Trichostrongylosis

The disease is widely-spread in Australia, Northern America, Asia and Africa. The agent is Trichostrongylus calabriformis, T. oxei, T. orientalis. The infection occurs at the use of the polluted vegetables and fruit, and also through dirty hands.

DIAGNOSTICS

In most cases helminthiasis proceeds asymptomatically, but the intensive invasions can cause unpleasant sensations in the field of the epigastrium and anemia. The diagnosis depends on the detection of eggs in faeces. Because of their small number they are usually find out only by the use of the method of enrichment. In case of manifested invasions leukocytosis with marked eosinophilia (up to 80 %) can take place.

TREATMENT

At manifested invasions tiabendazol in a dose of 25 mg/kg. 2 times a day during 2 - 3 days or Pyrantelum pamoatum according to the scheme used in ancilostomidoses are indicated.

Filar1ases

The group of diseases occurring in tropical and subtropical countries and caused by Filaria.

Wuchereria Bancrofti

Only people are ill with it. The adult Filaria live in the human lymphatic system. Microfilaria are found in the peripheral blood, usually at night. Infection is spread by many species of mosquitoes; carriers of W. bancrofti are Aedes, Culex, and Anopheles.

DIAGNOSTICS

1. The incubation period may be last almost for 2 months.

2. The preparing period (from time of infection to appearance of microfilaria in the blood) is at least 8 months.

3. Chills, fever, headache, and malaise, pccur.

4. Llymphangitis, lymphadenitis, orchitis, epididymitis, lymph varices, and chyluria may occur.

5. The lymphatic channels may become blocked so that the whole leg swells, the condition is called elephantiasis.

6. The intradermal antigen is useful when microfilaria cannot be found, but this method is not completely reliable.

TREATMENT

Promising results have been obtained in controlling filariasis by combining mass treatment and mosquito elimination.

Diethylcarbamazine taken in2 mg/kg body weight orally for from 2 to 4 weeks eliminates microfilaria from the bloodstream. In many patients it also kills adult worms or impairs their reproductive capacity. Severe allergic reactions and abscess formation may follow its use, but may be controlled by antihistamines or corticosteroids. Surgical intervention is indicated only in certain types of elephantiasis, especially of the scrotum. Elephantiasis of the legs is treated by elevation and elastic bandages.

Onchocerciasis (River Blindness)

DIAGNOSTICS

The disease is caused by Onchocerca volvulus and characterized by fibrous nodules in the skin and subcutaneous tissues. Ocular damages are common; blindness may result. The disease, spread by the bite of black flies (Simuliidae), occurs in tropical areas of Asia, Africa and America. The diagnosis depends on revealing of microfilaria in the skin or nodules.

TREATMENT

Microfilaria, but not adult worms, are destroyed by Diethylcarbamazine, given orally. Since an allegric reaction from the dead microfilaria can result in ocular damage if the eye is involved in the infection. The initial dosage is limited to 0.1 to 0.2 mg/kg body weight/day. Dosage is gradually increased to 2 to 3 mg/kg and then maintained at this level for 1 week. Antihistamines and Prednisolone from 20 to 40 mg/day orally may be necessary to prevent the acute allergic inflammation in the eye. Adult worms can be eliminated by surgically removing the nodules.