Ascaris infection

Introduction Ascariasis is one of the most common intestinal parasitic diseases that are infected after ingesting aphid eggs. Ascaris lumbricoides Linnaeus 1758, referred to as aphids, is one of the most common parasites in the human body. Adult parasitic in the small intestine can cause Ascariasis. In addition, Toxocrata canis is a common intestinal parasite in dogs, and its larvae can migrate in the human body, causing visceral larva migrans (VLM).

Cause

[pathogen]

Ascaris lumbricoides Linnaeus (1758) is abbreviated as aphids, and the human body ingests infected aphid eggs by mouth.

[pathological changes]

X-ray examination of some patients with larval pathogenicity shows invasive lesions. The lesions often have migration. Adults can damage intestinal mucosa, urticaria, itchy skin, angioedema, conjunctivitis and suppurative bile duct. Inflammation, cholecystitis, and even bile duct necrosis, perforation, and volvulus and intestinal necrosis.

Epidemiology

The distribution of aphids is cosmopolitan, especially in areas with warm, humid and poor sanitation. The rate of aphid infection is higher in rural areas than in cities, and children are higher than adults. At present, the infection rate of rural population in most areas of China is still as high as 60% to 90%.

an examination

Related inspection

Anal swab examination fecal parasite gastrointestinal disease ultrasound examination fecal microscopy

(1) Fecal examination: The eggs are detected in the feces of infected persons, and the diagnosis can be confirmed. Due to the large amount of eggs laid by female mites, the direct smear method, the detection rate of a smear is about 80%, and the rate of 3 sheets is up to 95%.

(2) B-ultrasound examination of biliary tract tract disease in the abdominal B-ultrasound can sometimes be found in the dilated common bile duct, and active, but the positive rate is not high.

Differential diagnosis

Differential diagnosis of mites infection:

1. Acute cholecystitis: acute cholecystitis is typical of acute cholecystitis. After eating greasy food, the upper right abdomen is strongly cramped, paroxysmal aggravation, often accompanied by right shoulder and back pain, nausea, vomiting, fever, chills, etc. There is also body jaundice. During the examination, there is tenderness in the right upper abdomen, and the swollen gallbladder can often be touched. Blood tests routinely found that white blood cells in the blood increased significantly, gallbladder ultrasound examination often found gallbladder enlargement, wall thickening, gallstones within the gallbladder.

2. Acute pancreatitis: Sexual pancreatitis is a common disease in abdominal surgery. In recent years, the incidence of severe pancreatitis has gradually increased. Because it is highly disturbed by the physiology and has obvious damage to all important organs, the mortality rate is very high. Sometimes it can cause sudden death. The mortality rate of severe pancreatitis is 20%, and those with complications can be as high as 50%. Clinical pathology often divides acute pancreatitis into two types: edema type and hemorrhagic necrosis. Although this classification can explain the pathological condition, the development of pancreatitis is not static. With the degree of obstruction of the pancreatic duct and the changes of interstitial blood vessels (arteries, veins and lymphatic vessels), the pathological changes are Dynamic development. Therefore, the method of classification of acute mild pancreatitis and severe pancreatitis is more suitable for clinical application. Serious pancreatitis (such as hemorrhagic necrosis) clinicians often attach great importance, but mild pancreatitis (such as edema type) can not be ignored, it can develop into severe pancreatitis.

3. Intussusception: A segment of the intestine is inserted into its connected intestinal lumen. It is the most common type of acute intestinal obstruction in infants. Most of the predilections are inserted into the wide cecal cavity from the end of the ileum. The incidence is related to factors such as intestinal caliber, intestinal wall tumor, diverticulum lesion, and intestinal peristalsis. The typical three major symptoms are abdominal pain, jam-like blood and abdominal mass. Mainly manifested as paroxysmal abdominal pain, sick children showed paroxysmal crying, pale, sweating, lower limb flexion of the abdomen, lasting for a few minutes and suddenly quiet. The abdomen can touch the active and tender mass, and the symptoms of intestinal obstruction are obvious. Adults have milder symptoms and fewer blood donors, often with incomplete obstruction. Atypical should be differentiated from appendicitis, tumors and other types of intestinal obstruction. The sputum angiography showed that the end of the sleeve was in the shape of a cup. If the nesting occurred for a long time, the necrosis or perforation of the intestine would be prohibited. A well-diagnosed early intussusception can be tested with air enema and abdominal external reduction; those who have not been able to be reset for more than 48 hours should be considered for surgical reduction; those with difficulty in resetting may be treated with local intestinal resection and anastomosis. Adult intussusception is caused by some pathological factors, so surgical treatment is generally appropriate. This disease can also occur in the elderly due to long-term constipation.

4. Aphid intestinal obstruction: Aphid intestinal obstruction is one of the common acute abdomen diseases in children. It can change the intestinal environment and intestinal peristalsis due to various stimuli such as fever, causing the aphids in the intestinal cavity to gather together and block. Intestinal cavity causes obstruction.

5. Adhesive intestinal obstruction: Adhesive intestinal obstruction is abdominal surgery, inflammation, extensive intestinal adhesion formed after trauma, acute intestinal obstruction caused by adhesion, is the most common type of intestinal obstruction. Most patients have a history of abdominal surgery, inflammation, trauma or tuberculosis, overeating or strenuous exercise before the attack; there used to be abdominal pain or a history of intestinal adhesions. A small number of congenital cords in the abdomen are more common in children. Symptoms mainly include paroxysmal abdominal cramps and repeated vomiting, and the sputum is yellow-green liquid, even for fecal juice, touching the bowel type and hearing high sputum bow sounds.

6. Biliary tsutsugamushi: biliary tract ascariasis (biliary ascariasis) is the most serious complication of intestinal ascariasis. More common in 6-8 years old school-age children, farmers and late pregnant women. It is an acute upper abdominal pain or biliary tract infection that is caused by various causes of intestinal mites and is drilled into the biliary tract. The pain of the patient was unbearable at the time of the attack, and it was very painful to cry. If the treatment measures can't keep up, the advanced patients may have different degrees of dehydration and acidosis, and even life-threatening. The eggs can be diagnosed by checking the eggs in the patient's stool. For the case where the eggs are not found in the feces, and the clinical manifestations are suspected to be tsutsugamushi, the therapeutic diagnosis of deworming can be used to identify the morphology of the discharged worms. Patients with suspected pulmonary snoring or allergic pneumonia caused by aphid larvae can be diagnosed with sputum.

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