The COENUROSIS (coenurosis) — the helminthosis from group of tsestodoz caused tsenury — a larval stage of cestodes of the sort Multiceps, characterized by defeat head, is more rare than a spinal cord or other bodies and fabrics.
The disease meets seldom, in literature is described apprx. 50 cases of diseases of the person of a coenurosis.
Etiology. C. a head or spinal cord Coenurus cerebralis — a larval stage of a tape-worm of Multiceps multiceps is caused, as a rule, S. is more rare than serialis
— a larval stage of M. of serialis. At the person also S. of brauni and S. of glomeratus can parasitize. Tsenura of the last three types at the person are more often localized in intermuscular connecting fabric, hypodermic cellulose, an abdominal or chest cavity, in an eye.
Length of a body of puberal representatives of the sort Multiceps of 20 — 100 cm, about several meters are rare; it is divided into joints, on a head there are two rows kryuchyev and suckers. Eggs of an oval form, their size apprx. 30 X 37 microns.
A larval stage (tsenur) S. cerebralis — large, to dia. 5 — 8 cm, a rounded or oval shape the bubble (a parasitic cyst) containing transparent or rather turbid liquid. The cover of a bubble thin, translucent, consists of outside and internal layers. The inner (germinative) layer is covered a set of a scolex (heads) located groups. A mature scolex is supplied with four suckers and poorly developed proboscis with a double row kryuchyev. In a human body, on the basis of a brain and in the fourth ventricle the branched (racemose) form of a tsenur reaching in length of 10 cm and consisting of a set of small bubbles with a diameter from 1 — 2 mm to 1 cm Tsenur
S. of serialis usually develops has the various forms and the sizes. It can otpochko-vyvat affiliated bubbles both is endogenous (in a bubble), and is exogenous. Affiliated bubbles are attached to a maternal bubble by means of short legs and have an appearance of finger-shaped shoots.
The COENUROSIS 173
Intermediate owners of S. of cerebralis are the sheep, a buffalo, a yak, a bison, a goat, an Asian mouflon, a saiga, a roe, the West Caucasian tour, single-humped and two-humped camels, a ren, a wild boar, a pig; intermediate owners of S. of serialis — a hare, a rabbit, a squirrel, a nutria, a rat, a monkey; intermediate owners of S. of brauni — mouse-like rodents, a monkey; intermediate owners of S. of glomeratus — sandworts of nek-ry types. Final (definitivny) owners of helminths of the above-named types — a dog, a wolf, a coyote, a jackal, a fox, a polar fox, a raccoon dog, a hyena, a cat, etc. Final owners catch, eating corpses of the infested animals who are intermediate owners. In a small bowel of these animals helminths develop to a puberal stage within 1 — 21/2 month. Duration of their life
is from 6 to 12 months.
Epidemiology and geographical distribution. A source of an invasion are final owners of helminths. These animals allocate the mature joints filled with eggs of helminths with excrements. The last are steady against influence of environmental factors though rather quickly perish at influence of high temperature in combination with insolation. Infection of the person and intermediate owners occurs at the use of food and water, to-rye are contaminated by excrements of animals (final owners) infested by a puberal stage of helminth. The contact of people with sick dogs is especially dangerous, on wool and language to-rykh there can be eggs of helminth.
The disease meets at men in districts of intensive sheep breeding more often.
From the listed representatives of the sort Multiceps at animals M. is most eurysynusic multiceps; it meets in Europe, Asia, Africa, America; in the USSR — it is preferential in the North Caucasus and in the areas of the South, neighboring to it, RSFSR, Nizhny Novgorod and Central Volga area, Siberia, Kazakhstan, in the republics of Central Asia, is more rare — in the Urals, in Transcaucasia, Moldova. The m of serialis is widespread in Europe (everywhere, but it is especially wide — in France and Italy), in the USA; in the territory of the USSR — by all European part (especially in sowing. - zap. areas and the Volga region), in Siberia,
Kazakhstan, the republics of Central Asia. The m of brauni is found in Africa and Italy; M of glomeratus — in Africa.
Pathogeny. At the heart of development of C. lie mechanical and toksi-to-allergic influence tsenur. Racemose bubbles-tsenury cause sharp inflammatory changes in covers of a brain in a look hron. a pia-arachnitis (see Meningitis), a leptomeningeal fibrosis (see), the basal tanks which are followed by fusion, disturbance of absorption and outflow of cerebrospinal liquid, development of an occlusal edema of a brain. Irrespective of localization of a tsenur focal changes of allergic character develop in different bodies and fabrics. They are more brightly expressed in the first months of an invasion.
Clinical picture. C. a brain it is shown by a headache, often pristupoobrazny, sometimes followed vomiting, pains in a neck, a backbone, weakness, perspiration, apathy. Gradually weakness increases, the convulsive movements, shaky gait, a disorientation in time and space appear, short-term losses are possible: consciousnesses, paresis, sometimes epileptiform attacks. Objectively note a focal anesthesia, a positive Kernig's sign (see Kerniga a symptom), muscle tension of a nape, congestive nipples (disks, T.) optic nerves. Build-up of pressure of cerebrospinal liquid is noted (see), quite often in it protein content increases, the lymphocytic pleocytosis is observed. The picture of blood normal, is sometimes noted: leukocytosis, insignificant eosinophilia.
At patients with localization of a tsenur in ventricles of a brain Bruns's syndrome — a sharp headache, dizziness, vasculomotor disturbances in the form of blanching or erubescence, perspiration, frustration of a rhythm of depth of breath, bradycardia develops, at height of an attack the loss of consciousness, tonic spasms are frequent. Emergence of a syndrome is usually connected with change of position of the head.
At localization of a parasite in a spinal cord a spastic paraplegia (see), disorders of functions of pelvic bodies, etc. are possible.
Cases of parasitizing the price a ditch in an eye of the person are described. At the same time eye pains, protrusion of an eyeglobe (see the Exophthalmos), decrease or loss of sight, increase in intraocular pressure are noted (see).
In cases of infection
of the person S. of serialis the parasite is more often localized in hypodermic cellulose, intermuscular connecting fabric where tumorous education from 1 to 8 cm in size is palpated, is more rare — in an abdominal cavity, a brain (at the same time the above described clinic is observed).
cases of sudden death of sick C Were observed. in an onset of the illness, before development of clinically expressed symptoms; the most probable cause of sudden death — an acute anaphylaxis (see). In later terms death can come at localization of a parasitic cyst in ventricles of a brain owing to the occlusal crisis which is followed by an acute edema of a brain, a prelum of vessels and ischemia of a brain (see. Occlusal syndrome)', at localization of a cyst in the fourth cerebral cavity — owing to a sudden cardiac standstill and breath.
The diagnosis is established on the basis epidemiol. anamnesis, wedge, pictures and inspections of the patient. The long headache, congestive nipples of optic nerves and other above described symptoms at the persons who are living in districts of intensive sheep breeding and having close contact with dogs allow to assume C. Such methods of a research as an encephalography (see), an ekhografiya (see. Ultrasonic diagnosis), a ventrikulografiya (see), a computer tomography (see the Tomography computer), a pneumoencephalography (see), a cerebral angiography (see) allow to define only localization and the amount of volume process. True character patol. process establish at an operative measure (allocate tsenur and direct in parazitol. laboratory for definition on morfol. to signs).
Treatment operational — removal of a parasitic cyst. Carry surely out the hyposensibilizing therapy (see an iposensibi-.lization).
Forecast. At cerebral C. without operative measure the forecast adverse: the disease lasts from several months to
5 years and more, gradually progressing. At a timely operative measure in case of single cysts recovery is possible. At localization of a tsenur in hypodermic cellulose, intermuscular connecting fabric the forecast favorable.
P rofilaktika. Personal prevention consists in careful washing of hands after contact with dogs, especially in districts of sheep breeding; protection of water and food against pollution. Public prevention includes veterinary supervision for dogs, extermination of stray dogs, identification of sheep, sick C., and control on a coenurosis of meat at a face of sheep.
Bibliography: Abuladze of K. I. Teniata — tape helminths of animals and the person and the diseases caused by them, M., 1964; Kornyanskiyg. Item, Vasin N. Ya. and E p sh t e y P. V N, Parasitic diseases of the central nervous system, page 140, M., 1968; Maximov P. I. and Astafyevb. A. Helminthoses in medicolegal diagnosis, Chisinau, 1984; Matchanov N. M., With and both e-in and A. T. and With and d y to about in V. M. Larvaceous teniidoza of the person and Karakul sheep, Tashkent, 1977; The Multivolume guide to microbiology, clinic and epidemiology of infectious diseases, under the editorship of H. N. Shukova-Verezhnikova, t. 9, page 533, M., 1968; Parasitology and invasive diseases of farm animals, under the editorship of K. I. Abuladze, page 295, M., 1975; Surgery of parasitic diseases, under the editorship of. And. JI. Bregadze and E. N. Wangqiang, page 100, M., 1976.
B. A. Astafyev.