Cysticercosis - Causes, Symptoms and Treatment .MF .
prevalence of cysticercosis in the world is similar to that in teniasis (pork tapeworm).The geographic area includes the areas with extensive development of animal husbandry.Cysticercosis draws attention to the severity of the experts at the person with the possibility of destruction of vital organs and systems, low efficiency of specific therapy and mortality.It is known that cysticercosis can cause the development of neurological disorders, including epilepsy, common in South America, Africa and Asia.
Cysticercosis - a human disease parasitic etiology, caused by the actual larvae pork tapeworm - cysticerci or Finns (Cysticercus cellulosae), able to settle down and parasitize various organs (brain, spinal cord, muscle, organs of vision, bone, etc.),and difficult to treat.In the case of this disease the person is an intermediate host of pork tapeworm.
Geographical prevalence of cysticercosis is almost the same as that of teniasis.This South and Central America, Africa, Indi
Causes of cysticercosis.
Pathogen cysticercosis - larval stage of the pork tapeworm (Taenia solium), cysticerci or Finn (Cysticercus cellulosae).Cysticercus is an oval-shaped formation or bubble, which houses the scolex or head of pork tapeworm, equipped with 4 suckers and double row crown of hooks (hence the name "armed tapeworm").The patient's tissues and organs form can evolve from round to spindle up to 15 mm, but seldom describe Huge bubbles with grozdevidnymi branches (so-called branched form cysticerci).Over time, the shell becomes more dense, which is associated with deposits of calcium salts in it, but cysticerci inside is still viable.
infection Source - a sick man, from which feces into the environment are allocated egg pork tapeworm.
mechanism infection usually fecal-oral and way - contact-household and food.When exogenous infection transmission factors are dirty hands, contaminated food, with which the eggs come pork tapeworm in the human stomach.Patients teniasis (pork tapeworm) may occur and endogenous infection or autoinvaziya (throwing mature tapeworm segments of bowel vomiting followed by ingestion hexacanth or eggs).
Susceptibility general population, but the disease occurs in a small percentage of cases - up to 5%.With the same frequency sick persons, male and female.
Pathogenic action of cysticerci in the human body.
Once in the human stomach, eggs (hexacanth) pork tapeworm moving to the small intestine, where they come larvae, embedded in the intestinal wall, and then enter the bloodstream.From the bloodstream, they spread throughout the body and deposited in various organs and tissues, where they form cysticerci (up to 15 mm vials of clear liquid and scolex inside).Main place of localization of cysticerci: subcutaneous adipose tissue, brain, organs of vision, muscle, heart, liver, lung, peritoneum, bone tissue.Up to 80% of lesions accounts for the central nervous system, in the second place - of bodies.Cysticerci Maturation occurs within 4 months.
Lifespan larvae 3-10 years.
pathological processes associated with larvae:
1) mechanical effects (pressure growing on helminth organs and tissues and, as a consequence, the violation of their functions).
2) Irritant effect on the larvae of the surrounding tissue and the development of the inflammatory process - is the emergence of degenerative and inflammatory infiltrates.For example, in the brain - the development of meningitis, encephalitis, hydrocephalus, in view of the organs - retinal lesions, vitreous and others.
3), toxic and allergic effects on the body in connection with the receipt of the parasite into the bloodstream of waste products - parasitic antigens (a generalized allergic reaction, with massive destruction of the parasite may develop anaphylactic shock).
symptoms of cysticercosis
Clinical symptoms of the disease varied, depending on the affected organ or system of the body, as well as on the degree of severity of the infection.Allocate cysticercosis of the central nervous system (CNS), eye cysticercosis, cysticercosis of muscle, skin, subcutaneous fat layer.Other forms are extremely rare.In the CNS account for about 80% of all lesions.
Cysticercosis of the central nervous system.
If it affects the central nervous system is accepted to allocate following forms:
1) cysticercosis of the cerebral hemispheres (GM);
2) cysticercosis ventricular system;
3) cysticercosis base of the brain;
4) cysticercosis mixed form.
With the defeat of the cerebral hemispheres of GM patients complain of headaches in the form of seizures, dizziness, nausea and vomiting, not bringing relief.All these symptoms are associated with impaired outflow of the cerebrospinal fluid of a brain ventricular occlusion floating cysticerci formations and, consequently, increased intracranial pressure.One of the most common symptoms are epileptiform seizures.
With the defeat of the ventricular system possible acute onset (the development of hypertension-hydrocephalic syndrome).There are sudden intense headache, worse when changing position of the head and the body, which leads to the appearance of forced postures in patients.Headaches accompanied by severe vomiting.
Cysticercosis base of the brain leads to symptoms of weight with less pronounced compared to the previous complaint form of the disease.Patients concerned about pain in the back of the head, neck, hearing loss, vertigo especially when turning your head, breach of taste sensations.There may be violations of motor activity from gait disturbances to paresis.In some patients the sensitivity disorders and mental disorders.
mixing forms cysticercosis characterized by epileptiform seizures, hallucinations, mental disorders of any kind.Proceeds this form unfavorably.
Cysticercosis, brain damage
If it affects the patients eye is first concerned a different kind of visual impairment, which may be aggravated up to total blindness (the prognosis of this serious, almost irreversible).Cysticerci can be located in all the shells and structures of the eye, can cause retinal detachment, changes in the lens.
Cysticercosis, eye damage
Cysticercosis skin and subcutaneous fat.
a long time, asymptomatic, only years later, you can find small rounded education, rises above the surface of the skin, painless and soft to the touch, but in the latter they become denser.Most are located on the palms of the hands, chest, shoulders.Often, patients have an allergic reaction, and generalized urticaria by type.This form occurs favorably.
Rarer forms of cysticercosis occur with damage to the heart from cardiac arrhythmia, as well as with lung involvement (as a random finding in radiography - rounded shade to 1.5 cm).
Cysticercosis subcutaneous fat
Diagnosis of cysticercosis.
diagnosis of cysticercosis is exposed on the basis of the following criteria:
1) epidemiological history (teniasis disease, not personal hygiene in the use of food).
2) Clinical data (the presence of specific complaints of the patient, specific to a particular clinical form of cysticercosis).
3) paraclinical methods of research: in the general analysis of blood eosinophilia and 40%, in the analysis of cerebrospinal fluid - lymphocytosis, an increase in protein.
4) Instrumental examination methods (EEG, CT, MRI, X-ray of the lungs and other organs, ophthalmoscopy) - the presence of cavity formation with a dense shell.
5) biopsy of nodules and istologicheskoe study materials (in particular the possible examination of cavity formation of subcutaneous fat, which is located inside the larva).
6) Serological blood tests to detect antibodies to the larvae of pork tapeworm, which are used for the purpose of RAC, IHA, IFA.
The differential diagnosis is carried out with tumor-like formations of the brain, echinococcosis, toxoplasmosis, neurosyphilis, phlebitis, pulmonary tuberculosis, and bones and others.
Treatment of cysticercosis.
Hospitalizations are subject to severe cases of cysticercosis (brain damage, eye).When cysticercosis skin, muscles and subcutaneous fat patients observed outpatients.
1) antiparasitic therapy is prescribed with extreme caution because of the risk of death of the parasite and the appearance of a severe allergic reaction due to its decay products (eg anaphylactic shock).The therapy is carried out only in a hospital.Treatment to be inoperable cases of cerebral cysticercosis, cysticercosis eyes.Appointed following antiparasitic drugs: praziquantel, mebendazole, albendazole.3 recommended course of therapy with 3hnedelnym interval.Skin Cysticercosis, VLS and muscles in the absence of complaints can not be cured, and patients subjected to follow-up.
2) Surgical methods of treatment used in the case of precise identification of the hearth and the possibility of its removal without damaging vital brain centers.In the absence of full recovery supplement therapy guarantees conservative treatment: appointment of antiparasitic agents - praziquantel.Any
antiparasitic therapy with cysticercosis purpose must be supplemented corticosteroids (corticosteroids) such as prednisolone, dexamethasone.
3) Symptomatic treatment complements assigned antiparasitic therapy (that antihistamines - zodak, zirtek, suprastin, pipolfen; anticonvulsants, sedatives, ddegidratatsionnaya therapy, local therapy, etc.).
Prognosis depends on the form of the disease.If there is a skin and muscle tissue cysticercosis, the prognosis is favorable.If the patient and damage the internal organs, which often occurs, the diagnosis is late in advanced process, the prognosis is poor.
- Compliance measures and personal hygiene (timely and thorough hand washing after using the restroom and before eating, careful treatment of food before eating - fruits, vegetables, berries, etc.).
- Hygienic education of the younger generation, instilling them hygiene life.
- Timely access to a doctor when the disease teniasis (pork tapeworm) to rehabilitation and dispensary observation.
- Avoiding eating raw, half-baked and poorly thermally processed meat pigs and wild boar.
- Visualization pig meat before consumption in order to identify Finn tapeworm.
- Survey decreed groups on taeniasis (meat-packing workers, pig farms).
- Sanitary-veterinary supervision to prevent the ingress of pork, pork tapeworm infected at the counters to the end consumer.
infectious disease doctor Bykov NI