Opisthorchiasis: symptoms and treatment in adults, photos, tests

What it is? Opisthorchosis( opisthorchosis) refers to helminthic diseases with severe form of helminthic damage to the human body and animals.

The parasitic flat worm Opisthorchis felineus, which belongs to the family Opisthorchidae, causes the disease.

At the end of the eighteenth century, an Italian scientist discovered this specimen in cats, and seven years later, at the beginning of the nineteenth century, the causative agent was discovered by a scientist at the Tomsk University at the autopsy.

Therefore, this species was named - Siberian or feline fluke.

Causes and causative agent of opisthorchiasis

The greatest number of registered patients is noted among residents living near freshwater rivers and reservoirs. The cause of infection is the consumption of insufficiently processed fish, mostly carp breed, infected with helminths. No other way the disease is transmitted to a person.

What is the mechanism of infection? At the stage of puberty, the fluke lives and parasitizes in the gallbladder, liver and pancreatic ducts not only in humans, but also in various domestic and wild carnivores that have become the ultimate host, giving "shelter" to the matured sexual forms of helminths.

Before reaching the place of parasitism, helminths undergo a triple development cycle. The intermediate host in the young development cycle is freshwater snails - shellfish and fish. The initial cycle is given by the beginning of the mollusks, swallowing the silt from the silt of the parasite eggs, trapped in the pond with the infected feces. During 6-8 weeks in the eggs develop cercariae( larva with a tail).

Ripe cercariae leave the cochlea, and move to the muscle fibers of the fish, screwing through the skin. The second stage of the cycle begins, lasting two months. In this cycle, the larva covers the double protective shell, transforming it into a metacircary.
The final host metacirculatory finds, getting into the stomach of an infected fish infected by an animal or human.

Under the influence of gastric acid, the protective shells of the metacyrian are destroyed, releasing the helminth. Reaching the bile excretory system, the process of laying eggs begins. Falling with the calves into the outer conditions, the eggs begin to "count down" their new cycle.

Read also, the symptoms of pinworms in adults, how to treat.

Symptoms of opisthorchiasis in adults

In adults, the development of dystrophic processes in opisthorchiasis largely depends on the number of pathogens penetrating the bile duct and liver, the duration of the disease.

The human immune factor plays an important role. In immunodeficiency, the latent period lasts from two weeks to a month. The nutrition of parasites is provided by cellular decay and glandular epithelium.

Vitamin activity of worms provokes a phage peeling of the epithelium in the bile ducts, which leads to excessive formation and proliferation of the basal layer of the epithelium with the manifestations:

• of adenomatous formations;
  
• abundant formation of glandular tissue;
  
• of Caroli's disease;
  
• fibrocystic disease in the ducts;
  
• promotes the manifestation of canal duct and cholangiocarcinoma.

By virtue of its structure, the suckers located on the surface of the parasite, when moving along the walls of the mucosa, detach epithelial cells, provoking the formation of multiple bleeding wounds that promote infection with the development of inflammatory processes in the bile ducts.

A large number of helminths accumulated in the ducts clog them, causing cholestasis with the development of cholelithiasis.

1. 1) At the stage of development of the disease, acute opisthorchiasis and chronic are isolated.
   
2. 2) In the course of the disease - an erased and manifest form.
   
3. 3) The severity of the disease is marked by the following forms - mild, moderate and severe.

Opisthorchias of erased form - characterized by a short-term fever, an increase in the level of eosinophils in the plasma, indicating a tendency to intoxication. In acute stage , the disease is expressed by allergic reactions, as a result of excreted metabolites by helminths, due to which:

• shows pruritus and urticaria;
  
• Quincke edema, arthralgia and food allergy;
  
• development of perivascular edema;
  
• shows increased vascular wall permeability;
  
• mucoid edema and destruction of the walls in small arteries;
  
• as a result of lympho-plasmocyte infiltration develops lymphoid nodes;
  
• destructive changes in the hepatic parenchyma with foci of necrosis.

The acute form of the opisthorchiasis with marked clinical symptoms lasts about two months, then the symptoms disappear and the disease acquires a chronic course.

Chronic form of opisthorchiasis. Different clinical symptoms in adults can appear after many years( 10 -30).Symptomatic of chronic course manifests itself:

• cholangitis or cholecystitis;
  
• disorders caused by a lack of digestive enzymes;
  
• by allergies;
  
• heart pain and tachycardia;
  
• increased heart boundaries;
  
• impaired systolic pressure;
  
• changes in the muscle tissue of the heart muscle

Multiple repetitive infections in "aboriginal" from endemic areas contribute to the development of the susceptibility of the immune system to helminthic agents, so opisthorchiasis takes place in the initially chronic form, bypassing the acute period, and can occur for many years in an erased or asymptomaticform. Clinical symptoms can make themselves felt in about twenty years.

The course of chronic opisthorchiasis alternates with remission and exacerbation. Exacerbation of disease provokes:

• infectious diseases;
  
• surgical operations;
  
• sclerotic processes in the bile excretory system;
  
• stagnation of bile in the liver;
  
• development of primary hepatitis

The mild form of opisthorchiasis is characterized by:

• prolonged, up to two weeks of temperature;
  
• increased fatigue;
  
• is a painful manifestation in the abdomen;
  
• diarrhea.

In the medium-severe form the disease proceeds:

• with various kinds of fevers lasting up to three weeks;
  
• very high temperature;
  
• by urticaria( confluent rash);
  
• with muscular articular pain;
  
• with hepatomegaly and swelling of the spleen;
  
• manifestations of intoxication and diarrhea;
  
• asthmatic bronchitis.

Opisthorchiasis of severe form is characterized by manifestations:

• of headache and a state of inhibition;
  
• increased excitability and insomnia;
  
• pain in the retroperitoneal part of the diaphragm;
  
• by enlarging the liver;
  
• toxic-allergic hepatitis
  
• bloating and diarrhea
  
• with painful bouts in the chest;
  
• hypoxic-ischemic CNS pathologies with possible edema of the brain and myocardium
  
• signs of general intoxication;
  
• development of intrahepatic cholestasis syndrome.

Possible manifestations of complications of

At the advanced stage of the disease, opisthorchiasis causes multiple complications presented:

• by inflammation of the hepatic ducts( angiocholitis);
  
• empyema( purulent inflammation of the gallbladder walls);
  
• with acute chronic hepatitis;
  
• by lesion of the gastric tissue( ulcer);
  
• by the development of acute or chronic pancreatitis
  
• by the manifestation of cholangitis;
  
• lesion and rupture of the biliary tract;
  
• development of cancer of the liver and its ducts.

Analyzes and diagnostics of opisthorchiasis

Diagnostic techniques that detect the disease are many, they are divided into direct methods and indirect ones. A direct method of diagnosis includes techniques that allow to determine the direct presence of a parasite in the body - the parasite itself, its fragments or eggs. It includes:

• helminthological methods;
  
• microhelminthoscopic and macrogelmeticoscopic analyzes
  
• electropuncture
  
• resonance testing

Indirect diagnostics allows revealing secondary changes in the body, as a result of parasite influence. These are:

• X-ray examination;
  
• molecular and immunological study.
  
• various tomographic examination methods

See also how to treat ascariasis in adults.

Treatment of opisthorchiasis

Once infected with helminthiasis, an adult becomes a potential carrier for life, and every resumption of opisthorchiasensensitizes the disease and worsens the patient's condition. Therefore, the result from the treatment of opisthorchiasis largely depends:

• on the intensity of helminth infection;
  
• duration of the disease;
  
• -level lesion functions of the gastrointestinal tract;
  
• risk of re-helminthic infection;
  
• from the level of the therapeutic process.

Treatment of opisthorchiasis has an integrated approach. Consists of:

• from drug therapy, which includes anthelmintic agents and drugs that remove the effects of intoxication;
  
• treatment of manifested symptoms;
  
• treatment of a specific nature, contributing to the restoration of functional activity of the gastrointestinal tract.

Patients with severe form of opisthorchiasis are hospitalized. Everyone who, although he has once again suffered from the disease, is put on dispensary control for a period of up to six months. As a preventive measure, there is only one rule - quality culinary processing in the preparation of any fish dishes.

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