Overview of Fecal Circular Nematodes
Fecal roundworms are generally parasitic in the submucosa of the small intestine, and can cause disseminated damage to the lungs and other internal organs in severely infected or immunocompromised individuals. Pulmonary fecal roundworm disease is caused by the filamentous larvae of fecal roundworm invade the skin or mucous membranes and then pass through the lymphatic or venous system, the right heart to the lungs, and develop into child worms after 3-30 days, a few of which mature in the lungs or bronchial tubes, and most of which break through the pulmonary capillaries and enter the alveoli, resulting in a series of respiratory symptoms. This disease has a global distribution, but in the tropics, subtropics and temperate zones more, most areas in China, the infection rate of less than 10%.
Causes
Fecal nematodes are generally parasitic in the submucosa of the human small intestine, and can also cause disseminated damage to the lungs and other internal organs in severely infected or immunocompromised individuals.
Symptoms
Most patients have mild clinical manifestations, which may include small localized bleeding spots on the skin, papules, migratory linear or banded urticaria, and allergic bronchitis, lobular pneumonia, or asthma. If accompanied by serious diseases, malnutrition or immunocompromised, severe diffuse infection may occur, and patients often have fever, severe cough, sputum, hemoptysis, shortness of breath, respiratory distress, etc., and may also be accompanied by multiple internal organ involvement and systemic toxicity and other symptoms, or even death within a short period of time.
Examination
1. Laboratory examination
Peripheral blood leukocyte count is often increased up to 20×109/L. Eosinophils are usually 25%-30%, and up to 70%-80%, serum total IgE level is increased by 50%, and serum IgG and IgE against filarial larvae antigens are positive in 90% of the patients. Sputum to find parasites and eggs such as female worms in the bronchial epithelial parasites, fresh sputum can be found in rod-shaped larvae, filarial larvae, child worms, adult worms and eggs.
2.Other auxiliary examination
X-ray chest film can be point-like, small piece, cord-like limited or diffuse inflammatory shadow.
Diagnosis
According to the epidemiology, clinical manifestations and laboratory examination, fresh sputum can be diagnosed by looking for pathogenic worms.
Differential diagnosis
Lung nematode disease should be distinguished from bronchopneumonia, bronchial asthma, tuberculosis, rheumatic fever and so on.
Complications
Complications of severe pneumonia, meningitis, brain abscess.
Treatment
1. Albendazole is the drug of choice.
2. Thiabendazole is effective in the treatment of fecal roundworm disease.
Prognosis
The prognosis of this disease is good, but the prognosis is worse in immunocompromised patients.
Prevention
Focus on strengthening hygiene publicity, promoting the harmless treatment of feces, reforming fertilizer application and farming methods, and conducting regular general investigation and treatment in endemic areas.