, constant stress, increase
level of education and culture of the population, many long-known disease
people have changed their clinical picture. Some symptoms are almost
ceased to meet, while others began to come to the fore. This
refers to diseases caused by helminths, in particular, the circular
parasitic worms (nematodes). In the temperate zone of the most widely
Distribution of nematodes - ascaris and pinworms.

Worms can cause dysfunction of the gastrointestinal tract (GIT)
cause allergic (or pseudoallergic) reactions or contribute to,
cause toxicity, as well as being a factor that could weaken the immune system. In
Currently, rare cases of massive invasion, when diagnosis is not
is straightforward, and the balls of worms cause intestinal obstasction -
worms were significantlymorelikely to be the cause of allergic
problems. In this helminthiasis refer to those diseases which are difficult
diagnose due to the objective and subjective difficulties (prolonged
periods of absence of oviposition, the lack of opportunity among parasitic
specimens of females, the probability of technical errors). It is therefore important to know the clinical
picture of the diseases to be able to appoint an in-depth
examination or an effective therapy for aggregate indirect evidence, even
without direct evidence of helminthiasis.

In order to evaluate the clinical picture at nematodoses reviewed the complaint,
history and results of the examination of 150 children who were found Ascaris (116
children), pinworms (27 children), ascarids and pinworms (7 children). Helminths found
standard methods: the detection of ascarid eggs in feces by smear or eggs
pinworms in scrapings on enterobiasis, as well as visual detection of Ascaris or
pinworms in the faeces, vomit, or the surgical or endoscopic
intervention in the abdominal cavity or the rectum.

The children were 67 boys and 83 girls. Age distribution
presented in Table. 1. Dominated by children of preschool age (from
one to three years), their number was 63%. It was at this age -
the largest epidemiological prerequisites for the nematosis.

in 150 children with proven invasions Ascaris and / or pinworms observed
The following clinical manifestations.

in 107 children (71.3%) had allergic problems: skin rashes, diathesis,
atopic dermatitis, atopic dermatitis - in 99 (66%) of these 18 patients, these problems were
periodic, have two children, except for skin easptions were noted
conjunctivitis; in ten (6.7%) had proven food allergy
some foods with high levels of specific IgE in seasm, in six
children (4%) had an asthmatic component, or has been diagnosed
bronchial asthma.

in 113 children (75.3%) had disorders of the gastrointestinal tract:
unstable chair, undigested stools, the presence of feces "green" slime - at 66
(44%), constipation, or a tendency to constipation - in 55 (36.7%) in 17 children (11,3%)
observed unstable chair with a tendency to constipation, ie, periods of normal
or liquefied stools alternated periods of constipation, flatulence, which is manifested
increased flatulence, abdominal bloating, asmbling, belching, manifested in
30 children (20%), nausea, vomiting, regurgitation occurred in 29 children (19,3 %).

in 60 (40%) children who are expected to complain of abdominal pain,
marked abdominal pain syndrome: the most frequently observed so-called
"Volatile pain, which occurred independently of food, periodically, usually
without a specific localization or localized around the umbilicus (in periomphalic
zone). Such pains were their own without medicines or in patients receiving
sorbents, antispasmodics, some children needed some time to lie down;
pain of this nature was found in 54 children (36%). Eight children
(5,3%), abdominal pain, wore a permanent nature, were often associated with food
(There after a meal), were intense, often required medical
treatment and hospitalization to exclude acute surgical pathology, one
child was held on this occasion appendectomy, and an appendix with
catarrhal changes detected roundworm; have two children, marked pain
abdominal syndrome of both types.

in 66 children (44%) had disorders of appetite: in 54 (36%), appetite was more
reduced or selective, in 12 patients (8%) - elevated (child constantly wants to eat).
Often the question of appetite parents answered "when both", ie, there were periods
normal appetite and decrease or increase of appetite. In assessing this
indicator is not without a large share of subjectivity, since parents
to different assessments of their children's appetite.

basxism (teeth grinding) - a symptom that is often associated with
helminthic invasion, but actually is a nonspecific symptom
intoxication of the central nervous system and can accompany any chronic
intoxication - was found in 25 children (16,7 %).

to sleep at night were noted in 81 children (54%): anxiety in the evening,
difficulty falling asleep - in 15 children (10%), a restless night's sleep (cries,
postanyvaniya, throwing in his sleep, waking, crying, insomnia, nightmares
dreams) - in 76 (50,7%). Some parents of older children found it difficult to
characterize the child's night sleep since the baby sleeps in another room.
Problems with sleep and night sleep - an important symptom of worm infestations, since
known that intestinal nematodes (including roundworm and pinworm) is often
is activated at night.

in 54 children (36%) had itching and / or redness in the anus
(Anal eskoriatsiya) - in 43 children (28,7%), itching - 38 (25,3%), both of symptoms - from
27 (18%). Anal eskoriatsiya and itching are symptoms enterobioze (pinworm)
but of the 54 children who have these symptoms were noted, enterobiasis was
proved in 17 children (31,5% of children with these symptoms). In other 37 children
(68,5% of children with these symptoms) proved the existence of ascariasis, but
either visually or in the analysis were not found pinworms. This may
indicate either that in these cases was attended by pinworms,
had not been diagnosed, ie, the bot has been mixed, or that
eskoriatsiya and anal itching - symptoms that are characteristic not only for enterobiasis, but
and ascariasis.

in 29 children (19,3%) showed signs of general weakening of the immune system: it is often
or long-term ill children (according to the standard classification Monto J. et al., 87)
- 18 children (12%), recurrent stomatitis, gingivitis were observed in 13 children
(8,7%), dental caries - for six (4%), recurrent puaslent skin diseases or
mucous membrane - in three (2 %).

in 15 children (10%) had results of a study of immune status in blood:
in 13 children had reduced the number of T-cells, all 15 children was reduced
number of T-helper cells, and six of them - essentially, 12 children were
decreased helper-suppressor ratio, with seven children, a decrease
levels of IgA (secretory immunoglobulin), including the three - a substantial, y
the remaining eight children, the level of IgA in the seasm was either normal,
or higher, have six children, a decrease of lymphocytes in the
including one child had severe lymphopenia and neutropenia. These results
confirm the known data that roundworm and pinworm depressing effect on
immune functions, and that people with weakened immune systems most
probability of helminthiasis.

in 49 children (32.7%) had various symptoms, which can also be linked
the impact of helminths on the body: "Geography" language - in 12 children (8%);
lag in physical development, insufficient weight gain or weight loss for
some period of time - in 21 children (14%), painful form (under the blue
eyes, pallor) was observed during the inspection in seven children (4.7%), unpleasant odor
mouth, especially in the morning, was found in ten children (6.7%), increased
fatigue, asthenia syndrome - in eight children (5.3%), emotional
lability, moodiness, irritability of the child - in four (2.7%), and
this index is subjective, as well as evaluation of parents of appetite, hypersalivation -
Another symptom commonly associated with helminthiasis, was found in three
children (2%), various manifestations of hypovitaminosis, including rickets - in five
children (3.3%). Often, when viewed from the skin to detect changes in the form
"Goose-skin».

Most children mentionedmorethan one symptom. A summary of
clinical picture presented in the Table. 2.

therapy in all cases consisted of two stages: first - anthelminthic
therapy, and appointed two different dasg (decaris and vermoks) with
intervals of three - five days in between to cover the various possible
life stages of helminths, some time after anthelminthic therapy -
products for microbiological and functional correction. Respectively
evaluated the results of antihelminthic therapy, the results of the treatment, and
also catamnesis within six months after therapy. In most cases,
improvement occurred rapidly during treatment. In 36 children after
anthelminthic therapy significantly decreased or completely disappeared
Allergic manifestations in 39 children after the first stage of treatment to normal
Work gastrointestinal tract, in 41 children immediately stopped the pain in the abdomen, on the other
symptoms also occurred after the improvement of anthelminthic dasgs. This
confirms that the symptoms were caused by the presence of helminths.

in 92 children after all treatments had no complaints, about 37 are no data on
state changes during and after treatment; in 16 children the effect was incomplete,
ie, some symptoms persisted and after treatment, with four children
the effect of therapy was unstable, because any relapses after
end of treatment; have three children, the effect of therapy was not.

Literature

1. Blagov N. Some factors of immunity in patients with ascariasis and
enterobiasis during treatment with Albendazole. Cand. Dis. ... Cand. med. Science.
St. Petersburg, 1997.

2. Epiphany YK, Rachkovskaya IV, Chebyshev NV Nematodes and
Anthelminthics. M., 1994.

3. Laboratory diagnosis of parasitic diseases:

www.infectology.spb.com/ . Herald infectology and Parasitology.

article was published in the journal

The attending physician