Ankilostomidoz – the helminthic invasion caused by parasitizing in intestines of the person of roundworms (hookworms or nekator) belonging to the Ancylostomatidae family. Clinically it is shown by papulo-vesicular rash, cough, short wind, appetite violation, nausea, belly-aches, diarrhea, iron deficiency anemia. The diagnosis of an ankilostomidoz is confirmed at identification of eggs of helminths in excrements and duodenal contents. Treatment of an ankilostomidoz consists in carrying out expulsion of helminths and correction of anemia with the subsequent triple control research a calla.
Ankilostomidoz - the helminthoses ( and ) caused by parasitic roundworms – ankilostomida. Ankilostomoz and are united in one group on the basis of biological similarity of activators, their frequent joint parasitizing in an organism, and also similarity of clinical and epidemiological signs of an invasion. Both helminthoses at early stages proceed with allergic damage of skin and a respiratory path, and on late – with dysfunction of a GIT and development of iron deficiency anemia. Ankilostomidoza – widespread parasitic diseases which struck 25% of the world population, mainly in regions with the low level of sanitary culture. On the frequency of infection of an ankilostomidoza concede only to an enterobioz and an askaridoz.
Reasons and ways of infection ankilostomidozy
Activators of an ankilostomoz (a hookworm - Ancylostoma duodenale) and a nekatoroza (a nekator - Necator amencanus) belong to the uniform Ancylostomatidae family. They are united by a community of morphology, cycles of the development and effect which had on the owner's organism. Both types of helminths belong to a class of roundworms (nematodes) and on the nature of development belong to geohelminths.
Activators of an ankilostomidoz have pinkish-yellowish color and the small sizes: females of a hookworm in length of 10-13 mm, males - 8-10 mm; a nekator - 9-10 mm and 5-8 mm respectively. On the head end of individuals the oral capsule by means of which parasites are attached to a wall of a small intestine settles down. In an oral sucker of a hookworm is available 2 dorsalny and 4 ventral cutting a tooth, for a nekator - 2 cutting chitinous plates.
Eggs have an identical structure: oval form, smooth colourless cover, sizes of 6638 microns. Each egg contains 4-8 blastomer. Life cycle of activators of an ankilostomidoz begins with hit of eggs of helminths with excrements to the external environment. Development of larvae happens in the soil at a temperature of 14-40 °C and humidity it is higher than 80%. After two molts, approximately in 7-10 days of a larva become invasive.
Infection of the person ankilostomidozy can occur on two mechanisms - fecal oral and perkutanny (chreskozhny); water, food or contact in the ways. In the first case of a larva get to the owner's organism through a mouth at the use of obsemenenny water, vegetables or fruit. The Perkutanny way of infection assumes active penetration of invasive larvae through skin at contact of the person with the polluted soil (during walking barefoot, lying on the earth, performance of earth and agricultural works). Having taken root through a skin barrier, larvae get to the blood course, then migrate in the right departments of heart and lungs from where on airways get into a throat and are again swallowed. Having appeared in a small intestine, in 5-6 weeks of a larva turn in the polovozrely helminths capable to independently lay eggs. At oral infection ankilostomidozy the migratory stage is absent - larvae appear in a small intestine at once. Life cycle of hookworms makes 7-8 years, nekator - up to 15 years. Agricultural workers, miners, summer residents, children treat the risk groups subject to infection ankilostomidozy.
Symptoms of an ankilostomidoz
During an ankilostomidoz allocate 3 phases: invasive, migratory and intestinal. The first phase is connected with introduction of larvae through skin in a human body that is followed by clinic of dermatitis or small tortoiseshell - emergence of rash (eritematozny, papular, vezikulezny), the local hypostasis, burning and an itch of skin remaining within 10-12 days.
During the second phase of an ankilostomidoz (migration of larvae on the owner's organism) there is an organism sensitization products of their activity to development of allergic reactions. Besides, traumatizing capillaries of air cells and tissues of airways is clinically shown by focal pneumonia, pleurisy, bronchitis, tracheitises, laryngitis. Patients ankilostomidozy complain of cough, short wind, hoarseness of a voice, subfebrilitt.
passes into the third (intestinal) phase in 30-60 days after an invasion. This stage has a long, chronic current and is connected with parasitizing in a small intestine where they by means of teeth are attached to a mucous membrane, injuring it. In the place of fixing of a parasite erosion are formed and ulcers which can it is long to bleed, leading to development of iron deficiency anemia. Besides, being gematofaga on a way of food, each individual of a nekator consumes a day 0,03-0,05 ml of blood, hookworms - 0,16-0,34 ml that also promotes chronic blood loss. The intestinal phase of an ankilostomidoz proceeds with the phenomena of a duodenit - appetite violation, a taste perversion, nausea, vomiting, pains in epigastralny area, diarrhea or a lock.
At a long current of an ankilostomidoz or a massive invasion at children decrease in body weight, a delay in intellectual and physical development can be observed. Adult patients can suffer from irritability, a sleep disorder, increased fatigue; at women violation of a menstrual cycle is quite often noted. Development of anemia is followed by weakness, dizziness, tachycardia, noise in ears.
Diagnostics and treatment of an ankilostomidoz
In various phases of an ankilostomidoz the patient can ask for medical care the otolaryngologist, the pulmonologist, the gastroenterologist or the therapist. At diagnostics of an ankilostomidoz clinical and epidemiological data are considered. In peripheral blood gipokhromny iron deficiency anemia, increase in SOE, an eozinofiliya, a gipoalbuminemiya is noted. At a research of the general analysis of a phlegm a large number of eosinophils is found. In a migration phase on roentgenograms of lungs inflammatory eozinofilny infiltrates can come to light; on the ECG – miokardiodistrofiya signs. Data of a X-ray analysis of a passage of barium indicate intestines hypotonia, violation of motility with the phenomena of stagnation of kalovy masses.
Results of the analysis a calla on eggs of helminths or a research of the contents of a 12-perstny gut received at duodenal sounding are decisive for confirmation of an ankilostomidoz. Besides, serological methods of diagnostics are used (reactions of hemagglutination and latex agglutination). As the identical structure, identification of helminths (hookworms and nekator) have eggs it is possible only after carrying out expulsion of helminths and an otkhozhdeniye with a stake of adult individuals. Ankilostomidoz demands performing differential diagnostics with other helminthoses, and also anemias of other etiology.
Etiotropny therapy of an ankilostomidoz is carried out by the protivogelmintny medicines appointed by the infectiologist (parasitologist). For carrying out expulsion of helminths the following medicines are used: pyranbodies, befeniye , , . In 3-4 weeks after antigelmintny therapy control of efficiency of treatment – a 3-hkratny research a calla at an interval of 1 month is carried out. Symptomatic and pathogenetic treatment of an ankilostomidoz assumes purpose of medicines of iron, B12 vitamin, folic acid, antihistamines, etc.
Forecast and prevention of an ankilostomidoz
In most cases at timely diagnostics and treatment of an ankilostomidoza come to the end with an absolute recovery. The subsequent medical examination of the patients who transferred is carried out annually within 4 years; transferred – within 7 years. Heavy complications and lethal forms of an ankilostomidoz develop at the started course of a disease.
Preventive actions consist in respect for standards of personal hygiene - washing of hands after visit of a toilet, protection of integuments at contact with the earth, careful processing of fruit and vegetables, water boiling before the use etc. Sanitary processing of sites of the soil and the objects of the external environment which are presumably polluted by larvae is important. Groups of the increased risk on incidence ankilostomidozy have to undergo annual medical examination.