Overview of the disease
Tapeworm is a disease caused by the parasitization of the human intestinal tract by the tapeworm (microscopic membranous cestode). The main clinical symptoms include nausea, vomiting, lack of appetite, abdominal pain, diarrhea, headache, dizziness and insomnia. Oral praziquantel, efficacy up to 98.5%, can also be used betel nut decoction, clonidine or mebendazole, etc., must be consecutive treatment for 3 to 5 days. Paying attention to personal hygiene and environmental hygiene, exterminating rats, washing hands before and after eating, and disinfecting eating utensils can play a positive preventive role.
Causes
The adult short membrane shell tapeworm is 25-40mm long and 1mm wide, with an anastomosis in the head segment and 20-30 head hooks in the terminal segment. The adult tapeworm parasitizes the upper end of the small intestine of the host, and the pregnant segment of the end of the worm body often breaks down before shedding, and the eggs are scattered and discharged with the feces. Eggs are swallowed by humans or rats and hatch in the intestine, developing into adult worms that lay eggs about 1 month after infection. In addition, fleas and many kinds of beetles can become intermediate hosts, and can be infected when swallowed by humans or rodents.
Adults and larvae are parasitized in large numbers in the lumen of the small intestine, causing mechanical and toxic irritation of the small intestinal mucosa. Attached to the intestinal mucosa by head segments, the mechanical stimulation of the human intestinal wall by its adhesive organs and microhairs and the toxin stimulation of the worm metabolites cause intestinal mucosal inflammation, necrosis, ulceration, cytolysis, and infiltration of lymphocytes and neutrophils. Larval invasion can also destroy the mucosal villi, causing absorption and motility dysfunction in the small intestine. Repeated self-infection is common in this disease and can result in severe infections. When a large number of worms in the body can cause intestinal obstruction, occasionally lead to intestinal perforation, and most often complicate appendicitis. Short membrane shell tapeworm infection can also cause an immune response, the body appears immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin E (IgE) have different degrees of increase. It is suggested that the immunity of the organism has some connection with the development of the disease.
Symptoms
Mild infections usually show no symptoms. Severe infections may present:
1. Gastrointestinal symptoms
Nausea, vomiting, lack of appetite, abdominal pain, diarrhea, loose or knotty stools, and weight loss. Symptoms are similar to those of duodenal ulcer. Children may have changes in appetite and developmental delays after infection.
2. Neurological symptoms
Headache, dizziness, fatigue, irritability and insomnia, nervousness, and even convulsions. If the tapeworm invades the brain, it may cause epilepsy, increased intracranial pressure and mental disorder.
3. Rash
Itchy skin and hives and other allergic symptoms.
4. Blood system symptoms
Causes anemia, slightly increased eosinophils in peripheral blood.
Examination
1. Routine examination
Eggs or pieces of pregnancy nodes are found in feces. The perianal eggs can be examined by swabbing with glass paper. If the number of eggs is scarce, it can be concentrated by floating in sodium chloride or sodium nitrate saturated liquid, and the surface liquid can be taken for microscopic examination, but the positivity rate of floating concentration method is low.
2. Blood test
Blood test is normal in patients with mild infection. Peripheral blood eosinophils are slightly increased.
Diagnosis
Diagnosis can be confirmed by finding eggs or pregnancy nodes in feces. Anal swab smear for perianal eggs. Microscopic examination of surface fluid by floating method of concentration.
Differential diagnosis
It should be differentiated from other tapeworm diseases.
Treatment
Praziquantel, oral, efficacy of up to 98.5%, can also be used betel nut decoction, clonidine or mebendazole, etc., must be consecutive treatment for 3 to 5 days.
Prevention
Paying attention to personal hygiene and environmental hygiene, exterminating rats, washing hands before and after eating, and disinfecting eating utensils can play a positive preventive role.