Symptoms and treatment of acute opisthorchiasis

Clinic of opisthorchiasis in the early stages are quite varied: the disease can proceed in the erased form, or manifest in the form of a generalized allergic reactions, causing multiple tissue damage of various organs. The acute course of pathology is characteristic of people arriving in endemic area of places where opisthorchiasis is practically not found. Among the local population is most common primary chronic course of the disease.

Symptoms of acute opisthorchiasis

The characteristic symptoms of acute opisthorchiasis, occurring almost every patient are considered: a high level of eosinophilic leukocyte and increase in body temperature to 40-41 °C, the severity of these manifestations depends on the severity of the lesion.

If acute opisthorchiasis has mild, feverish state lasts a relatively short period of time, and the body temperature does not rise above 38 °C, eosinophilia is 15-25% at moderate values of leukocytosis. In moderate disease, which is found in almost half of patients, fever is constant or remitting disseminated in nature, numbers the body temperature reaches in this case 38-39 °C. patients appear itchy rash on the skin, eosinophilia reaches 20-25 %, leukocytosis is 10–15h10h9/l, in addition, have high values of ESR. After a couple of weeks after the disappearance of all of the above symptoms, patients, pain in the right upper quadrant and there comes a latent period. Severe acute opisthorchiasis is found in 10-15% of cases, the disease occurs in one of the three above scenarios.

Tipofday opisthorchiasis occurs on the background of a high temperature with pronounced symptoms of intoxication and hepatolienal syndrome. For the initial stage is characterized by a sharp current, and the temperature reaches 38-40 °C, causing the patients a chill. In the further course of the disease the fever becomes continuous, remitting disseminated distorted or intermittent in nature, symptoms of intoxication become pronounced. During the inspection, has light subicteric, rashes on the skin, lymphadenopathy, liver and spleen increase to moderate in size. In the lungs during the survey can be detected by volatile eosinophilic infiltrates. A blood test shows leukemoid eosinophilic reaction, which is characterized by the following parameters: leukocytosis up to 20 30h10h9/l, eosinophilia of up to 80-90 %, accelerated ESR of 30-40 mm/h.

In the casehepatocholangiocarcinoma acute opisthorchiasis is dominated by symptoms of lesions of the hepatobiliary system. Typical for the disease is considered subacute beginning. The patient's temperature rises to high values increases the severity of symptoms of intoxication, eosinophilia is 40-60 %. Among the complaints of patients are dominated by complaints of pain in the right hypochondrium radiating to the back and right shoulder, less common are complaints of pain in the epigastric region. During the inspection there is enlargement of the liver, and patients palpation feel pain. Also the doctor with the diagnosis can focus on the positive symptoms of Ortner, Kera, Mussi. 80% of the patients revealed cytolytic syndrome with high activity of transaminases (ALT, AST), a rate that exceeds the rate of 2-7 times, found the expressed mesenchymal-inflammatory hepatic syndrome, in some cases, you may develop cholestasis.

Gastroenterokoliticheskaya form of the disease is short-lived febrile syndrome. Pathological changes affect more the stomach and intestines. Patients note a feeling of heaviness in the epigastric region, they are concerned about nausea, vomiting, heartburn, in patients, decreased appetite, stool is frequent and loose, there is flatulence, pain in the navel and in the course of the colon. When fibrogastroscopic examination revealed erosive-hemorrhagic gastroduodenitis, found ulcers of the stomach and duodenum. Quite often there is a combination of several diseases of the gastrointestinal tract.

Sometimes the clinic opisthorchiasis accompany the symptoms characteristic of lesions of the lung tissue, and the pathogen in the lungs is not detected, and the pathological process arising is allergic in nature. The disease itself in this case proceeds as asthmatic bronchitis, vasculitis, or focal lesions associated with the presence of migratory eosinophilic infiltrates. Very rarely acute opisthorchiasis accompanied by allergic myocarditis, diseases of the kidneys, occurring with symptoms of proteinuria, microscopic hematuria, cylindruria, and in the basis of these pathological processes are also immunopathological reactions.

Treatment of acute opisthorchiasis

Treatment of acute opisthorchiasis, as well as chronic, requires an integrated approach based on the principles of causal and pathogenetic therapy. The schemetreatment is conventionally divided into three stages: preparation, the purpose of anthelmintic medications against the background of pathogenetic therapy, rehabilitation. The goal of treatment of acute opisthorchiasis in the first place is the relief of allergic reactions and treatment developed on the background of diseases of internal organs. To do this, patients are advised to take antihistamines and anti-inflammatory medications. With the development of vasculitis patients prescribed salicylates, phenylbutazone, ascorutinum. It is important to remember that even with complete elimination of parasites from the body violated the function of internal organs do not regenerate themselves, as well as not tested independently of organ pathology caused by helminth infections. Therefore, patients need to conduct rehabilitation treatment approach that should be individualized, taking into account the nature of complications.