Overview
Ginger worm disease is a zoonotic parasitic disease caused by the ginger worm, referred to as ginger worm, parasitized in the intestines of humans and pigs, the number of worms occurring in the infection often appear abdominal pain and diarrhea, malnutrition, digestive disorders, albumin reduction, a variety of vitamins deficiency; there may also be diarrhea and constipation alternately, and even intestinal obstruction, severe infection of children may have emaciation, anemia, edema, ascites, mental retardation, Children with severe infections may have emaciation, anemia, edema, ascites, mental retardation, and developmental disorders. In cases of repeated infections, a few may die due to exhaustion and collapse.
Causes
People are infected by eating aquatic food with cystic larvae of gingerbread, and the adult gingerbread is flat and plump, flesh-red in color when it lives, which is similar to the slices of fresh ginger, so it is named. It is the largest parasitic trematode in the human body. Its caecal larvae from the snail body constantly escape, adsorption in the surrounding aquatic plants on the surface, the formation of cystic larvae. Cystic larvae in the humid conditions of strong vitality, but weak resistance to dryness and high humidity, when the intermediate host swallowed the cystic larvae, in the small intestine by the action of intestinal fluids cyst wall rupture, the caecal larvae escaped, adsorbed in the mucosa of the small intestine to absorb the nutrients in the intestinal lumen, the adult can develop in 1 to 3 months. The life span of adult worms in human body is 4-4.5 years. In pigs, it is about 1 year.
Symptoms
Incubation period of 1 ~ 3 months, mildly infected people with mild symptoms or no symptoms, moderate and severe people can appear lack of appetite, abdominal pain, intermittent diarrhea (mostly indigestible feces), nausea, vomiting and other gastrointestinal symptoms, mainly abdominal pain. Abdominal pain is often located in the epigastric region and the lower right quadrant of the ribs, a few in the umbilicus, occurring in the morning on an empty stomach or after a meal, occasionally severe pain and colic, the patient often has intestinal tinnitus, increased peristalsis, intestinal flatulence, many patients have a history of spontaneous excretion of worms or spitting worms, children often have neurological symptoms such as poor sleep at night, teeth grinding, convulsions, etc., a small number of patients with prolonged diarrhea, severe malnutrition can produce edema and ascites, the severe advanced patients can be Failure, collapse or secondary bacterial infection of the lungs and intestines may occur, resulting in death. Occasionally, the worms may collect into a mass and lead to intestinal obstruction.
Examination
1. Concentration method of various worm eggs
Can improve the detection rate, but the diagnosis of ginger worm disease also need to consider the number of parasitic worms and clinical manifestations, the former can be used to get a rough impression of the egg counting method, the patient’s red blood cell count and hemoglobin are often mildly decreased, the white blood cell count is slightly increased, eosinophils can be increased to 10% ~ 20%, occasionally up to 40%, fecal occult blood test is occasionally a positive response to the stool with a direct smear or precipitation egg collection can be found in ginger worm eggs, the former for mild infections of ginger worm eggs, the former for mild infections, the former can be found in a group. Eggs of gingerbread can be found in feces by direct smear method or precipitation egg collection method, the former is easy to miss the diagnosis of mildly infected patients, and the latter can improve the detection rate, and quantitative transparency method (i.e., modified Kato smear method) can also be used, which can be used to characterize and count the eggs of the worms.
2. X-ray examination
It can show bone growth retardation or dwarfism.
3. Physical examination
Abdominal distension, hyperperistalsis, and increased bowel sounds are special signs of the disease. Severe cases present with edema of the eyelids as well as the whole body with ascites.
Diagnosis
Where in the gingerbread endemic area, there is a history of raw food aquatic plants, accompanied by varying degrees of gastrointestinal symptoms, should be considered this disease, the confirmation of the diagnosis depends on the detection of gingerbread eggs in the feces, a fecal smear of three can be a positive result, the eggs of the lesser can be used to formaldehyde – ether method of concentration of the collection of eggs, in order to improve the detection rate.
Differential diagnosis
This disease should be distinguished from ascariasis. Ginger worm eggs should be differentiated from the eggs of liver flake trematode and echinococcus trematode.
Complications
This disease can be complicated with allergic reaction, intestinal obstruction, granulocytic infiltration, pulmonary and intestinal bacterial infections.
1. Allergic reaction
It is also called hypersensitivity reaction, which refers to a kind of specific immune response that occurs when the body receives the same antigen stimulation again after the body responds to some antigen for the first time, and the body’s physiological dysfunction or tissue cell damage is the main cause of the specific immune response. People encounter daily skin allergies, skin itching, redness and swelling, is a kind of allergic reaction.
2. Intestinal obstruction
It refers to the obstruction of the passage of intestinal contents in the intestine. It is a common acute abdominal disease and can be caused by a variety of factors. At the beginning of the disease, there are anatomical and functional changes in the obstructed intestinal segment, followed by loss of body fluids and electrolytes, circulatory disorders of the intestinal wall, necrosis and secondary infections, which can finally lead to toxemia, shock and death.
3. Granulocyte infiltration
Mostly refers to neutrophil infiltration, is a kind of leukocytes. Granulocyte infiltration refers to the inflammatory reaction caused by a foreign body. Neutrophils gather at the site of inflammation, and their intracellular protein hydrolyzing enzymes and other chemicals are released, causing damage to blood vessels and surrounding tissues.
4. Lung infection
The main symptoms include dyspnea, temperature change, cough, increased sputum volume and sputum character.
5. Intestinal infection
The main symptoms are diarrhea, vomiting, abdominal pain, visible fever.
Treatment
For gingerbread worms severe patients first active supportive therapy, improve nutrition and correct anemia, physical and mental recovery to a certain extent and then discretionary deworming, deworming drugs should not be too large a dose.
1. Thiobis(dichlorophenol)
This product has obvious killing effect on the cysts of Schistosoma lungis, clinically used for Schistosoma lungis, beef tapeworm disease, ginger worm disease.
2.Furapropamide
This product is the first non-antimony internal anti-schistosomiasis drug in China. It is mainly absorbed by the small intestine after internal administration, and its mechanism of action is to have a significant effect on the sugar metabolism of schistosomes, through the inhibition of glycolysis, blocking the energy supply of the worm, paralyzing the worm, and playing a direct role in killing the worms. Clinically used in the treatment of schistosomiasis, gingerbread and Chinese branch testicular schistosomiasis.
3. Praziquantel
It is a broad-spectrum anti-scalpel and tapeworm drug. It is suitable for all kinds of schistosomiasis, schistosomiasis, schistosomiasis, trematode, tapeworm and cysticercosis.
4.Thiabendazole
This product is a broad-spectrum anthelmintic, for roundworms, hooks, whips, pinworms, fecal worm and trichinella infections, have the effect of expulsion; to drive pinworms with the best results; is also the fecal worm of choice for drugs. Mainly used for fecal roundworm and trichinella infections, as well as skin and visceral helminth larvae (larval stage) migration disease.
5. Betel nut
This drug is one of the earliest medicines used in ancestral medicine to treat ginger worm. Betel nut contains betanin, which is able to paralyze the nervous system of the ginger worm body and enhance the peristalsis of human intestines, therefore, it has the effect of repelling ginger worm. There are various ways to use betel nut in the treatment of gingerbread.