Trichocephalosis in children: causes, symptoms, diagnosis, treatment

Trichocephalosis in children - chronic helminthiasis caused by a round worm - vagus head, with primary lesion of the gastrointestinal tract, anemia and asthenia.

ICD-10 code

B79 Trichurosis.

See also: Trichocephalosis in adults

Epidemiology of trichocephalus

Trichocephalosis is widespread in all climatic zones of the globe, excluding deserts and permafrost zones. The severity of the population of the humid tropics and subtropics is especially high, where invasion is detected in 40-50% of cases. In the temperate climate zone in rural areas, up to 16-36% of the child population is affected, mainly at the age of 10-15 years.

The source of infestation is a person who secretes parasite eggs into the environment with feces. The development of eggs occurs in the soil at a temperature of 15 to 35 ° C with sufficient humidity. At a temperature of 26-28 ° C, the development of invasive eggs is completed within 20-24 days. Eggs are resistant to low temperatures, but quickly die on drying, insolation. Infection occurs when entering mature eggs in the mouth with contaminated hands, as well as fruits, vegetables, water.

[1], [2], [3], [4], [5], [6],

Causes of trichocephalus

The causative agent of Trichocephalis Trichiuris trichocephalus is a thin nematode of a brownish color. The anterior part of the body is filiform, the posterior part is short, thick. The length of the female is 3.25-5 cm, the male is 3-4.5 cm. The tail end of the male is spirally folded, the female has a conical shape. Eggs barrel-shaped, with "stoppers" at the poles. The female releases up to 1,000-14,000 eggs per day. Vlasoglavy live mainly in the caecum, with intense infestation - throughout the colon, including the straight. The anterior anterior part of the body parasite penetrates into the surface layers of the intestinal mucosa, sometimes to the submucosa and muscle layers. The back of the parasite hangs in the lumen of the intestine. The life span of a whimper is 5-7 years.

[7], [8], [9], [10], [11], [12], [13]

The pathogenesis of trichocephalus

In the small intestine larvae emerge from the invasive eggs, which penetrate the mucosa, where they develop. After 5-10 days they again exit into the lumen of the intestine and descend into the large intestine. Maturation to adult individuals occurs within 1-2 months. The introduction of the head of the vagal head into the intestinal mucosa, the isolation of enzymes and metabolites by the larval stage of the parasite cause a pronounced local and relatively limited overall inflammatory response. Antigens of vagal heads have low immunogenicity, but in the early period of the disease a moderate eosinophilic reaction is observed, with intensive infestation, an increase in ESR, serum alpha and beta globulin content.

Symptoms of trichocephalosis in children

With moderate invasion without repeated infections, trichocephalosis often proceeds subclinically or is manifested by rare, periodically occurring stitching or spastic pain in the abdomen with predominant localization in the right ileal region, epigastrium, sometimes throughout the colon. With massive invasion and repeated infections in children, nausea, loss of appetite, salivation, unstable stools, headaches, increased fatigue are not uncommon. Children of early age may lag behind in physical development, they develop anemia, hypoalbuminemia.

The invasion is divided into acute (early) and chronic stages, the disease - into a subclinical, compensated, manifest and severe, complicated form.

In a temperate climate zone, trichocephalosis often combines with ascariasis. In this case, pain is common throughout the abdomen, accompanied by nausea, vomiting, unstable stool, loss of appetite, weight loss. In young children, a lag in physical and even mental development is possible. Especially difficult is the infection in combination with amebiasis and acute intestinal infections: with bloody stools, tenesmus, prolapse of the rectal mucosa, rapid anemia, loss of body weight. Trichocephalosis complicates the course of acute intestinal infections, contributing to prolonged convalescence, which often can not be achieved without eliminating the invasion. Trichocephalus infection mainly infects active age, infancy in newborns - casuistry, in children of the first year of life, trichocephalosis is rare, it erases in the absence of complicating factors. Congenital trichocephalus does not exist.

Diagnosis of trichocephalus

Trichocephalosis is diagnosed on the basis of an epidemiological anamnesis, a characteristic clinical picture and detection in the faeces of eggs of the whipworm. With rectomano-colonoscopy, moderate puffiness, flushing of the mucous membrane is detected; with intensive infestation - superficial erosions, pinpoint hemorrhages. A sharp mucosal edema, ulcers, hemorrhages are detected when parasites are spread throughout the large intestine and when combined with a protozoal or / and bacterial infection, when seen in the sigmoid and even in the rectum hanging in the lumen of parasites.

[14], [15]

Treatment of trichocephalus

Trichocephalosis is treated with carbamate-benzimidazole derivatives: medamine, vermox (mebendazole), albendazole, pyrimidine derivative - oxantel. Medamin is prescribed in a dose of 10 mg / kg per day, 3 meals after meals for 3 days, vermox - at a dose of 2.5 mg / kg per day in the same scheme. The diet is normal, without a lot of coarse fiber, fat; with poor tolerance of fresh milk, it is excluded from the diet. A control study of feces is carried out 2-3 weeks later, three times. If eggs are detected after 2-3 months, treatment can be repeated.

How to prevent trichocephalosis in children?

Prevention of infection with trichocephalosis consists in instilling in children hygiene skills, in protecting water sources from contamination, in communal improvement of settlements, and for using fertilizers for gardens and kitchen gardens only after composting them.