Iron worm disease
Introduction
Introduction to ironworm disease Ironworm disease is a rare parasitic disease caused by accidental infection of human worms. From incomplete statistics, there are more than 50 reports at home and abroad, including 22 reports in China, which were found in Shandong and Hubei. , Shaanxi, Henan, Yunnan, Sichuan, Guangdong, Guangxi, Xinjiang, Fujian and other places. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: digestive tract spread complication:
Cause
Cause of ironworm disease
(1) Causes of the disease
Mermithid nematode, also known as hair worm (hair snake) or horsehair worm, is a general term for Nematomorpha worms. The adult is slender, round and linear, like iron wire, 10 to 100 cm long and 0.3 wide. ~3mm, the color changes greatly, can be yellow, gray, brown or dark brown, the insect is very active in vitro, often have self-knotting habits (Figure 1), dioecious, males smaller than females, insects The front end of the body is obtuse, the mouth is located at the top of the head or the ventral surface of the front end. The end of the male tail is divided into two leaves. The end of the female tail is complete or divided into three leaves. The body wall is thick and extremely rough. The outermost layer is the stratum corneum. The surface may have a pattern or small protrusions, which may have hair or holes on it, and the adults live in the water. After the males and the males, the males die. When the females mature, the females produce a large number of eggs at the waterside. It can lay eggs between 1.5 million and 1.6 million. The egg adhesions are rope-like, which can be as long as 15-20 cm. The females die after spawning. The time of egg development in the water is related to the water temperature, such as the eggs of Gordius aquaticus, at a water temperature of 13 °C. It takes about 35 days to mature, and it takes 74 days to incubate at 10 °C. The larvae are small, about 0.25mm, without a digestive tract. There is a cross in the middle of the body. The worm is divided into two parts. The larva is eaten by the aquatic insects or drilled into the blood wall, and the body is absorbed by the body surface. The fat grows up gradually, but because the host's body is too small, it often hinders its growth. If the hatched larva can enter the insect within 24 hours, it can form a sac in the water, and the larvae can survive for at least 2 months in the water. It can survive for 1 month in moist soil. When the capsule is swallowed by insects, the wall of the capsule dissolves, and the larva escapes and passes through the intestinal wall of the insect to develop into the blood cavity. The larvae are in the appropriate intermediate host, cockroach and beetle. In vivo growth, sometimes infecting ticks and leeches, larvae develop in these insects to grow scorpions to form nymphs (infectious larvae), sometimes small insects are eaten by larger arthropods such as tarragons, crickets or mites The nymphs can still continue to develop in these hosts. When the host comes into contact with water or insects, it falls into the water. The mature nymphs escape from the insects into the water and live spontaneously. The color of the worms gradually deepens. Wall gradually harden, thus, the life cycle in the wire, there may be one or two intermediate hosts.
The worms live in swamps, ponds, streams, ditches, etc., and can infect humans. The infection may be due to the infective larvae (the larvae) entering the body when exposed to water or drinking raw water. In the digestive tract, the worms can secrete one. The substance can continue to develop in order to alleviate the damage caused by the intestinal fluid. Most of the worms are excreted with the feces, and are also discharged through the urethra. The worms are detected from the orbital mass or the ear canal, and the parasites in the bladder are parasitic. It can survive for at least 3 to 4 years.
(two) pathogenesis
The worms live in swamps, ponds, streams, ditches, etc., and can infect the human body. The infection may be due to the infective larvae (the larvae) entering the human body when exposed to water or drinking raw water. The path of the iron worm to invade the urinary tract may be A nymph or an adult that is close to maturity is infected by retrograde invasion from the urethra when swimming in a water such as a pond.
Prevention
Ironworm disease prevention
The prevention and treatment of this disease, mainly do not drink unclean raw water, avoid raw food can be used as insects and unsuitable host fish or snails in the intermediate host of ironworm, and should wear tight tights when entering the water to prevent the insect from invading from the urethral opening. human body.
Complication
Iron worm disease complications Complication
Patients who are parasitic in the urinary tract can occasionally develop bacterial infections.
Symptom
Symptoms of iron worm disease Common symptoms Bladder irritation urinary frequency Urinary urgency Diarrhea Urinary pain Heat pain Dyspepsia Hematuria
Patients with parasitic nematodes parasitic in the digestive tract generally have no obvious symptoms, occasionally symptoms such as chronic indigestion and diarrhea. The way to invade the digestive tract may be that the worms drink water or swallow a host containing nymphs such as insects, fish, snails, etc. Infected human body, parasitic in the urinary tract, more women, have urinary tract irritation, such as abdominal pain, frequent urination, urgency, dysuria, hematuria, radiation low back pain and perineum and vaginitis, etc. May be caused by mechanical stimulation of the worm's movement in the bladder and urethra. Once the worm excreted with the urine, the symptoms gradually disappeared. The path of the iron worm invasion into the urinary tract may be close to the mature nymph or adult. When people swim in water bodies such as ponds, they invade and invade from the urethra. It is extremely rare to be parasitic in the eyelids and external auditory canal. Sayad (1936) reported that the parasites in the parasites formed a mass and caused redness and heat pain. The invasion route may be childish. Invasion of the insect into the cheek by the mouth reports that the parasite is parasitic on the external auditory canal due to the movement of the insect can cause extreme itching.
Examine
Inspection of ironworm disease
There are many mild abnormalities in urine routine examination. The urine may contain a small amount of protein and red blood cells, but the eggs are not found.
Diagnosis
Diagnosis and identification of iron worm disease
The detection of the worm body can confirm the diagnosis. Patients with parasitic worms in the digestive tract generally have no obvious symptoms, and the eggs are not found in the feces; those who are parasitic in the urinary tract are only non-specific bladder irritation, cystoscopy It can be seen that the bladder triangle area is chronic inflammation, and there are mild abnormalities in urine routine examination. The urine may contain a small amount of protein and red blood cells, but the eggs of the insects cannot be found. Therefore, it is difficult for the doctor to consider this before the patients are discharged. Parasitic insects.
Clinical attention must be paid to the identification of rabies and other helminthiasis.
