GNATOSTOMOZ

From Big Medical Encyclopedia

GNATOSTOMOZ (gnathostomosis) — the helminthosis caused by parasitizing in various bodies and tissues of the person of larvae and occasionally puberal nematodes of Gnathostoma spinigerum Owen, 1836, and Gnathostoma hispidum Fedtschenko, 1872.

It is registered in Thailand, Japan, the People's Republic of China, India, Bangladesh, Kampuchea, Indonesia, Malaysia, on the Philippine islands, Australia, Mexico. Cases of G. in the USSR are not described.

An etiology

G. spinigerum — a reddish nematode, her body it is covered with gear chitinous plates; on the blown-up head end hooks cylindrical are located; male 11 — 25 mm long, female of 15 — 54 mm. Eggs of an oval form, 0,065 in size — 0,075 X 0,038 — 0,040 mm, with a transparent cover, have an outgrowth on one pole. Final owners of a gnatostoma — a cat, a dog, a puma, a tiger, a leopard at whom she parasitizes in tumorous formations of a stomach. Eggs gnatosty, allocated with excrements of final owners, get to fresh-water reservoirs where from them larvae are released. The last can be swallowed by intermediate owners — Copepoda crustaceans — a Cyclops. The infested Cyclops together with water gets into a digestive tract of the final owner; here larvae leave a body of a Cyclops and in 3 months develop in a wall of a stomach of animals in adults of helminths.

Some species of fish, frogs, amphibians and reptiles are reservoir owners gnatosty in which larvae of helminth remain live, grow, but do not develop.

G. hispidum — a male 12 — 25 mm long, a female — 25 — 45 mm. The body is covered with spinules. Its front part pinkish-red, back grayish-brown with yellowish strips. On head swelling — kryuchya. Final owners — pigs, occasionally cattle; intermediate owners are a Cyclops; reservoir — fishes.

Epidemiology

People can catch at drink of not decontaminated water from open reservoirs or consumption of the crude fish infested by larvae. Having got into a stomach, larvae through its wall migrate in a liver, and then are brought in hypodermic cellulose, lungs, a brain, eyes and other bodies. Larvae and young gnatostoma, occasionally puberal individuals usually are found in the person.

Pathological anatomy

Multiple hemorrhages and necroses in a head and spinal cord, in a cerebellum and roots of nerves, hematomas in ventricles, subarachnoidal and subcortical spaces. In a liver, kidneys, lungs, heart, a spleen and a pancreas — eosinophilic infiltrates; sometimes find fragments gnatosty.

A clinical picture

the Incubation interval apprx. 3 — 4 weeks. Larvae and young gnatostoma, getting into hypodermic cellulose, cause linear dermatitis or intermittent hypostases on a face, a breast, a stomach, extremities. The pulmonary and abdominal syndromes (which are followed by fever and an eosinophilia in blood) which, apparently, are caused by migration of larvae gnatosty soon after infection are described.

During the parasitizing gnatosty in lungs pains behind a breast, cough suddenly develop; on the roentgenogram — multiple blackouts of pulmonary fabric, sometimes the phenomena of a hydropneumothorax.

Of an eye proceeds with the phenomena uveitis (see), iridocyclitis (see) with amotio of a retina (see).

In Thailand the disease even more often is registered — eosinophilic radikulomiyeloentsefalit, the activator to-rogo consider G. spinigerum. As a rule, the disease proceeds hard; deaths are frequent. In the beginning there are abdominal pains, weakness, sleeplessness, the migrating hypodermic tumors, the recurrent current is characteristic. Further there is painful a liver, temperature increases. Disturbances from c are noted. N of page: decrease in tactile and painful sensitivity in all body, numbness, a paraplegia, and then a horizontal nystagmus, hoarseness of a voice, lack of a deglutitory reflex, paralysis of a facial nerve, extremities, an incontience of urine and a calla. In certain cases there occurs difficulty of breath, a circulatory disturbance, the general tonic spasms and death. In blood — the progressing high leukocytosis with an eosinophilia to 96%. Cerebrospinal liquid yellowish with the increased maintenance of cellular elements, including eosinophils and neutrocytes, sometimes existence of metamyelocytes.

The diagnosis

the Diagnosis is established by means of an intracutaneous allergy test. The precipitation test with blood serum and urine of patients is considered more specific. The diagnosis is confirmed by allocation gnatosty.

Treatment

Gnatostoma is deleted in the surgical way.

The forecast at defeat of c. N of page serious. Gnatostoma more than 10 years can parasitize in a human body, but sometimes leave spontaneously.

Prevention

Boiling of the water used for drink from open reservoirs; careful heat treatment of fish.


Bibliography: Gefter V. A. Gnatostomoz — a disease of the person of a parasitic etiology, Medical parazitol., t. 43, No. 3, page 343, 1974, bibliogr.; The multivolume guide to microbiology, clinic and epidemiology of infectious diseases, under the editorship of H. N. Shukova-Verezhnikova, t. 9, page 645, M., 1968; Bashirullah A. K. M. of Occurrence of gnathostoma spinigerum owen, 1836, in Dacca, Bangladesh, J. Parasit., V\58, p. 187, 1972; Tanghai P., N at e S. W. a. B e a v e r P. G. Eosinophilic meningoencephalitis caused by angiostrongyliasis in Thailand, Amer. J. trop. Med., v. 16, p. 454, 1967.

V. A. Gefter.

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