst symptoms.

Severe pain in the chest.

Symptoms of pneumonia or pulmonary tuberculosis.

When the parasites lodge in the abdomen there may be symptoms of enteritis or hepatitis.

If they settle abdominal wall they produce sinuses with the discharge through the skin.

Develompent in the central nervous system may cause signs of cerebral irritation, encephalitis or myelitis.

Ova may be found in microscopic examination of the feces, sputum, or discharges. Extrapulmonary lesions are diagnosed in life by biopsy.

TREATMENT

Antibiotics are useful to combat secondary pyogenic infections. The specific drug is Bithionol given in a dose of 50 mg/kg body weight daily in three divided doses on alternate days. In all, 10 to 15 days of treatment are required and results are encouraging. PRASICVANTEL is prescribed in a single dose of 25 mg/kg body weight. Lesions localized in one lobe of the lung only may be treated surgically.

Prevention. In an endemic area crabs or crayfish should not be eaten unless adequately cooked.

FASCIOLIASES

Fascioliasis is registered in Cuba, France, England, Vietnam, Georgia, Uzbekistan and on Hawaiian islands.

Causitive agents — Fasciola hepatica and Fasciola gigantica. Fasciola hepatica has a foliaceous form, length of a body — 20 — 30 mm, width — 8 — 12 mm. Eggs of helminth are large, oval form, size - 125 - 150 Х 62 - 81 microns. Fasciola gigantica (gigantic fluke) is characterized with prolonged, in comparison with hepatic fluke, form and large sizes: length 50 - 75 mm, width 9 - 12 mm; eggs are 137- 162 Х 87 - 112 microns.

The man is infected by the use of polluted water, vegetables and berries.

DIAGNOSTICS

Incubation period of a fascioliasis is from 1 up to 8 weeks.

Weakness, nausea.

Abdominal pain.

Fever.

Urticaria.

Icterus, enlargement of the liver and spleen.

Leukocytosis, eosinophilia (up to 85 %).

In the chronic form there appear dyspeptic phenomena pressing or paroxysmal abdominal pains, the rising of temperature up to 38^oС and higher. These pain attacks can last from several hours to about several days.

The fascioliasis can be complicated by a purulent cholangitis, liver abcesses and icterus, owing to the occlusion of ductus cholicus..

TREATMENT. With the purpose of particular treatment apply PRASICVANTELUM nominate in a dose 25 mg/kg body weight 3 times a day within 1 day and also tryclabendazolum in dose 10 mg/kg/day, bytionolum - 30-50 mg/kg/day within 10-15 days.

SCHISTOSOM1ASIS (B1LHARZIAS1S)

Genitourinary shistosomiasis is spread in countries of Africa and Middle East, intestinal one - in Africa, Central and Southern America (especially in Brasil), Japanese one - in China, Japan and on Phillippines.

The agents of shistosomiasis in men are 4 kinds of parasites: intestinal (S. mansoni), intestinal intercalatum (S. intercalatum), genitourinary (S. haematobium) and Japanese (S. japonicum). The length of a female - 15- 20 mm, width - 0,17- 0,36 mm, male - 9,5 - 17 and 0,55 - 1,2 mm.

The man is infected by shistosomiasis at working on rice fields, bathing, catching fish, washing of linen and other kinds of work made near open reservoirs. Shistosomiasis more often affects village population, fishermen and persons connected with the construction of reservoirs, irrigation systems and other hydrostructures.

SCHISTOSOMIASIS ENTERICA MANSONI

DIAGNOSTICS

Incubation period is 5-8 days. There are the following symptoms:

Fever.

Losing of appetite, nausea, vomiting.

Often liquid stools.

Abdominal pain.

Enlargement of the liver and spleen.

Rash urticaria, peripheric edemas appear on the skin

Eosinophilia, leukocytosis, rising of BSR

The clinical signs of intestinal intercalatum shistosomiasis do not differ from intestinal shistosomiasis Mansoni. Intestinal intercalatum shistosomiasis is the most benign of all the group of intestinal shistosomiases.

The clinical signs in the acute stage of the development of genitourinary shistosomiasis last for 3- 4 weeks. Cystitis and terminal hematuria plus the signs of acute intestinal shistosomiasis can be seen.

SCHISTOSOMIASIS JAPANESE

DIAGNOSTICS

Incubation period is 2 - 3 weeks

The main signs of the diseases:

Fever.

Exantema urticaria.

Quincke's disease.

Vomiting, diarrhea.

Pains along the colon.

Lymphatic nodes, enlargement of the liver and spleen.

Leukocytosis with marked eosinophilia.

Helminthiasis called Schistosoma mekongi

S. mekongi occurs on the coast of the Mecong rever in the countries of Indochina (Laos, Cambodja and Thailand). The intermediate hosts are the aqueous molluscs Т. aperta. The eggs are similar to eggs S. japonicum, but of more spherical form and a little smaller, size is about 56 - 64 microns. The dogs and man are most often subjects of natural infection. The clinical signs are similar to those of the infection S. japonicum.

TREATMENT

PRASICVANTEL has the high effectiveness in all the shistosomiasis. The drug has to be given from 20 to 40 mg/kg 1 - 3 tames within 1 day. The efficiency of its effect is noted at 90 — 100 % of patients.

Vanzil is applied in 15 mg/kg in one dose during or after meal.

Niridazol (ambilgar) is applied in a daily dose of 25 mg/kg divided into 3 times for 5 - 7 days.

Miracil nominate at genitourinary schistosomiases in dose 15- 20 mg/kg during 3 - 5 days.

Hyganton (atrenol) is prescribed in one dose intramuscularly of 2 - 3 mg/kg or 2 ml of 10 % of the solution. The efficiency of the drug is noted in 40 — 80 % patients.

Metryphonat if taken by a single dose of 7,5 mg/kg 1 time in 2 weeks, only three doses. The treatment is effective in 40 — 80 % patients.

Ocsamnicdin is prescribed per os and intramuscularly in the dose 10 mg/kg 2 times a day for 2 days or 15 mg/kg 2 times within 1 day. The drug is effective in 50 - 80 % of patients.