Intestinal Ascaris
Introduction
Introduction to intestinal mites Ascariasis is the most common intestinal parasitic disease, and the source of infection is tsutsugamushi patients and infected people. A large number of eggs are discharged with the patient's feces, contaminating vegetables and soil. Under suitable temperature and humidity, after about 2 weeks, they develop into mature eggs, mature eggs are passed to the stomach, most of them are killed by gastric acid, and a few enter the small intestine. Hatching develops into larvae, larvae penetrate into the intestinal mucosa, enter the lungs through the lymphatic vessels or microvessels, the liver and the inferior vena cava, and form a larva of about 1 mm after peeling in the lungs. The larva passes through the microvessels and rises to the pharynx through the alveoli, bronchi, and trachea, and then is swallowed into the stomach. This constitutes a sputum transition, and the sputum develops into an adult after reaching the small intestine. It takes about 75 days from the swallowing of eggs to adult maturation, and the survival time in the small intestine is about 1-2 years. basic knowledge The proportion of sickness: 0.04%-0.07% Susceptible people: no specific people Mode of infection: non-infectious Complications: abdominal pain, intestinal obstruction
Cause
Intestinal mites
Dietary factors (60%):
Often caused by eating cold vegetables, melons, or other unclean things that are contaminated with locust eggs. The mites are parasitic in the small intestine, disturbing the spleen and stomach, and sucking the water valley. Because aphids have a warm temperature, aversion to cold, heat, good sputum, good at drilling, so when the spleen and stomach dysfunction, or systemic febrile illness, the mites are easy to smash in the abdomen and cause a variety of illnesses .
Living habits (20%):
The temperature, rainfall and people's production and living habits in nature are epidemiologically important factors. A large number of eggs are discharged from the patient's feces, contaminating vegetables and soil. Under suitable temperature and humidity, after about 2 weeks, they develop into mature eggs. The mature eggs are passed to the stomach, most of which are killed by stomach acid. The small intestine hatches and develops into larvae. Cause intestinal tsutsugamushi disease.Other factors (10%):
Poor living habits can cause intestinal ascariasis.Prevention
Intestinal mites prevention
1. Personal hygiene: Kindergarten teachers actively cultivate children's good personal hygiene habits, wash hands carefully before and after eating, cut nails frequently, and correct bad habits of sucking fingers in time to eliminate the chance of egg entry.
2. Dietary Hygiene: All faculty and staff in kindergartens wash their hands with soap and running water before work, and disinfect them with 1:1000 disinfectant; ensure that children do not drink raw water, and wash and peel when eating raw fruits.
Complication
Intestinal mites complications Complications abdominal pain intestinal obstruction
Complication treatment
(a) biliary ascariasis
1 atropine chlorpromazine or dulidine to relieve analgesia.
2 Defecation treatment after remission of abdominal pain.
3 timely use of penicillin, streptomycin and other antibiotics to control biliary tract infection.
(B) aphid intestinal obstruction incomplete intestinal obstruction first medical treatment including sedation, antispasmodic, analgesic and gastrointestinal decompression, to relieve abdominal pain after re-worming, taking soybean oil or peanut oil 80-150ml (children 60ml) The mites can be loosened and relieved. The symptoms will be re-dewormed 1-2 days after the symptoms disappear. Oxygen therapy can also relieve the mites. When complete obstruction occurs, surgery should be performed.
Symptom
Intestinal mites symptoms common symptoms abdominal pain biliary ascariasis diarrhea peritonitis indigestion abscess aphid intestinal obstruction aphid infection high fever nausea
A small number of mites in the small intestine can be asymptomatic when infected.
A large number of infections cause diseases. Aphids, glassy intestines, often cause recurrent epigastric or abdominal pain in the upper abdomen. Due to the mechanical stimulation of the worm and its secreted toxicants and metabolites, it can cause digestive tract dysfunction and heterosexual protein reactions such as anorexia, nausea, vomiting, diarrhea and urticaria. Children with serious infections can cause malnutrition, mental restlessness, insomnia, molars, and night terrors. Intestinal mites are generally in a quiet state, but after various stimuli (such as high fever, indigestion, improper deworming, etc.), it is easy to cause aphid turbulence and drilling, which can cause serious complications.
Examine
Intestinal mites inspection
Direct smear examination of feces: In this experiment, the color and traits of the feces were observed by the naked eye, and the smear was observed under a microscope using a stool smear to observe whether there were eggs, larvae, various cells, cysts, crystals, and the like in the smear. Large worms such as aphids, mites, and mites in the intestine can be distinguished by the naked eye.
Diagnosis
Diagnosis and identification of intestinal aphids
diagnosis:
According to the patient's clinical features: abdominal pain in the upper abdomen or umbilical cord. Due to the mechanical stimulation of the worm and its secreted toxicants and metabolites, it can cause digestive tract dysfunction and heterosexual protein reactions such as anorexia, nausea, vomiting, diarrhea and urticaria. Serious infection of children can cause malnutrition, mental anxiety, insomnia, molars, night terrors and so on.
Differential diagnosis:
Amoebic enteritis: In the fresh feces of the patient, especially in the bloody mucus, look carefully for the amoeba, and once the active phagocytic amoebic trophozoite with red blood cells is found, the diagnosis can be confirmed. Once found, it should be repeated several times and strive to do bacteria and amoebic culture. Attention should be paid to thermal preservation during microscopy, otherwise the amoebic trophozoites are inactive and are not easily distinguished from macrophages. Sigmoidoscopy is helpful for diagnosis, especially for differential diagnosis. In the acute phase, the flask-like ulcer can be seen, and the mucosa between the ulcers is normal. In the chronic phase, hyperplasia of the intestinal mucosa, granuloma and polyps can be seen. The pathological examination can be performed on the lesion to obtain the pathological examination to further determine its nature.
Giardia lamblia:
Pathogen diagnosis: (1) Fecal examination The trophozoites were examined by saline smear method, and the capsules were examined by iodine staining and smear, and the capsules were also examined by formaldehyde diethyl ether precipitation or zinc sulfate concentration method. The cysts are usually examined in the formed feces, while the trophozoites are found in the thin stools. Due to the intermittent characteristics of the capsule formation, it is advisable to check the feces every other day for more than three times. (2) Duodenal juice or bile examination can be used for multiple negative feces to increase the positive detection rate. (3) Intestinal capsule method allows the subject to swallow the capsule containing the nylon thread, the free end of the thread is left outside the mouth, after the capsule is dissolved, the nylon thread is loosened and stretched, and after 3 to 4 hours, it reaches the duodenum and the jejunum, nourishing The body adheres to the nylon thread, then slowly pulls out the nylon thread and scrapes the attached object for microscopic examination.
Immunodiagnosis: For the auxiliary diagnosis, there are mainly enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody assay (IFA) and convective immunoelectrophoresis (CIE). Among them, ELISA is simple and easy, and the detection rate is high (92%-98.7). Features such as %) apply to epidemiological investigations.
