Symptoms of diphyllobothriasis and methods of treating helminthic infestation

Worm infestations are parasitic diseases that are widespread throughout the world. The occurrence of helminths in the body contributes to a decrease in immunity, a deterioration in general condition and an increase in the amount of opportunistic microflora. Diphyllobothriasis is one of the types of helminthic infestation, which, like any other disease, has a number of features. To prevent the development of serious complications, it is necessary to know the main symptoms of diphyllobothriasis and the routes of its transmission.

Features of the disease and routes of transmission

Diphyllobothriasis occurs as a result of infection with helminths of a certain type: the group of cestodoses, the genus Diphyllobothrium (broad tapeworm). Disorders of the gastrointestinal tract, the development of anemia (lack of vitamin B12) are only part of the pathologies that arise as a result of the appearance of this type of parasite in the body.

Diphyllobothriasis can be transmitted in several ways:

• when consuming insufficiently thermally processed freshwater fish or caviar (the larvae die at very low and very high temperatures);
• infection through larvae remaining on hands, dishes or cutlery after cutting fish.

The life cycle of the broad tapeworm begins in freshwater bodies of water filled with the larvae of these helminths. Before reaching its final host, it goes through several more stages of development, and manages to change two intermediate hosts: different types of copepods and predatory fish (in the body of fish that swallow infected crustaceans, a wide tapeworm migrates from the intestines to the muscles and eggs).

Worms of this species reach 10 m in length, their body consists of many proglottids and a head with suction cups, with which they are attached to the intestinal walls.

The definitive hosts are humans and carnivores. Once in the human body, the helminth can parasitize for a long time, damaging the intestinal walls, and if left untreated for a long time, it can affect the central nervous system and spinal cord.

It is impossible to become infected from pets or from a person who has this disease.

Thanks to this factor, this disease is not common.

Symptoms

The disease may not manifest itself for a long time. On average, the incubation period can last up to 2 months. Further mild symptoms are observed: gastrointestinal disorders, increased body temperature to subfebrile levels, itching, stomach pain. As helminths increase in size or accumulation, intestinal obstruction may occur.

• 
• As a result of the vital activity of the broad tapeworm, a person may develop pathological processes not only in the gastrointestinal tract, but also in other organs and systems.
• The presence of diphyllobothriasis in the body is confirmed by the following symptoms:

• the occurrence of allergic reactions (allergic dermatitis);
• deficiency of vitamins B12 and B9 and, as a result, the development of anemia;
• weakened immune system;
• disturbances in the functioning of the nervous system (numbness, paresthesia, unsteady gait);
• enlarged liver and spleen;
• the presence of inflammatory processes in the oral mucosa;
• changes in general blood test parameters.

According to the nature of the course, diphyllobothriasis is divided into two forms: acute and chronic. The disease can also occur in manifest and latent (latent) forms.

Diagnostics

Diagnosis of diphyllobothriasis should be carried out under the guidance of a qualified specialist. If this disease is suspected, the doctor may ask a series of questions regarding the preparation or consumption of fish over the past few months (specifying what kind of fish was prepared or eaten).

A number of the following diagnostic measures are also prescribed:

• general blood test (there is a decrease in hemoglobin levels and the number of red blood cells, an increase in ESR, eosinophilia, neutropenia and lymphocytosis);
• biochemical blood test (increased levels of bilirubin are detected);
• stool examination (the main test that confirms or refutes the presence of diphyllobothriasis; stool must be collected on the day of the test so that the helminth eggs do not lose their viability).

After a thorough diagnosis has been carried out and an accurate diagnosis has been established, there is a need to examine the patient's family or those around him (if they also ate contaminated fish).

Specialists whose help may be needed when infected with diphyllobothriasis: therapist, infectious disease specialist, hematologist, neurologist, surgeon.

Treatment

In most cases, treatment is carried out on an outpatient basis, but in the presence of severe anemia, inpatient care may be required.

You can get rid of helminths with the help of medications, traditional medicine and surgery.

Drug treatment

1. 
2. For drug treatment, the safest and most effective medications are prescribed:
3. The instructions for use of Biltricid say that it is prescribed in an individual dosage (depending on the patient’s weight and what pathogen is present in the body); for diphyllobothriasis, this treatment regimen applies: 25 mg/kg once a day.
4. Biltricide is contraindicated for use during pregnancy and breastfeeding, in children under 4 years of age, and in the presence of individual intolerance to the components of the drug.

Decaris is prescribed for diphyllobothriasis in the following dosages: children 3-6 years old (dosage 50 mg) - 0.5-1 tablet per day, 6-10 years old - 1-1.5 tablets, 10-14 years old - 1.5-2 tablets. Adults – 1 tablet per day at a dosage of 150 mg.

The medicine Dekaris has the same contraindications for use as Biltricide.

In addition to anthelmintic drugs, the patient is prescribed other drugs necessary for complex treatment:

• antihistamines (Suprastin, Tavegil, etc.),
• enterosorbents (Smecta, Polysorb, Enterosgel, etc.);
• immunomodulators (Pentoxyl, Sodium Nucleinate, etc.);
• probiotics (Linex, Yogurt, etc.);
• vitamin complexes (containing vitamins B12 and B9);
• laxatives.

Treatment with drugs for diphyllobothriasis is the most effective way to get rid of the disease.

Unconventional methods of treatment

One of the old methods of getting rid of helminths is the use of pumpkin seeds: the seeds (300 g) are poured with warm boiled water (60 ml), then ground and consumed on an empty stomach. After 3 hours, take a laxative and do an enema.

The advantage of using this product is its non-toxicity. Pumpkin seeds are also rich in beneficial minerals and substances. The main one is the amino acid cucurbitin, which paralyzes helminths and removes them from the body.

The seeds can be combined with carrots: grated carrots (3 tbsp) and crushed pumpkin seeds (30 g), diluted with vegetable oil (2 tbsp). The prepared mixture must be taken on an empty stomach, after 3 hours drink castor oil (1 tbsp).

Traditional medicine can only be used as an aid, only after the approval of the attending physician and under his close supervision.

The need for surgical intervention arises when the patient develops intestinal obstruction. This condition is very dangerous for health, as it threatens irreversible changes, which sometimes cannot be restored even after surgery to eliminate the obstruction.

Prevention and possible complications

Prevention of diphyllobothriasis is based on the implementation of the following recommendations:

• observe the temperature regime for storing and preparing fish;
• carry out regular sanitary control of fresh water bodies;
• persons at risk (fishermen, food industry workers) must be systematically examined for the presence of helminths in the body;
• Personal hygiene must be observed (after handling fish, you must thoroughly wash your hands with antibacterial soap).

If left untreated, complications such as anemia, funicular myelosis (spinal cord damage), intestinal obstruction (blockage), peritonitis (inflammation of the peritoneum) are possible. With timely consultation with specialists and proper treatment, the prognosis is favorable.

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Source: https://glisty24.ru/zabolevaniya/difillobotrioz/

Diphyllobothriasis - causes, symptoms, treatment and photos

An invasive disease caused by a tapeworm is called diphyllobothriasis. In humans, this unpleasant and dangerous disease occurs most often in Europe, Russia, Africa, the USA, Japan, and South America. It appears most often after eating fish raw or insufficiently cooked.

This helminthic disease affects the gastrointestinal tract and leads to anemia; to detect it in a person, it is necessary to undergo a simple test to determine the eggs of adults in the feces.

Pathogenesis of diphyllobothriasis

The causative agent of the disease successively replaces three hosts during its development. Initially, immature viable eggs live in freshwater, where they are eaten by crustaceans. The second host is fish, which feed on crustaceans and other freshwater microorganisms.

In the body of fish, the larvae penetrate the muscles, turning into plerocercoids. Their length can reach 4 cm. But these microorganisms transform into viable mature individuals only in the body of the final host - humans and other carnivorous mammals.

If they enter the gastrointestinal tract, the larvae can attach to the mucous membrane and continue their development. At high body temperatures, they reach mature size within two to four weeks. The lifespan of this parasite can be more than 20 years.

The infection process can occur when consuming freshwater fish meat that has not undergone sufficient heat treatment - frying or boiling. But in some cases this can happen through a knife and hands.

Causes of diphyllobothriasis

Diphyllobothriasis in humans is a rather unpleasant disease, so it is important to determine the causes of its occurrence. This will allow us to determine preventive measures to prevent helminthic infestation.

These include:

• Poor nutrition associated with eating fish meat that has not undergone heat treatment;
• Insufficient hygienic treatment of utensils and knives for cutting fish, as well as their use when cutting other products - bread, fruits and vegetables;
• Failure to comply with personal hygiene rules, since infection with eggs from a sick person can occur through a handshake or any other contact. A patient with helminthic infestation releases more than 2 million eggs into the environment every day.

Symptoms of diphyllobothriasis

The incubation period in humans can be 1-2 months, while the symptoms of the disease are mild. Typically, many patients are unaware of their disease for a long time and only find out about it when they are required to take a test during an annual preventive examination.

The following symptoms of diphyllobothriasis should be highlighted:

• General weakness, feeling of malaise;
• Dizziness;
• Rapid fatigue even in the absence of physical activity;
• Nausea and vomiting as a result of digestive system disorders;
• Painful sensations in the abdomen;
• Stool disorders (constipation or diarrhea);
• Loss of body weight for unexplained reasons;
• Decreased appetite;
• Sleep disorders;
• Intestinal obstruction with a significant accumulation of pathogens;
• Excretion along with feces of tail processes, which the worms periodically shed.

In severe cases of the disease, a person experiences changes in the tongue. These include pain and numbness, as well as cracks and reddish spots. Subsequently, the papillae on the tongue atrophy and become smooth.

Diagnosis of diphyllobothriasis

Diagnosis of diphyllobothriasis in humans is a rather complex and lengthy process that requires a special approach and attention from the doctor to the patient. Some signs of the disease can be confused with intestinal disorders, so special analysis is required to confirm the invasion.

Diphyllobothriasis is diagnosed by assessing the patient's complaints. Based on the collected medical history, the doctor makes a preliminary diagnosis. To confirm it, a number of examinations are prescribed, since one stool test may not give a reliable result. These include:

• Blood test. The analysis determines an increase in ESR, a decrease in hemoglobin and the number of red blood cells, an increase in bilirubin, as well as relative neutropenia and lymphocytosis;
• Blood examination for antibodies to helminths;
• Contract radiography of the intestinal area. This examination method involves the use of a special contract serum, after which, after passing through the intestines, the exact places of accumulation of parasites can be detected;
• Determination of stomach contents using the Castle factor method;
• Detection of parts of worms and their eggs in feces. The analysis allows us to distinguish this disease from other forms.

Also, during the first examination, the doctor may note disturbances in the activity of the cardiac system. Patients experience hypotension, tachycardia, expansion of the borders of the heart on ultrasound scanning, as well as systolic murmur.

Treatment of diphyllobothriasis

Treatment of diphyllobothriasis is carried out conservatively in a hospital with severe intoxication of the body or by the patient on an outpatient basis in normal condition and well-being. The following potent medications are prescribed for humans:

• Praziquantel;
• Niclosamide.

These drugs are used to expel helminths. They increase the resistance of cell membranes to calcium ions. This causes contraction of the muscles of the parasites and their complete paralysis, as a result of which the pests detach from the mucous membrane and leave the intestines. The effectiveness of medication treatment is about 95 percent.

The dosage and time of taking the drug are calculated by the doctor based on the patient’s health status, body weight, and the degree of worm damage. It is not recommended to take these potent drugs on your own, as they have a strong effect on the body.

Therapy for helminthic infestation should be comprehensive, aimed not only at eliminating worms, but also at minimizing complications:

• To prevent an allergic reaction of the body when taking medications, antihistamines are prescribed;
• To improve the functioning of the intestines and digestive system - enterosorbents;
• For anemia, iron supplements, vitamin B12, and folic acid;
• Vitamins to improve general condition;
• A balanced diet with limited consumption of flour and sweets, as well as other carbohydrate foods.

• To prevent the spread of the disease to relatives, family members and acquaintances, patients should cut their nails short, wash their hands thoroughly after visiting the toilet, boil all bedding and underwear, and wash clothes at high temperatures.
• Only if acute intestinal obstruction due to filling with tapeworms is detected, surgical intervention is indicated to increase its lumen and patency.
• After therapy, observation at the dispensary is required for three months, during which regular blood and stool tests are carried out to detect eggs and other signs of helminthic infestation.
• In the absence of severe anemia, the outcome of therapy is favorable, the patient completely gets rid of helminths and returns to normal life.

Treatment of diphyllobothriasis with folk remedies

Treatment of diphyllobothriasis in humans can also be carried out with folk remedies, which, according to the principle of their action, coincide with medications. They are used to expel pests from the intestines by reducing their waste matter and completely paralyzing them.

The most effective remedy is pumpkin seeds, the shell of which contains a special substance that, at maximum concentration in the blood, leads to paralysis of the worms. In terms of their effectiveness, they are inferior to medications, but do not have a pronounced toxic effect.

Pumpkin seeds are prescribed to young children and adults who do not tolerate anthelmintic drugs well. Peeled seeds are used in the form of a ground and ground mixture with water and honey.

Unrefined ones are used to prepare a decoction, which is consumed on an empty stomach. After using the drugs, saline laxatives are prescribed to expel helminths.

Prevention of diphyllobothriasis

Prevention of diphyllobothriasis helps prevent helminthic infestation and many other complications associated with the normal functioning of the gastrointestinal tract. Preventive measures include:

• Thorough heat treatment of fish, seafood and crayfish before consumption;
• Washing vegetables and fruits in hot water and soap;
• Compliance with hygiene rules - regular washing of hands, tableware and cutting objects.

Prevention of diphyllobothriasis is necessary for those people who like to eat freshwater fish. Any meat that is freshly salted or low-cooked/fryed is potentially dangerous.

Complications of invasion include intestinal obstruction, the development of severe anemia, as well as other consequences from internal organs.

Source: https://narhiler.ru/difillobotrioz-simptomy-i-lechenie.html

Diphyllobothriasis

Diphyllobothriasis is a helminthic disease accompanied by infection and damage to the digestive tract of humans and animals. The disease leads to megaloblastic anemia. The parasite is a fairly large tapeworm - the broad tapeworm (D.latum), it grows up to 10 m in length; in nature there are more than 10 species of little studied tapeworms of the genus Diphyllobothrium.

Causes of the disease

A person can become infected with diphyllobothriasis by consuming infected, poorly thermally processed food, or insufficiently salted fish products. Infection through poorly disinfected dishes after cutting fresh fish is also possible. To reach the final host, the parasite travels a long way.

Method of spread of diphyllobothriasis

The wide tapeworm consists of several thousand segments (proglottids), which contain parasite eggs; it clings tightly to the walls of the host’s small intestine with the help of two slits (bothria) and parasitizes the body. Despite the impressive size (10 meters) of the helminth, there are cases when several such worms parasitized the human body.

Geography of the spread of the disease

The disease diphyllobothriasis is most often diagnosed in people in populations where fish and its caviar are considered the main food for residents; these are regions with temperate and cold climates. Most often, a parasitic disease is recorded: in Japan, South America, Africa, the USA, Canada, especially in Scandinavia, there have been cases in Russia.

Pathogenesis and pathological picture of diphyllobothriasis

When the broad tapeworm enters the human body, it begins its parasitic effect in the form of a pathogenic, mechanical, toxic-allergic, neuro-reflex disorder. First of all, the intestinal mucosa suffers, since the helminth attaches to the walls, damaging it with bothria.

As a result, the intestinal mucosa atrophies and becomes necrotic. The waste products of worms negatively affect autosensitization processes in the body. Severe endogenous hypovitaminosis of folic acid and vitamin B12 occurs.

In addition to severe intoxication of the body, 2% of patients experience megaloblastic anemia. A person can be infected up to 10 years of age.

Symptoms of diphyllobothriasis

Symptoms in humans do not appear for a long time, and the incubation period of diphyllobothriasis ranges from 20 to 60 days.

Within two months, the parasites become familiar, transform into sexually mature forms, attach themselves to the intestinal walls with the help of bothria, damaging the mucous membrane, and begin their parasitic work.

The disease diphyllobothriasis manifests itself gradually. The earliest symptoms are accompanied by:

• attacks of nausea, belching,
• gag reflexes,
• bloating,
• painful sensations in the epigastrium,
• loss of appetite,
• stool disorder.

The patient suffers from tachycardia, hypotension, drowsiness, systolic murmurs at the apex and a spinning top murmur.

Laboratory tests of the blood of an infected patient reveal abnormalities in the body such as:

• decrease in hemoglobin,
• decreased number of red blood cells,
• increased bilirubin,
• increase in color index,
• neutropinia,
• leukocytosis,
• increase in ESR.

The severity of the disease, rapid helminthic infection, concomitant diseases, general resistance of the body, quantity and quality of food consumed - all these factors together affect the severity of anemia

In a severe form of diphyllobothriasis, funicular myelosis (combined sclerosis) is acutely manifested, the patient has impaired deep sensitivity, weakness in the legs, and mild paresthesia (sensitivity disorder). Allergic rashes (urticaria) are observed on the skin, and internal organs (liver, spleen) increase in size.

In some difficult cases, epileptoform (convulsive) seizures are recorded, limbs become numb, and instability in walking is observed. The symptoms of diphyllobothriasis disease are very serious, therefore, after diagnosing and establishing a diagnosis, it is recommended to immediately begin therapy. With maximum long-term treatment, intestinal obstruction is possible.

Despite such an impressive list of symptoms of the disease, it is worth noting that sometimes the disease proceeds completely latently (asymptomatic) for many years; the invasion is discovered by chance by fragments of the helminth in the patient’s feces.

Diagnosis of diphyllobothriasis

To make a diagnosis, it is necessary to undergo medical laboratory tests.

When diagnosing the blood of an infected patient, the following indications are revealed:

• eosinophilia in the blood,
• thrombocytopenia,
• leukemia,
• hyperchromic anemia,
• increased erythrocyte sedimentation rate.

Megaloblastic type of hematopoiesis is one of the characteristic factors of this disease. A blood test shows a large number of young red blood cells (megaloblasts, normoblasts, polychromatophils, poikilocytes, etc.).

When making a diagnosis, the epidemiological history is taken into account: the patient’s consumption of fresh freshwater fish and its poorly prepared caviar, as well as his presence in an epidemic zone.

An accurate diagnosis is made by analyzing the patient's stool, only if it contains eggs and segments of the tapeworm.

The symptoms of parasitic diseases are in many ways similar to other diseases, so it is important not to make a mistake in making a diagnosis. Because of this, additional diagnostics of gastric contents are often carried out for the presence of Castle factor, which is absent in anemia.

Diphyllobothriasis: treatment

If the diagnosis is accurately identified, immediate treatment is carried out in a hospital.

If the patient has an illness at the stage of anemia, then before removing parasites from the patient’s body, it is necessary to resuscitate him with a course of vitamin therapy, which includes: vitamin B12, folic acid, iron.

Vitamin B12 is carried out in a course of 30 days, administered intramuscularly 2-3 times a day at a dosage of 200-500 mcg.

Antiparasitic drugs are prescribed:

• Biltricide,
• Praziquantel,
• Niclosamide,
• Azinox.

Drug therapy carried out by specialists in a hospital is 95% effective, and only in rare patients is it complicated by intestinal obstruction; in such cases, deworming is performed surgically. After successful deworming, patients diagnosed with diphyllobothriasis are prescribed clinical observation, which includes mandatory stool testing for six months.

Folk remedies

Parasitic diseases are successfully treated with traditional methods; pumpkin seeds and infusions from them have an anthelmintic effect.

You need to take raw or dried pumpkin seeds, grind them thoroughly with water and honey, take them on an empty stomach in portions for an hour at a dosage of 300 grams.

This recipe effectively expels parasites from the human body during diphyllobothriasis. This is evidenced by numerous patient reviews.

Diet, nutrition

During therapy, the patient is recommended to follow a light diet; it is advisable to exclude foods that irritate the intestinal mucosa. It is advisable to expand the diet towards a high content of vitamin B12 and folic acid.

Features in children

Children suffer from parasitic diseases much more severely; the symptoms of anemia and hypovitaminosis are much more pronounced in young patients.

Prevention of diphyllobothriasis

It is necessary to observe the rules of personal hygiene when cutting fish products and preparing food from them. To avoid invasion, you need to properly heat-treat the fish, boil and fry it, and salt the caviar well.

It is important to know that the larvae in salted fish die 2-7 days after salting, this depends on the salt concentration. When salting fish eggs, the parasite eggs die after half an hour, but only with a 10% mass fraction of salt relative to the weight of the eggs.

It is possible to disinfect fish products by deep freezing at a temperature of -18C for 2-4 days and at -6 for 7 days; under such conditions, the parasite larvae die.

On a global scale, in order to minimize the likelihood of infection, it is necessary to reduce the percentage of intermediate carriers in water bodies by reducing or eliminating the discharge of feces into lakes and rivers, ensuring sanitary control over this process, as well as the general condition of shores, beaches and fish products entering the food industry and store counters

It is necessary to carefully monitor in medical institutions the occurrence of symptoms inherent in a disease such as diphyllobothriasis. Treatment, once the diagnosis is confirmed, should be started immediately and with mandatory testing of all family members for the presence of invasion.

Features for pregnant and lactating women

Parasitic infection, which develops into hypovitaminosis, anemia and anemia, poses a huge danger to a pregnant woman and to an unborn child. It is important to follow all the rules of prevention when a pregnant woman eats fish and caviar.

Specialists select safe therapy for a pregnant woman and her unborn child. In general, pregnant and lactating women are not prescribed antiparasitic drugs such as Biltricide, but are recommended to use safe folk remedies, such as pumpkin seeds.

In more severe cases, breastfeeding women are prescribed standard drug therapy, and the child switches to artificial feeding.

Source: http://gelmintozanet.ru/gelmintozy/difillobotrioz.html

Treatment of diphyllobothriasis in humans: correct dosage regimen and symptoms

One of the dangerous parasites that can infect humans and is transmitted through fish is the broad tapeworm. Its fairly widespread prevalence among fish from many river basins around the world causes a certain concern and caution, and the disease itself requires careful consideration.

Diphyllobothriasis is a chronic intestinal helminthiasis caused by a tape parasite, the broad tapeworm, and is characterized by damage to the small intestine and the development of B12 - deficiency anemia.

What to do in such a situation? To get started, we recommend reading this article. This article describes in detail methods of controlling parasites. We also recommend that you consult a specialist. Read the article >>>

Appearance of the parasite

A connection has been noted between the prevalence of diphyllobothriasis and the basins of many rivers on the planet, the location of lakes, as well as with temperate and cold climates. The disease is widespread in North America, Canada, France, Denmark, Sweden, Holland, Finland, Italy, Germany and other countries.

In the Russian Federation, diphyllobothriasis is more common in the Krasnoyarsk Territory and the river basins of the Ob, Lena, Yenisei, and Amur. Foci have been identified in the reservoirs of Nizhny Novgorod, Volgograd, Samara, and Tatarstan.

Treatment of diphyllobothriasis

Treatment is based on the use of antiparasitic drugs. For treatment the following are used:

• Phenasal (niclosamide) once from 1 to 3 grams depending on the age of the patient.
• Biltricide at an average dose of 25 mg/kg once.

As aids:

• Male fern seed extract : for 2 days, a light diet, devoid of fats, spicy foods, a light dinner the night before therapy, a saline laxative (magnesia sulfate) at night, a cleansing enema in the morning on an empty stomach, then taking the drug 1 capsule every 2 minutes (general dose depending on age from 4 to 7 grams). After 30 minutes, a saline laxative is given again, and after 1.5 hours, a light breakfast. If there is no stool for 3 hours, then a cleansing enema is performed.
• Pumpkin seeds in the amount of 300 grams, pour 50-60 ml of warm water, grind and consume on an empty stomach for 1 hour. After 3 hours they give a saline laxative and then after 30 minutes a cleansing enema. You can steam the seeds in a water bath (as with taeniasis).



In case of severe anemia, its correction is carried out: vitamin B12 or cyanocobalamin is prescribed from 200 to 500 mcg parenterally 3 times a week for 1-1.5 months, as well as iron supplements (ferroplex, actiferrin, ferronal, hemofer and others).

Symptomatic therapy (painkillers, probiotics, drugs that normalize intestinal motility, laxatives, if necessary, and others).

Treatment monitoring is carried out 1 and 3 months after antiparasitic therapy. If the copro-ovoscopy tests are negative, no further medical examination is required. If the discharge of eggs and fragments of tapeworm strobila continues, then a second course of treatment is prescribed.

Patients are prescribed treatment immediately after diagnosis. The treatment regimen may include a healthy diet, which involves the consumption of liquid or creamy foods, anthelmintic drugs, injections of vitamin B12, and iron supplements.

Diphyllobothriasis should be treated with the following medications:

1. Praziquantel . The dosage is 10-25 mg per kg of patient body weight. The drug promotes paralysis of parasites, which leads to their death. The worm leaves the body naturally - during bowel movements. Do not give to children under 4 years of age.
2. Niclosamide works on the same principle as Praziquantel. Leads to paralysis of the smooth muscles of helminths with further removal from the body. Children can take it from two years of age - the dosage is 500 mg. An adult is recommended to take the drug at a dose of 2-3 g per day. Take once, after which you need to take a laxative.
3. Biltricide. The dose is 60-70 mg per kg. The dosage per day is divided into three applications, drunk at equal intervals. Take the tablet during meals, do not chew it, wash it down with water. Not allowed during pregnancy or while breastfeeding. The effectiveness of the drug is over 90%.

Taking antiparasitic drugs leads to the death of worms. When helminths die, this leads to intoxication of the body and allergic reactions, which affect the condition of the skin.

Therefore, it is necessary to carry out antiallergic treatment - antihistamine tablets are prescribed - Tavegil, Suprastin, etc. The dose is determined depending on the severity of the clinic.

On the day of completion of the course of therapy, enterosorbents (Polysorb, Smecta) and laxative medications suitable for the patient’s age are prescribed. Additionally, immunomodulators are prescribed after completion of the therapeutic course.

With adequate treatment, the symptoms of diphyllobothriasis quickly disappear. Anemia disappears as the cause of the condition goes away. Only in rare cases is additional treatment of the pathological condition required.

Diagnostics

Since it is impossible to diagnose diphyllobothriasis without tests, if these symptoms occur, it is recommended to immediately contact a medical facility.

The doctor must first conduct a detailed survey, as he needs to determine:

• does a person live near bodies of water;
• whether you ate fish of questionable preparation;
• Have you cleaned fish in the last few months?

The main test for determining diphyllobothriasis is stool analysis (the eggs of the broad tapeworm can be found in the excrement). Under a microscope, they are easily distinguished by their specific oval shape, length and yellowish-gray color.

Sometimes patients can talk about excreting some parts of the worm along with their feces. After discovering eggs in the stool, all doubts about the disease disappear, and the doctor confidently diagnoses diphyllobothriasis.

A blood test is also performed to determine the size and composition of red blood cells. With diphyllobothriasis they are enlarged and saturated with hemoglobin. This test is also necessary to determine the level of vitamin B12 in the blood.

After determining the final diagnosis of the patient, it is necessary to conduct an examination of his entire family or immediate environment.

Symptoms and first signs

Drits Irina Alexandrovna. Parasitologist

Helminth infections can lead to numerous health problems, shortening life by 15-25 years. Many parasites are extremely difficult to detect. They can be anywhere - in the blood, intestines, lungs, heart, brain. Symptoms of helminthic infestation can be confused with ARVI, gastrointestinal diseases and others. The main mistake in such cases is delay! If you suspect the presence of parasites, you need to contact a specialist. More information about modern methods of treating helminth infections is described in this interview with a doctor . If we talk about medications and self-treatment, then this antiparasitic complex .

Immediately after infection, the disease may not appear until the end of the incubation period, which can last up to 2 months.

After its completion, mild signs of the disease may appear, which increase very slowly (as the helminth grows in the intestinal lumen). Patients may experience nausea, vomiting, abdominal pain, bowel movements, and sometimes body temperature rises to 37.5 C.

If the tapeworm is large in size or a large number of helminths accumulate in the intestinal lumen, obstructive intestinal obstruction may develop, a condition requiring emergency surgical care.

A characteristic sign of diphyllobothriasis is the development of B12-deficiency (pernicious) anemia with sufficient dietary intake of cyanocobalamin. This is due to the fact that the parasite uses vitamin B12 to ensure its vital functions, resulting in its deficiency in the human body.

The first signs of pernicious anemia are nonspecific; patients complain of weakness, nausea, dizziness, headaches, poor exercise tolerance, and rapid heartbeat.

Take a parasite test

Then signs of damage to the gastrointestinal tract appear, glossitis develops (the tongue is bright red, the papillae atrophy, as a result of which it becomes shiny and smooth – “varnished”).

As cyanocobalamin deficiency increases, damage to the peripheral nervous system occurs. Patients may complain of numbness in the fingers and toes, “crawling”, unsteadiness of gait, and impaired sensitivity.

Sometimes in physically healthy people, provided they have good nutrition, the disease is asymptomatic for a very long time.

Symptoms and treatment of diphyllobothriasis in children

Parasitic diseases develop faster in people with low immunity. This is exactly what children have. The presence of a parasite in a child’s body can be determined by whitish discharge in the stool.

If adults notice this feature, you should immediately contact your pediatrician and have your stool tested. Since the symptoms may be mild or similar to other diseases.

What to pay attention to:

• the child refuses to eat or eats more than usual;
• complains of abdominal pain, nausea;
• bowel dysfunction occurs, most often constipation;
• low temperature;
• formation of red spots on the tongue;
• anemia develops;
• problems with the gastrointestinal tract;
• irritability, mood swings;
• sleep disturbance.

In general, the manifestations of diphyllobothriasis are practically no different from those of an adult. The only difficulty is that the child cannot always describe his condition. When did it all start?

Due to the fact that conscientious parents do not allow their children to eat freshwater fish in any form until they are 3 years old, the development of diphyllobothriasis is possible in older children.

Treatment consists of taking anthelmintic drugs, vitamins, and iron supplements. Therapy is prohibited without a doctor's recommendation.

Diet, nutrition

During therapy, the patient is recommended to follow a light diet; it is advisable to exclude foods that irritate the intestinal mucosa. It is advisable to expand the diet towards a high content of vitamin B12 and folic acid.

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Source: https://NoParasites.ru/lekarstva-i-narodnye-sredstva/lechenie-difillobotrioza.html

Diphyllobothriasis - symptoms, treatment, diagnosis, photos

Larvae of a tapeworm (the causative agent of diphyllobothriasis) in the body of a fish

Diphyllobothriasis (lat. diphyllobothriasis) is a parasitic infection caused by the tapeworm Diphyllobothrium latum (wide tapeworm) or other cestodes of the genus Diphyllobothrium (for example, D. Dendriticum, D. klebanovskii).

It is endemic in countries and areas where people frequently consume raw, smoked or pickled freshwater (less commonly sea) fish. Cases of infection are often observed in residents of Eastern Europe, North and South America, some African, Asian and Scandinavian countries.

Anyone, regardless of age, gender, nationality and race, who consumes poorly thermally processed fish can be infected with diphyllobothriasis.

Historically, Jewish women were once most likely to become infected with the parasite due to their tradition of tasting fish before it was fully cooked. For this reason, Diphyllobothriasis is also known as the "Jewish housewife's disease."

Causes

A person becomes infected with the causative agent of the disease by consuming raw fish containing tapeworm larvae. In addition to humans, the definitive hosts of the parasite are dogs, cats, walruses, seals and other animals.

After entering the intestine, the larva begins to grow and develop. Over time (about 3-6 weeks), it turns into a sexually mature individual capable of producing eggs. Eggs are produced in each segment of the worm and are then passed in the stool.

Sometimes the whole worm or parts of it can be seen in the stool.

Around the middle of the 20th century in Japan, before the use of freezing equipment, many connoisseurs of such dishes as sushi and sashimi began to get very sick and die. Research in the field of parasitology showed that the main reason was the relatively favorable conditions for the proliferation of parasites that people became infected with when eating raw fish dishes.

The causative agent of diphyllobothriasis is the adult broad tapeworm. The average length is 10 m. Life expectancy is up to 20 years.

Symptoms

The incubation period of the disease is 1-2 months.

Most people with diphyllobothriasis are asymptomatic. However, in some cases the following may occur:

• loss of appetite, sudden weight loss;
• abdominal pain;
• stomach upset;
• vomiting, nausea;
• dyspepsia;
• the presence of eggs or parts of a worm in the stool.

A characteristic symptom of this disease is the development of megaloblastic anemia (a blood disorder characterized by the formation of larger and more modified red blood cell precursors - megaloblasts). It occurs due to a deficiency in the body of vitamins B12 or folic acid, which are used by parasites to ensure vital functions.

Other, less common symptoms include the following:

• fatigue;
• diarrhea;
• bloating;
• dizziness;
• weakness (rare);
• numbness of the limbs;
• feeling of hunger;
• itching in the anus;
• disturbances in movement and coordination, loss of vibration sense and proprioception;
• tachycardia.

Diagnostics

Laboratory tests that may be useful if diphyllobothriasis is suspected include the following:

• microscopic examination of stool for the presence of eggs and parts of parasites (the most accurate basis for making a diagnosis);
• complete blood test to determine folic acid and vitamin B12 levels;
• analysis of hemoglobin and hematocrit levels.

Since the symptoms of this disease are similar to those of many others, the specialist will carefully study the medical history, existing risk factors for infection and may prescribe additional tests to clarify the diagnosis.

Treatment

Most patients with diphyllobothriasis, unless they have severe symptoms, can be safely treated as an outpatient. Inpatient care is usually not needed, but it may be required in complex cases.

Drug treatment

Once diagnosed, treatment is quite simple and effective. The standard treatment for diphyllobothriasis, as well as many other cestodiases, is a single dose of praziquantel at 5-10 mg/kg orally for adults and children.

An alternative is Niclosamide, which is much more expensive and is not listed in some countries, available as a single dose of 2 g orally for adults or 50 mg/kg (not more than 2 g) for children.
Albendazole may also be effective.

Another interesting potential tool for treating Diphyllobothriasis is a contrast fluid that is commonly used for diagnosis, diatrizoic acid.

Male fern extract is highly effective in the treatment of diphyllobothriasis, however, due to its high toxicity, it is better to give preference to the above chemicals.

Surgery is required only in rare cases when the disease is accompanied by intestinal obstruction.

Even in the setting of low vitamin B12 levels, less than 2% of patients with diphyllobothriasis develop anemia. Vitamin supplements may be required in severe cases of the disease.

Typically, no activity restrictions or dietary changes are necessary.

Home treatment

Treatment with folk remedies is often auxiliary. It does not always allow you to completely get rid of the disease, but it can help reduce symptoms.

One of the popular methods of deworming is the use of pumpkin seeds. They contain an amino acid called cucurbitin, which paralyzes the worms and helps eliminate them from the gastrointestinal tract.

In addition, pumpkin seeds have a number of other health benefits - they are rich in protein, amino acids, iron, copper, phosphorus and magnesium, calcium, zinc, potassium, folic acid and niacin, i.e. all important nutrients to ensure the normal functioning of the human body.

Another important factor in consuming seeds is that they are non-toxic and do not cause side effects, and therefore can be consumed even by children.

To combat parasites, adults should consume 25-30 grams (about 2 tablespoons) of fresh, peeled, finely ground pumpkin seeds on an empty stomach. Approximately 2 hours after administration, you should take a laxative. To be sure, treatment can be repeated after 2 days.

To make the treatment more effective, pumpkin seeds can be combined with another natural remedy for parasites - carrots.

You need to mix 3 tablespoons of grated carrots, 25-30 g of crushed pumpkin seeds and 2 tablespoons of vegetable oil. Eat the mixture prepared in this way on an empty stomach.

To treat diphyllobothriasis in children, mix 15-30 g (the younger the child, the smaller the dose) of fresh peeled and crushed pumpkin seeds with milk and give the mixture to the child on an empty stomach. Instead of milk, you can mix the seeds with honey.

After this, feed the baby breakfast. After 3 hours, the child should be given 1-2 teaspoons of castor oil (for very young children or those who have intestinal problems, the oil can be replaced with olive oil) to cause a laxative effect.

If necessary, treatment can be repeated after 2-3 days.

Prevention

Diphyllobothriasis can be easily prevented with the following recommendations:

• cook fish at a temperature not lower than 54 0C for five minutes;
• Freeze fish to a temperature below 10 °C;
• carry out sufficient salting before smoking, drying and other cooking methods that exclude sufficient heat treatment;
• practice proper food handling and safety, such as washing and avoiding cross-contamination of fruits and vegetables with raw fish;
• Be careful when eating when traveling in developing countries.

Photo

The causative agent of diphyllobothriasis in the form of plerocercoids (larvae) of tapeworms and other tapeworms can often even be visually seen in the body of the fish on organs, eggs or muscle fibers. Most often they will be in the form of pale cysts (plerocercoid stage) attached to the outside of the intestines and other internal organs. Examples in the photo below.

Larvae of a tapeworm of the genus Diphyllobothrium on the outer wall of the intestine
Larvae of a tapeworm of the genus Diphyllobothrium in the intestine of a fish

Source: https://gelmintoz.net/gelmintozy/difllobothrioz.html