Zaporozhyan state medical university departement of infectious diseases

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helminthes parasiting in intestine and possibly complications. In the early stage of 

ascaridosis the clinical manifistations are feebly marked, disease development is 

not noticeable. Sometimes the begining of disease is manifested by obvious 

fatigue, dry cough appears or with small amount of mucous sputum, rarely 

mucopurulent. Sometimes sputum has orange staining and has a small blood 

admixture. The body temperatura normal as a rule or subfebrile. Dry and moist 

rales are marked in the lungs, some patient have shortening of percutaneous sound. 

In some cases dry and exudate pleuritis. Physical methods not always reveal 

changes in the lungs. It is typical for this disease stage the changes on the hands 

and foot skin as urticaria and little vesicles with transparent contents. At X-ray 

examination of lungs is marked existence of oval, round, stellate, festone, 

polyangle infiltrates. Infiltrates may be or solitary or plural, are found in one lobe 

or all over the lung. They have rough and indistinct out lines. Eosinophilic 

infiltrates are found for 2-3 weeks; in some cases they disappears, then they appear 

again in some time. The main difference of infiltrates at ascaridosis – is rapid 

disappearance without any residual signs. The number of leucocytes as a rule is 

normal, sometimes leucocytosis is observed. Eosinophilia is typical up to 60-80% 

(some patients have it), it appears simultaneously with infiltrates in lungs. E.S.R. is 

normal, rarely accelerated. The late (intestinal) ascaridosis phase is connected with 

presence of helminthes in intestinum. The patient noted fatigability, appetite 

lowering, nausea, sometimes vomiting, pain in epigastrium, around umbilicus, in 

the right iliac region. Some patients have diarrhea, some have constipation. 

Neurologic sings - dizziness, fatigability, anxious sleep, sometimes hysteric 

attacks, epileptic cramps, meningism. Some ocular signs – pupil ectasia, 

anisocoria, photophobia, ambliopia. Cardiovascular signs – some patients note 

artery pressure lowering, moderate hypochromic or normochromic anemia often 

are revealed in the blood analysis, eosinophilia is met not always. 

Complications.  Purulent cholangitis, liver abscess, acute pancreatitis, 

appendicitis, intestine obstruction, asphyxia. 

Specific diagnosis of ascaridosis in migrate phase on the finding of 

Ascarides larvas in sputum and caring out serologic reaction to determine specific 

antibodies in patients blood (reaction on of indirect hemagglutination, latex 

agglutination with Ascarides antigens). In the intestinal phase of disease the main 

method is examination of feces and duodenal content on presence of Ascarides 

eggs.  

Treatment. In the early phase of disease desensitizing therapy and 

antinematodeus medicines of the wide spectrum of action are prescribed: 

mebendazol (dosage 100 mg twice a day during 3 days), mintezol (50 mg /kg a 

day, 2-3 times during 5-7 days), albendazol (400 mg one time). For treatment of 

intestinal ascaridosis are used: levamizol (150 mg one time), pirantel (10 mg/kg of 

body mass, one time), mebendazol, albendazol. In 2-3 week helminthologic 

examination must be done (3-4 times). The absence of eggs in feces during this 

time confirms the effectiveness of treatment. As Ascarides accommodate themself 

to the life in anaerobic conditions, the high concentration of oxygen is dangerous 

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for them. That`s why it is necessary to apply moistened oxygen, which is 

introduced through tube into the stomach on an empty stomach. 

ASCARIDOSIS  

 

Profilaxis.  In ascaridosis prophylaxis sanitary improvement of populated 

areas is very important. Fertilizing of the soil is permitid only with refined feces. 

 

ENTEROBIOSIS  (syn. - enterobiasis, oxyuriasis) is the contagious 

anthroponotic helmintosis, belongs to nematodosis. 

Etiology. The agent of enterobiasis is seatworm (Enterebius vermicularis 

or oxyuris vermicularis).  

Female proportions are 9-12 mm., male 2-5 mm. Seatworms are found in the distal 

part of small intestine and proximal part of large intestine. After insemination 

females move into the lower part of large intestine, crawl out from anal hole and 

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lay eggs in perianalis folds, which become invasion in 4-6 hours. After lay eggs 

female died. The term of female life is not more then 1 month.  

Epidemiology.  The source of invasion is man ill with enterobiosis. The 

mechanism of transmission is fecal-oral. Disseminated with invasion eggs food, 

toys, hands are the factors of transmission. The dust way of invasion is also 

possible – seatworm eggs is rather light and are swallowed with dust. 

Autoinvasious (as the result of contamination of fingers at scratching of perional 

region) are observed at patients with enterobiosis.  

Pathogenesis. The seatworm eggs get into gastro-intestinal tract . Released 

from coats the larvas eggs are fixed but  sometimes penetrait into the mucous 

membrane of distal part of small intestine or proximal part of large intestine. In 12-

14 days they became puberal. Around invaded seatworm granulomas may be 

formed, consist of eosinophyles, limphocytes, macrophages, that may be the cause 

of intestine dyskinesia. The products of helminth metabolism cause the 

development of toxic-allergic reaction. Seatworm female invading into woman`s 

genital organs carries the bacterial infection from intestine. 

Symptoms and course. Incubative period leasts about 15 days. There are 

asymptomatic and clinically acute forms of enterobiosis. The main clinical 

symptom is perianal itching, appearing usually in the evening and at night as a 

result of seatworm crawling. Itching last 1-3 days then disappears and at reinvasion 

appears in 2-3 weeks. At massive invasion itching becomes tormenting and 

constant.  

Scratching of anus circle leads to the development of secondary bacterial 

skin infection. Some patients have intestine disorder – accelerated semi – liquid 

stool, sometimes with mucus, tenesmus, at rectorhomanoscopy on the mucous 

membrane punctate hemorrhages, small erosions irritations of mucous tunic of 

external and internal sphincters. The signs of intoxication may be observed – 

weakness, fatigue, irritability, lowering of appetite. Subfebrile temperature, 

urticaria are observed seldom. It is often marked eosinophilia in blood at the 

beginning of enterobiasis. 

Complication. Appendicitis, sphincteritis, paraproctitis, dysbacteriosis of 

intestine, women have vulvovaginitis, endometritis.  

Specific diagnosis. The discovery of eggs in scrape from perionale folds is 

the informative method of diagnosis. The scrape is made in the morning defecation 

with wooden spatula, cotton – wool tampon or with adhesive tenia for the later 

microscopia. It is necessary to do 3 examinations with interval 3-5 days. Grown up 

active female seatworms you may often see on the surface of the fresh separated 

feces of the patient.  

Treatment of enterobiosis includes hygienic measures and prescribing of 

medicines. Hygienic measures to prevent autoinvasion: daily toilet of perionale 

region, sleep in pants with elastic round the legs, daily change of under wear and 

linen with following washing and ironing, soda purifaing clysma before sleep. The 

more effective medicines are mebendazol (0,1 gr one time), pirantel (10mg/kg of 

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