Contents
What is a liver fluke?
liver fluke – This is a flatworm that belongs to the class of digenetic flukes. It parasitizes in the biliary tract, as well as in the liver of humans and other warm-blooded animals.
Liver flukes are called worms of various kinds, among which:
Lancet fluke.
Eastern fluke.
Giant liver fluke.
Liver fasciola.
Cat fluke, etc.
For humans, the giant fluke and hepatic fasciola are dangerous. These two types of trematodes provoke a disease called fascioliasis.
The giant fluke has quite impressive dimensions, its body can reach 76 mm in length and 12 mm in width.
The liver fluke has a leaf-shaped body of a flat shape. On the head of the parasite are two suckers. In length, the liver fluke can reach 20-30 mm, and 12 mm in width. Immediately after the short esophagus, the parasite has two intestinal loops that end blindly. Worms are hermaphrodites, inside their body are unpaired ovaries, a small uterus and two branched testes. In the external environment, parasites secrete large oval eggs covered with a yellow shell.
Outbreaks of parasitic invasion are both massive and sporadic. The statistical coverage of the population affected by fascioliasis is between 2,5 and 17 million people. The main symptoms of human infection with a liver fluke are: fever, urticaria, nausea, pain in the right hypochondrium.
The permanent host of the liver fluke is most often domestic animals (cattle, small cattle, horses, rabbits, donkeys and sheep), less often a person becomes infected. The liver fluke can parasitize in the body of wild animals, including kangaroos, beavers, deer, squirrels, etc.
The next liver fluke that parasitizes in the human body is a trematode of the genus opisthorchis, which provokes a disease called opisthorchiasis.
An adult is a flat parasite, the body of which can reach 18 mm in length and 2 mm in width. The anterior end of the body of the worm is pointed, the suckers are located on the peritoneum and on the upper part of the body (oral sucker). The digestive system of the parasite is not closed; there is an excretory canal at the posterior end of the body.
Trematodes have both male and female reproductive organs. For reproduction, one individual is enough to parasitize in the body.
This parasitic invasion is widespread throughout the world, but the palm belongs to Russia. In some regions, the number of infected people reaches 75%, which is explained by food traditions (the use of dried, lightly salted or frozen fish). Cases of opisthorchiasis are registered in Belarus, Kazakhstan, Ukraine, Western European countries, etc.
Another worm, the liver fluke, which is able to parasitize in the human body, is the lanceolate fluke. This fluke causes a disease called dicroceliosis.
The parasite is up to 15 mm long and 5 mm wide. Also, like the rest of the liver flukes, lanceolate flukes are hermaphrodites. They lay eggs that have already developed miracidium. The larva will hatch after it enters the body of the first intermediate host.
It should be noted that dicroceliosis is a rare disease among humans. Medicine knows only isolated cases of parasitic invasion by this liver fluke. The final host of the lanceolate fluke is most often small and large cattle.
What organs are affected by the liver fluke?
The liver fluke affects the human hepatobiliary system. It includes the liver, intrahepatic and extrahepatic bile ducts, and the gallbladder.
The first signs and symptoms of a liver fluke
The first signs of a liver fluke are associated with the incubation period of the development of the parasite.
There are three stages of parasitic invasion:
Symptoms of the liver fluke at the stage of the incubation period
The incubation period can last from 7 days to 2 months. It depends on how many parasites have entered the body. At this time, the infected person does not experience any signs of illness.
Symptoms of the liver fluke in the acute stage
This stage is also called the migration stage.
It is characterized by general toxic and allergic symptoms, including:
Increase in body temperature. The mark on the thermometer can remain at the level of subfebrile numbers, or it can rise to 39-40 ° C. The temperature can rise in waves, or it can be remitting when daily fluctuations exceed 1-2 degrees.
The patient experiences weakness, headaches, general malaise.
Of the allergic reactions, urticaria most often appears, which is accompanied by severe itching. The development of Quincke’s edema is not excluded.
Dyspeptic disorders are characteristic, including: pain in the right hypochondrium, nausea and vomiting.
The liver increases in size, jaundice develops. On palpation, the organ responds with pain.
Pain behind the sternum is a sign of developing myocarditis of an allergic nature. Perhaps an increase in blood pressure, increased heart rate.
In the blood, the number of eosinophils and leukocytes increases.
The acute phase can last several weeks, after which the symptoms of the disease disappear.
Symptoms of a liver fluke in the chronic stage
Chronicization of the parasitic disease occurs 3-6 months after the invasion.
At the same time, symptoms indicating damage to the liver and biliary tract come to the fore:
The patient experiences frequent paroxysmal pain in the right side.
During an exacerbation of the disease, jaundice develops.
The liver remains constantly enlarged in size.
The longer an untreated invasion persists, the worse the prognosis. Perhaps the formation of cirrhosis of the liver, hepatitis, anemia.
Secondary infection is dangerous, which can provoke a liver abscess, purulent cholangitis and cholecystitis.
Medicine knows cases when liver flukes developed in the mammary glands, in the brain, in lung tissue, in the larynx and under the skin. Long-term stress of the immune system causes a person’s susceptibility to diseases of various etiologies.
Ways of infection with a liver fluke
Infection with liver fluke and giant fluke occurs when eating plants (garden and wild) that were watered with water from fresh water, provided that it contained invasive larvae of worms. Infection is possible while drinking unboiled water, when swallowing water while bathing.
Infection with a liver fluke that causes opisthorchiasis occurs when a person eats infected fish that has not undergone high-quality heat treatment.
Infection with a liver fluke of the genus lanceolate fluke occurs when infested ants are accidentally swallowed, for example, while eating berries, meadow herbs, vegetables from the garden, etc.
Thus, the route of infection with the liver fluke is food. That is, in order for any worm – a liver fluke to be able to start parasitizing in the human body, it will need to get into the gastrointestinal tract.
Treatment of a liver fluke
Treatment of the liver fluke consists of two stages. The first stage is preparatory, and the second is aimed at the direct elimination of the parasite from the human body.
The first stage of treatment of the liver fluke
Treatment of this parasitic invasion is carried out in a hospital, although with a satisfactory state of health of the patient, outpatient management of the patient is possible. If the disease is diagnosed in the exacerbation phase, then the patient is transferred to a sparing diet and desensitizing drugs are prescribed to him.
As for the diet, when getting rid of the liver fluke, table No. 5 according to Pevzner is considered optimal. Spicy, smoked and fried dishes are removed from the menu. It involves steaming, boiling and baking foods. After passing the second stage of treatment, the patient is recommended to consume more foods rich in fiber, which will enhance intestinal motility and improve bile discharge.
The second stage – antiparasitic treatment of the liver fluke
Antiparasitic therapy begins after the symptoms of the acute phase of the disease subside. All drugs are prescribed by a doctor in a hospital setting. Choleretic drugs are prescribed for the speedy removal of dead parasites from the human body.
Control diagnostics with fecal analysis and duodenal sounding is carried out 3 months later and another six months after treatment.
Taking antibiotics is necessary in case of development of purulent complications. Surgical intervention with drainage of the liver, bile ducts, etc. is not excluded.
The third stage is the restoration of the body after the treatment of the liver fluke
Since the liver fluke disrupts the functioning of the digestive organs and the functioning of the body as a whole, patients will be required to undergo a rehabilitation period.
It may include the following activities:
Normalization of the gallbladder and liver with the help of a course of choleretic drugs.
Improving the functioning of the liver, its protection and restoration with the help of hepatoprotectors.
Normalization of digestive processes with the help of enzyme preparations.
Improve metabolism with multivitamins.
The earlier the disease is detected, the faster and easier it is to achieve a full recovery. If the parasite infestation is high-intensity, or if a secondary bacterial infection has joined, then the prognosis worsens significantly. Even the death of the patient is not ruled out.
Prevention of the liver fluke
Prevention of the liver fluke is a set of measures that will prevent the development of the disease:
In no case should you drink raw water from reservoirs.
Vegetables, fruits, garden greens, berries must be thoroughly washed before eating.
Avoid eating raw fish.
An important role in the prevention of liver fluke is assigned to public services. They are obliged to prevent pollution of water bodies from the ingress of fecal matter into them, to combat the reproduction of mollusks. No less significant are preventive measures for deworming livestock, as well as conducting sanitary and educational work among the population.
Doctors have the task of timely identification of patients-carriers of the baked fluke and their high-quality treatment. If you suspect a parasitic invasion, you should contact an infectious disease specialist.