Toxocariasis in children. Treatment of toxocariasis in children. Toxocariasis: symptoms, treatment

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Toxocariasis is a disease about which, despite its widespread distribution, practitioners know not so much. The symptoms of the disease are very diverse, so specialists from various fields can face it: pediatricians, hematologists, therapists, oculists, neuropathologists, gastroenterologists, dermatologists and many others.

Toxocariasis in children is much more common than in adults. Children usually become infected between the ages of ten and fourteen. It is noteworthy that most of the patients live in rural areas. In general, the disease responds well to therapy, but if vital organs are affected, a fatal outcome is also possible. And what is this disease, what are its causes and symptoms? This is what we will try to find out. So, the subject of our conversation: toxocariasis - symptoms, treatment and prevention of the disease.

Features of pathology

Toxocariasis in children occurs as a result of damage to the body by toxocara - parasitic worms. ithelminths atypical for humans, although in their properties they are in many respects similar to roundworms. Depending on the pathogen that has entered the body, two types of pathology are distinguished. How is this or that toxocariasis manifested? Symptoms, treatment and one and the other variety will be the same. So, the disease can be caused by Toxocara, a parasite in dogs, or Toxocara, a parasite in cats.

Children who come into close contact with infected dogs are often infected. Helminth larvae can be found on the surface of the animal's fur, in dog feces, and even in the ground that the dog walked on. The prevalence of worms in cats is an order of magnitude lower.

Parasite morphology

Toxocars, when they enter the human body, die due to the lack of suitable conditions for their survival and development of full-fledged sexually mature individuals. Man, therefore, in their life cycle is a dead end branch. That is why the disease from the carrier is not transmitted to other people, in other words, toxocariasis is not contagious. In children, despite this, such a pathology is not at all a rare occurrence. What to do, our kids love to pet stray animals, dig in contaminated sand or soil. In addition, many parents do not teach children to pay due attention to hygiene. As a result - toxocariasis!

The photo on the right obviously does not cause positive emotions. And imagine that the larvae of such a worm enter the body of your child! Yes, really creepy. Adult toxocara can grow up to fifteen or eighteen in length.centimeters. Their development from larva to sexually mature form occurs in the intestines of the hosts - dogs and cats. Then the females release eggs into the external environment (up to two hundred thousand pieces per day), but at this time they are still immature, therefore non-infectious. The process of maturation of eggs in the soil takes up to twenty days, and in the conditions of an apartment they can remain dangerous all year round, being in the fur of animals. A person becomes infected with an invasive form of eggs when swallowed, they usually fall into the mouth from dirty hands. You can become infected at any time of the year, because the larvae show resistance to environmental factors, however, infection often occurs during the warmer months, when conditions are most favorable for the development of invasive forms.

What happens in case of infection

In the human body, Toxocara can only be in the larval stage. Once from the external environment into the intestine, invasive eggs are transformed into larvae, which then penetrate the intestinal wall into the bloodstream and, like roundworms, migrate from the systemic circulation to the small one, after which they enter the liver and lungs, settle there and form specific granulomas. This happens most often, but in general the larvae can settle in any organs and tissues. The parasite is surrounded by a dense capsule, and thanks to it it can remain viable for many years. Therefore, even if the treatment of toxocariasis in a person is successful, a relapse of the disease is possible.

Symptoms of disease

Clinical manifestations will be entirelydepend on the severity of the response of the child's immune system and on how widespread toxocariasis has become in the body. Symptoms in children appear the brighter, the higher the level of contamination. Often the disease is characterized by a latent or latent course, periods of exacerbation are replaced by remissions. Toxocara can exist in the body from several months to many years. In extremely rare cases, as already mentioned, everything ends in death. Death occurs if parasites infect the central nervous system or heart.

Depending on which organs or systems of the body have been affected, there are several forms of the disease: visceral, ocular, skin and neurological. Signs of pathology in each case will differ.

1. Visceral toxocariasis

In children, this form occurs most often. The disease affects the internal organs. The more invasive larvae enter the body, the more pronounced the symptoms. Toxocariasis in this case is manifested by fever, accompanied by severe chills (this indicates damage to the lungs), swelling of the lymph nodes. Of the signs of the disease, which are detected only in the course of laboratory tests, one can distinguish an increase in the level of eosinophils and gamma globulins in the blood, an increase in the liver. The most common symptom in this form, occurring in almost seventy percent of children, is a pulmonary syndrome, which is expressed in a dry cough that worsens at night, shortness of breath, and a blue area around the mouth. There may also be wheezing in the lungs. If you do not start treatment of toxocariasis on time, a person may develop progressive pneumonia. Timely diagnosis and adequate therapy is a guarantee that the disease will be defeated!

2. Ocular toxocariasis

This form usually occurs when helminths enter the body in small quantities. Pathology is manifested by optic neuritis, keratitis, the development of chronic endophthalmitis, uveitis, and the formation of granulomas. The doctor, when examined in the vitreous body, can detect floating larvae that form an abscess surrounded by an area of inflammation.

3. Cutaneous toxocariasis

With this form, allergic reactions usually occur in the form of eczema, urticaria, and various rashes. At the same time, the affected areas become inflamed, can swell strongly, turn red. The appearance of a rash is accompanied by painful, unbearable itching. The strongest and brightest inflammation is found in the migration zone under the skin of the larvae and along the vessels.

4. Neurological toxocariasis

This is the most dangerous and severe form, because in this case, the parasites get into parts of the nervous system, and this is fraught with all sorts of neurological disorders, including memory impairment, restlessness, behavioral problems, irritability, reading difficulties, hyperactivity. In some cases, convulsions and epileptic seizures occur.

Blood test for toxocariasis: transcript

In a laboratory blood test, the mostconstant symptoms in the case of this disease are an increase in the number of eosinophils to a high level (they can reach up to 90 percent of the number of all white blood cells) and the development of a leukemoid reaction, which has an eosinophilic orientation. At the same time, leukocytes in the total number also increase to 10-15x109/l, and the erythrocyte sedimentation rate increases sharply. The total number of erythrocytes and hemoglobin against the background of an acute blood reaction can decrease.

In addition, in the early stages of infection, hypergammaglobulinemia is observed - a significant increase in IgM immunoglobulin in the blood, and then IgG immunoglobulin. At the same time, the amount of albumin in the serum falls sharply. Also, the level of the total IgE fraction, reaginic IgE immunoglobulins (antibodies), circulating immune complexes gradually increases, resulting in severe allergic manifestations.

The final point in the study puts the titer of antibodies. Infection is diagnosed at a titer of 1:200, but if it is above 1:800, then the disease is already in the clinical stage. In this case, it is urgent to start treatment of toxocariasis in children.

External inspection

It is worth noting that, in addition to prescribing a laboratory test, the doctor also conducts an external examination of the child. If there is a disease, during the analysis of the skin integument, he may notice tuberculo-like nodules on the palms and feet. Inside these nodules are just the larvae. Also, dystrophy of hair and nails can be detected by a specialist.

Cure disease

Today univers althere is no way to completely get rid of parasites. There are quite effective drugs, but the difficulty lies in the fact that the larvae are surrounded by a protective capsule, and drugs do not enter it. Medicines have a good effect only on parasites that are in the process of migration. And yet, how to treat toxocariasis?

The most effective drugs are Albendazole, Vermox, Mintezol, Ditrazin. But keep in mind that they are all toxic, and therefore dangerous for the liver. Only under the supervision of a doctor and in a strictly defined dosage should they be used to cure toxocariasis. Reviews of many parents indicate that after taking such medications, children begin to feel nausea, intestinal upset occurs. Therefore, before using any of these remedies, you need to do a liver test and a blood test. Best of all, parents respond to the drug "Vermox". They say that of all other drugs, this is an order of magnitude better tolerated by children and rarely causes side effects. The medication should be taken in a course of two to four weeks, one tablet twice a day.

When using "Mintezol" the dose is calculated based on the weight of the child. You need to drink it without interruption for ten days. The drug is quite well absorbed, but can cause serious negative effects, such as headache, nausea, neurological disorders, and appetite disorders. At the same time, the work of the respiratory system and the heartmedication does not interfere. All side effects are quickly eliminated after the drug is discontinued. According to the features of the application, the drug "Ditrazin" is similar to it. It is also not without negative effects - it can provoke a fever.

Therapy of ocular or visceral toxocariasis is recommended by doctors with Albendazole or its analogue, Thiabendazole.

Forecast

Usually the treatment of toxocariasis in children is successful. But do not wait for spontaneous healing and do not delay the course of therapy, otherwise the larvae can penetrate the vital organs, hit the eyes, heart. A child diagnosed with a disease should be under dispensary observation by an infectious disease specialist until the condition is completely normalized. Monthly after the end of treatment, blood control and enzyme immunoassay are carried out. A repeated therapeutic course is prescribed after three months, not earlier. It happens that the treatment is delayed for two or three years before it is possible to completely destroy Toxocar. The dosage and course of taking medicines cannot be increased, since this is not only ineffective, but also unsafe. The patient has been under control for three years.

How to protect yourself from illness

Prevention of toxocariasis includes the following actions:

• Perform seasonal pet deworming with nematode treatments;
• avoid dog feces contamination of your garden, garden plot;
• plant crops that preventmaturation of toxocar eggs (legumes, delphinium, marigolds, calendula and others);
• don't let your child eat soil-contaminated foods;
• Wash and boil raw fruits and vegetables thoroughly before giving them to children;
• before eating, subject the meat of paratenic hosts (poultry and wild birds, pigs) to a good heat treatment.