Teniarinhoz
Last reviewed: 23.04.2024
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Teniarinhoz (lat. Taeniarhynchosis) - helminthiasis from the group of cestodoses, caused by Taeniarhynchus saginatus (bovine chain) or Taeniarhynchus confusum and characterized by the development of dyspeptic manifestations. A person becomes infected by eating beef containing the larvae of the pathogen and not having undergone sufficient heat treatment.
Epidemiology
The source of the contamination of the environment with the oncospheres of the bovine tapeworm is man - the only definitive host. Persons caring for animals (shepherds, milkmaids, etc.) pose the greatest danger.
Infection of animals most often occurs on pastures. Helminth eggs with feed enter the intestine of the intermediate host. 16 weeks after the animal is infected, its meat becomes infectious for humans. Cysticerci in the muscles of animals remain viable for 1-3 years.
The mechanism of human infection is oral - when eating raw or insufficiently cooked finnozy meat of animals, intermediate owners of the helminth. The most affected meat is young animals. Helminthiasis is common in areas where pasture and distant cattle keeping is adopted.
Causes of the teniarinhoza
Teniarinhoz is caused by Taeniarhynchus saginatus (unguided, bullish), which belongs to the type Plathelminthes, class Cestoda, family Taeniidae. Its body is flat, ribbon-like and consists of a head with four powerful suckers and many (1000 or more) segments (proglottids). Length of mature segment 20 mm, width 5 mm. The uterus has a median trunk and 18-30 lateral branches. Helminth reaches a length of 4-12 m. Mature hermaphroditic proglottids contain more than 140,000 eggs.
Eggs are almost spherical in shape, the germ (oncosphere) is inside. The bovine tapeworm belongs to biohelminths, with the development replaces two masters. The man - the final owner, intermediate - cattle, buffalo, yak, zebu.
In humans, adult worms parasitize in the small intestine for a long time (up to 20 years). Mature segments, detaching from strobila. Enter the environment with faeces, passively or actively crawl out of the anus. In the intermediate host organism, the larvae develop in muscular and connective tissue, where they turn into oval-shaped larvotsist - cysticercus (Finns). The larvae trapped in the intestines of a person reach the stage of adult helminth after 2.5-3 months.
Pathogenesis
The bovine tapeworm in the human intestine, as a rule, is parasitic in the singular (the old name of the helminth is the tapeworm). The parasite, reaching a size of several meters, attaching suction cups to the mucous membrane of the small intestine, causes damage and irritates the intestinal receptors. Affecting the motor and secretory functions of the intestines. Separated proglottids that provoke pain syndrome, especially when passing through the ileocecal valve, can have an additional mechanical effect.
Cases of parasite penetration into the appendix, common bile duct and pancreatic duct have been described, leading to obstruction and inflammatory changes. Perhaps the development of teniarinhoznaya intestinal obstruction. Intensive parasite consumption of nutrients in the process of growth and development (young individual per day lengthens by 7-10 cm) creates a shortage of the most biologically valuable components in the patient's diet. The blocking effect of substances secreted by the helminth on the human intestinal enzyme system, as well as sensitization by products of bovine tapeworm metabolism, have a certain value in the pathogenesis of teniarinhosis.
Symptoms of the teniarinhoza
There are no symptoms of teniarinhoses when invading a bull chain. Teniarinhoz is manifested only by the separation of segments from the anus with feces and / or outside the act of defecation as a result of their active creeping out of the anus. At the 2-3rd week, heartburn, nausea, a feeling of heaviness in the epigastrium appear, and at the 8th week the chair is broken. With prolonged invasion, patients note general weakness, abdominal pain, sometimes there is a decrease in body weight, diarrhea, increased appetite, asthenoneurotic manifestations occur: dizziness, headache, sleep disturbance. Fainting, epileptiform convulsions. In some cases, blood eosinophilia and anemia are recorded.
Complications and consequences
Teniarinhoz can have such complications: mechanical intestinal obstruction, appendicitis, cholangitis, pancreatitis - occur very rarely.
Diagnostics of the teniarinhoza
Symptoms of teniarinhoz are not specific. Suspected invasion can be caused by a combination of dyspeptic syndrome and loss of body weight with increased appetite.
Conduct a study of feces to identify fragments of strobila (proglottid) and helminth eggs enrichment methods.
Indications for consulting other specialists
In case of intestinal obstruction and acute inflammatory diseases of the abdominal organs, the surgeon’s consultation is indicated.
What do need to examine?
How to examine?
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Differential diagnosis
Differential diagnosis of teniarinhosis is carried out with other intestinal cestodoses — teniasis and diphyllobothriasis, in which, unlike teniarinhosis, there is no independent active separation of the helminth segments from the anus.
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Treatment of the teniarinhoza
Treatment of teniarinhose consists of administering praziquantel once at a dose of 15 mg / kg. Niclosamide can also be used for deworming: 2 g is taken at night, carefully chewing and drinking water. 15 minutes before taking, it is recommended to drink 1-2 g of sodium bicarbonate (baking soda). The drug causes death of scolex and immature segments. If the discharge of the joints is resumed, they are re-treated with the same anthelmintic drugs. If the discharge of the segments ceases within 2-3 months after antiparasitic treatment, this indicates an effective treatment. In such cases, conduct a control study of feces for the presence of helminth oncospheres.
Approximate periods of disability
Disability during illness is not impaired.
Clinical examination
Teniarinhoz does not require medical examination. 2-3 months after treatment, a control helminthological study is performed. When identifying in the feces of oncospheres repeat the treatment.
More information of the treatment
Prevention
Prevention of teniarinhoz is carried out with the help of a complex of medical and veterinary measures aimed at identifying the sources of invasion during mass screening of the population. Carry out activities to protect the environment (pastures) from faecal pollution. Personal prevention is to exclude from the diet of raw and insufficiently thermally treated cattle meat.
Forecast
Teniarinhoz usually has a favorable prognosis.