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Worm Infections-WPS Office-1.pdf
1. Worm Infestations
Worm Infestations
कृ म रोग
कृ म रोग
कृ म रोग
कृ म रोग
Presented By-
Priya Yadav
Batch-2019
Roll No-422191110041
Recommended By-
Dr. Surya Prakash Chaudhary
(Lecturer)
2. Contents
Contents
न
कृ म के भेद
नदान
स ा त
कृ म के व प एवं ल ण
च क सा
3 groups of worm
a-Nematodes (Roundworms)
b- Trematodes(Flukes)
c-Cestodes(Tapeworm)
Life cycle, clinical findings, diagnosis,
treatment
3. कृ म रोग
न
मः ेमेध त ।
माँस के त नेह रखने वाले क कृ म सं ा होती है।
अजीणात् कृ मस वः।
अजीण म कृ मय क उ प होती है, इस लए अजीण के
अ तगत कृ म का वणन है।
4. आचाय चरक अनुसार कृ म भेद
कृ म
उ रकालज
बा आ यांतर
सहज
यूका
पप लका
पुरीषज[5]-कके क,मके क,सशूलक,सौसुराद,ले लह
े ज[7]-अ ाद,उदराद, चर,चु ,दभपु प,सौगं धक,महागुद
शो णतज[6]-के शाद,लोमाद,लोम प,सौरस,औ बर,ज तुमा
5. आचाय सु ुत अनुसार कृ म भेद
कृ म
पुरीषज[7]
अजवा
वजवा
क य
च य
ग डूयद
चु
दमुख
े ज[6]
दभपु प
महापु प
लून
च पट
पपी लका
दा ण
शो णतज[7]
के शाद
रोमाद
नखाद
दंताद
क क स
सौग त
प रसप
6. आचाय हारीत अनुसार कृ म भेद
कृ म
आ यंतर[6] बा [7]
पृथुमु डा(TAPEWORM)
कशुकस भा(ROUNDWORM)
नभा
सू म
अणु
सुचीमुखी
7.
सामा य नदान
अजीण, अ यशन, असा य भोजन, व ाशन, मलीन आसान
अ ायाम, दवाशयन
गु , अ य धक न ध एवं अ तशीत आहार सेवन
माष, प ा , वदल(मकु ,चने आ द दाल से न मत ग र पदाथ)
बस(कमलनाल), शालूक(पद् कं द), कशे क, प शाक
सुरा, शु , ीर, गुड, इ ु, पलल( तलक क)
आनुपदेश के पशु प य के माँस
प याक ( तल क खली), पृथुक( चवड़ा), का नरंतर सेवन
मधुर, अ ल एवं व का अ धक सेवन
स ा त
उपरो नदान का सेवन
कफ एवं प कु पत
शरीर के व भ अवयव म व वध व प
के कृ म
8.
च क सा
च क सा स ांत- *अपकषण
* कृ त वघात
* नदान प रवजन
संशोधन
नेहन
वेदन कृ म वधक
आहार से ेरण
आ ापन ब त वमन तथा
वरेचन
प रषेक पंचकोलाद यवागू
वडंग तेल से
अनुवासन ब त
9.
*मुधागत कृ म- शरोगत तषेध म न द च क सा एवं अ तशय त कटु एवं अ प नेहयु
भोजन न द ह
*पुरीषज कृ म- नरंतर ब त एवं वरेचन
*कफज कृ म- न य, वमन एवं शमन च क सा
*र ज कृ म- कु म न द च क सा कर
योग
न बा क चूण
पलाशबीजा द चूण
प रभ वरस
वडंगा द तेल
सुरसा द तेल
पा रभ ावलेह
कृ ममु र रस
कृ मकु ठार रस
कृ मघा तनी वट
10. WORM INFESTATIONS
Worm Infestation are long-term
diseases that produce few symptoms
in their early stages and sometimes
serious effects at well developed
stages or may be quite fatal at times
12. ETIOLOGY
• Fecal contamination of water
• Unsanitary conditions
• Eating raw or undercooked meats or fish
• Keeping animals in close unsanitary conditions
• Rat or insect infestations
• Malnourished or diseased persons
• Heavy mosquito or fly infestations
• Playgrounds where children can eat or come in contact with
soil
• Contaminated food and water
• Unhygienic life style
13. Worm Transmission Cycle
1. An infected child contaminates soil
with faeces containing worm eggs.
These eggs develop into larvae in
the soil
2. Other children are infected
by eggs ingested through
food or dirty hands, or by
larvae penetrating the skin
3. In an infected child,
eggs and larvae develop
into adult worms, which
produce eggs and have
an ill effect on the child's
health
6
14. SYMPTOMS
• Abdominal pain
• Nausea/vomiting
• Diarrhea
• General malaise & weakness
• Anemia and retarded physical
growth & development in
children
• Intestinal obstruction
• Itching around anus and vagina,
inability to sleep, urinating in bed,
and abdominal pain is seen in
pinworm infections
15. Ascaris lumbricoides
•
Life cycle
Infection occurs by swallowing food contaminated
with ascaris eggs from feces.
• The larvae hatch in the intestine, burrow through the gut
wall, and migrate to the lungs through the blood system.
• There they break into the alveoli and pass up
the trachea where they are coughed up and swallowed.
• The larvae pass through the stomach for a second time
into the intestine where they mature into adult worms.
• They maintain their position by swimming against the
intestinal flow caused by peristalsis.
• Adult worms have a life-span of 1-2 years which means
that individuals may be infected all their lives as worms die
and new worms are acquired
18.
Diagnosis
*Eggs in stool sample
*Worms in stool / vomitus
*Imaging
Treatment
•
•
•
*Albendazole 400 mg Once (Taken with
food)
*Other options
Mebendazole
Ivermectin
Nitazoxanide
19. (Enterobius vermicularis)
LIFE CYCLE
•
•
Female threadworms lay an average of 11,000 tiny eggs ,
which are invisible to the naked eye.
• Eggs are laid outside the anus, or, in girls, around the vagina
and urethra.
• Eggs are usually laid at night while the child sleeps.
• The eggs are accompanied by an irritant mucus, which
causes intense pruritus and scratching
• The eggs get on to the hands and from there to the mouth
to reinfect.
Following ingestion of the eggs ,the larva hatch in the small
intestine and establish themselves in the colon, reaching
maturity in approximately 2 weeks. Adult worms live for up to
6 weeks.
PINWORM
21. C/F
• Majority of children have no complaints
• The infected child may present with vague general
symptoms like poor appetite, loss of weight, teeth
grinding, abdominal pain, nausea, vomiting and
diarrhoea.
• Pruritus ani is an important feature. It occurs due to
crowding of gravid females at anus.
• Scratching may cause secondary infection
• In female child vulvovaginitis may be found
• Child may have irritability, restlessness, sleep
disturbance, enuresis.
22.
•
•
Diagnosis
*Stool microsopy: not useful
*Eggs can be demonstrated in peri anal swabs
collected early morning
*Sticky tape on a tongue depressor
Treatment
*Albendazole 400 mg Once, repeat in 2wk
*Other options
Mebendazole
Pyrantel
*Treat entire family
23. Hook worm
(Ancylostoma duodenale / Necator americanus)
•
Life cycle
• Eggs are passed in the faeces and on warm and moist
soil they hatch larvae after 1-2 days.
• Newly hatched larva becomes infective and able to
penetrate skin within 5-10 days.
• Infection occurs when the larva enters the body through
the skin of bare footed individual.
• Larva of A. duodenale are infective also through the
mouth.
In the human body larva migrates via lymphatics and
blood stream to the lungs and from there up the trachea,
and coughed and are swallowed.
• They then pass down the esophagus and enter the
digestive system, finishing their journey in the intestine,
where the larvae mature into adult worms and may
survive for 1-4 years.
25.
•
•
•
•
•
•
C/F
Ground itch
Abdominal pain, anorexia
Iron deficiency anemia
Hypoproteinemia
Dx
Stool microscopy
Peripheral smear
Treatment
•
•
•
Albendazole 400 mg Once
Other options
*Mebendazole
*Pyrantel
Oral Iron therapy
26. WHIPWORM
(Trichuris trichiura)
•
•
•
•
•
•
•
Whipworms live in large intestine .
Female produces 200-10,000 eggs per day for more than
5 yrs.
Embryonization takes 21 days.
Infection is directly from faeces.
Eggs in small intestine and larvae emerges in it.
It attaches to villi, develops for a week, and reemerges
and passes to caecum and colorectal where it attaches
to mucosa and develop into an adult.
Period from ingestion off egg to appearance of egg in
stool is 60 – 90 days.
Life cycle
28.
•
•
•
•
C/F
Majority of infections are mild and asymptomatic.
Epigastric pain, nausea, vomiting, distension, flatulence, weight loss.
Moderate infection causes growth deficit and anemia.
Severe infection causes diarrhoea with blood and mucus rectal
prolapse, colonic obstruction, hypoproteinaemia,chronic iron
deficiency, anemia.
•
Dx
Stool mircroscopy
[barrel and lemon shaped eggs].
•
•
•
•
Treatment
Piperazine
Mebendazole
Levamisole
Pyrantel
29. Filariasis
(Wuchereria bancrofti, Brugia malayi, B. Timorai)
•
•
•
•
•
•
LIFE CYCLE
W. Bancrofti accounts for 98% of filariasis in India.
During a blood meal, an infected mosquito introduces third-stage
filarial larvae onto the skin of the human host.
A mosquito ingests the microfilariae during a blood meal .
After ingestion, the microfilariae lose their sheaths and some of
them work their way through the wall of the proventriculus and
cardiac portion of the mosquito's midgut and reach the thoracic
muscles .
There the microfilariae develop into first-stage larvae and
subsequently into third-stage infective larvae .
The third-stage infective larvae migrate through the hemocoel to
the mosquito's prosbocis and can infect another human when the
mosquito takes a blood meal.
32.
•
•
•
•
Dx
*Mf identified in thick blood film
*Nocturnal periodicity
*Adult worm in LN biopsy
Treatment
Di –Ethyl-Carbamazine (DEC) 6mg/kg /day q8hr for 12
days
Other options
Single dose Ivermectin
Ivermectin + Albendazole
33. BLOOD FLUKES
(Schistosoma)
•
•
•
Life cycle
Eggs are eliminated with feces or urine.
Under optimal conditions, the eggs hatch and release miracidia ,
which swim and penetrate specific snail intermediate hosts.
The stages in the snail include two generations of sporocysts and
the production of cercariae.
C/F
•
•
Within 1-2 months of infection, symptoms may develop
including fever, chills, cough, and muscle aches.
Without treatment, it can persist for years and in chronic stage it
include: abdominal pain, enlarged liver, blood in the stool or blood
in the urine, and problems passing urine.
35.
•
•
•
Dx
The detection of parasite eggs in stool
or urine specimens.
Antibodies and/or antigens detected in
blood or urine samples are also
indications of infection
Treatment
DOC-praziquantel 40–60 mg/kg
body weight
36. Tapeworm
(Taenia solium/ Taenia saginata)
•
•
LIFE CYCLE
A cestode requires one or more intermediate hosts in their
life cycle.
• The eggs are passed into the environment from the primary
host.
• The eggs are ingested by an intermediate host in which they
hatch.
•The larvae enter the tissues of the intermediate host and
encyst.
• The primary host ingests the cysts in the flesh of the
intermediate host
• When humans are the primary hosts, the adult cestode is
limited to the intestinal tract.
When humans are the intermediate hosts, the larvae are
within the tissues, migrating through the different organ
systems.
38.
•
C/F
*Mild epigastric discomfort, nausea, flatulence,
diarrhea
Dx
*Microscopic identification of eggs and proglottids in
feces
Treatment
*Praziquantel 5-10mg/kg single dose
*Alternative option
Niclosamide 50mg/kg single dose
39.
Echinococcosis
Echinococcus granulosus, E. multilocularis
LIFE CYCLE
The life cycle involves a primary or definitive host and a
secondary or intermediate host, each harboring
different life stages of the parasite. Foxes, coyotes,
domestic dogs, and other canids are the definitive hosts
for the adult stage of the parasite. Cats may also be
involved.
Echinococcus involvement in children has a different
pattern than adults. In adults, liver is the most common
site of localization of the larval forms while in children it
is more common in the lungs.
