Overview of Trichomonas
Trichinella is a flagellate parasite of the intestinal tract, mostly found in the cecum and colon, which can cause diarrhea and other clinical symptoms, so it is also known as intestinal trichinosis. The disease spreads throughout the year, and is more common in summer and fall. The onset of the disease can be slow or urgent, the course of the disease from a few hours to more than 20 years. Diarrhea is the main symptom, thin paste stool, may have mucus, but pus and blood stool is rare. It occurs several times a day to more than ten times a day. Accompanied by nausea, vomiting, abdominal pain, bloating, loss of appetite.
Causes
Trichomonas humanis is morphologically similar to Trichomonas vaginalis, but the fluctuating membrane and basal chromatophore are longer until the posterior end of the body, and the posterior flagellum runs parallel to the left side of the fluctuating membrane and protrudes out of the body at the posterior end of the body. Pseudopod formation is less common, and pseudoencapsulation can be formed in unsuitable environments. The worm obtains nutrients by swallowing and phagocytosis. Humans are infected by ingesting food or drinking water contaminated with the trophozoites, and it can also be transmitted by flies and so on.
Pathogenesis
Trichinella can cause intestinal mucosal congestion, edema and inflammatory reaction, mucosal epithelial cell necrosis and shedding, lymphoid follicle small abscess formation. When the resistance of the host decreases, in the presence of intestinal commensal bacteria, the worms multiply, the mucosal damage increases significantly, and the number of diarrhea increases. The active motility of Trichinella causes strong mechanical stimulation, causing hypersecretion of the glands. The worms have a high number of lysosomes, which are rich in acid phosphatase and other hydrolyzing enzymes. The lysosomal enzymes released by a large number of worms can cause degeneration and necrosis of the epithelial cells of the intestinal mucosa, and diarrhea occurs.
Symptoms
The disease is distributed throughout the year, with summer and fall being the most common. The onset of the disease can be slow or acute, and the duration of the disease ranges from a few hours to more than 20 years. Diarrhea is the main symptom, thin paste stool, may have mucus, but pus and blood stool is rare. It occurs several times a day to more than ten times a day. Accompanied by nausea, vomiting, abdominal pain, bloating, loss of appetite. About 1/5 patients have moderate to low-grade fever, high fever is rare. A few patients show alternating diarrhea and constipation. Trichinella parasites in the biliary tract may cause paroxysmal pain in the right upper abdomen, nausea and vomiting, fever and increased white blood cell count.
Examination
In addition to the clinical manifestations of the disease, ancillary tests are also required to confirm the diagnosis. The disease can be detected by direct fecal smear microscopy or positive culture.
Diagnosis
Based on the above clinical manifestations, the search for worms in feces and bile is the basis for definitive diagnosis.
Differential diagnosis
Trichinellosis should be differentiated from other diseases causing diarrhea and, in the case of biliary parasitism, from bacterial biliary tract infections.
Complications
Biliary trichomoniasis can be complicated.
Treatment
Metronidazole is the first choice for pathogenic treatment, and it is given orally to children in 3 or 4 doses, with 5-7 days as a course of treatment, with an immediate efficacy of 100%, and a near-term efficacy of 95%. In addition, can also be used tinidazole, or with ornidazole at once. The new drug Seknidazole, 1 time taken at once also has good efficacy.
Prognosis
The prognosis is generally good.