Giardia in a child of 8 years. Giardiasis treatment in a child with medicines and folk remedies. Treatment regimens. Favorite recipe of parasitologists

Giardia are very small, but can harm a person

In the external environment, Giardia cysts show a very high resistance. At a temperature of +18 °C, they remain viable for more than 40 days. At higher temperatures - a week. In a cold environment, when the temperature is below 0 ° C, they die after 3-4 days.

Giardia is most commonly found in the intestines.

There are 3 main ways of getting giardiasis:

Giardiasis occurs in 2 forms:

1. Acute - develops in babies, as well as in older children, when the immune system is weakened. The disease is accompanied by pronounced symptoms. With proper treatment, it will be possible to get rid of the disease in 5-7 days.

1. Chronic - at this stage, there are no acute symptoms. But constant intoxication of the body provokes a significant deterioration in the general condition of the child.

Why are lamblia dangerous for a child?

Giardia cause serious harm to the health of the child

In addition to the absorption of nutrients, in the process of life Giardia constantly release toxins. This leads to suppression of the immune system and the development of a large number of chronic diseases. The fragile body in infants is especially affected.

Symptoms of children's giardiasis

The insidiousness of giardiasis is that its symptoms are easily confused with signs of other diseases. It is especially difficult to recognize the disease in children who find it difficult to accurately describe their condition.

The acute and chronic stages of the disease manifest themselves in different ways. Consider the features of the symptoms of the course of the disease in children:

1. Symptoms of the acute form, which develops with a weakened immune system or the simultaneous penetration of a large number of giardia cysts into the body:

• loss of appetite;
• sharp weight loss;
• nausea and vomiting;
• severe diarrhea;
• fever, often up to 38 °, but in some cases up to 39 °, it lasts up to 10 days, without being accompanied by other symptoms of a cold;
• bloating;
• fever;
• choking cough;
• stomach ache;
• pale skin;
• allergies - rashes appear that look like hives;
• bruxism - teeth grinding during sleep;
• weakness and irritability;
• excessive capriciousness.

Excessive capriciousness is a symptom of Giardia infection

1. Symptoms of the chronic form of the disease:

• constant problems with digestion - diarrhea alternates with constipation;
• dysbacteriosis;
• avitaminosis;
• weight loss, in advanced cases comes to anorexia;
• frequent headaches;
• malaise;
• irritability and moodiness;
• emotional instability;
• a yellow coating forms on the tongue;
• flatulence;
• dermatitis.

When such symptoms appear, the possibility of infection with Giardia should be excluded. It is especially important to do this when the baby's health periodically deteriorates without objective reasons.

Tests for Giardia in a child - how to pass?

The following tests will help determine Giardia:

Blood on Giardia is taken from a vein. The analysis should be done on an empty stomach in the morning, before breakfast. A child of any age can donate blood for research.

1. Coprological analysis- detection of cysts in the stool. To carry it out, you need to select a little stool from the child in a sterile jar in the morning. In 3-4 hours, it is desirable to deliver them to the laboratory, where specialists will study the material under a microscope.

The accuracy of the analysis is 60–70%. The reason for this is that even in the presence of Giardia, their cysts do not always end up in the feces. To obtain an objective result, the analysis should be repeated 4–5 times, observing a weekly interval.

1. Duodenal analysis- involves the study of bile for the presence of cysts. Guarantees high accuracy, but is prescribed only for children over 10 years old. The procedure for sampling bile by probing at an earlier age is not carried out.

How to treat Giardia in children

A well-chosen course of treatment will help get rid of Giardia. The treatment regimen for giardiasis in children provides for a phased therapy, designed for 3 stages:

Polysorb enterosorbent is well suited for cleansing the body.

Pharmacological preparations, as well as folk recipes, will help to cure Giardia. Consider the features of the reception of different means.

Medical preparations

Tablets and suspensions intended for the treatment of giardiasis in children:

1. Nemozol- available in the form of tablets or suspensions. Contains Albendazole. An approximate dose is 10 mg of the drug per 1 kg of body weight for 5-7 days. Side effects may include fever, nausea, and weakness. Contraindications - liver disease, problems with the retina, intolerance to the components. Price - from 180 rubles.
2. - antimicrobial tablets containing Nifuratel. Assigned for 7-10 days to children only older than 2 years. The daily dose should not exceed 0.4 g, it is calculated as follows - for 1 kg of weight 0.15 g of the drug. Tablets are drunk twice a day only after meals. Contraindications - hypersensitivity, neurological disorders, kidney disease. Side effects are rarely diagnosed. Nausea, dizziness, weakness are possible. Price - from 860 rubles.

Flamin - 30 tablets

Read more about tablets for worms in children.

Folk remedies

For the treatment of children from giardiasis, you can use folk remedies. They are prepared on the basis of natural ingredients, therefore they are more harmless than pharmacological drugs. Consider effective recipes:

1. horseradish tincture- Cut 2-3 horseradish roots into small pieces and place in a liter jar. Pour the crushed root with cold boiled water, cover tightly with a lid. When the composition is infused for 3 days at room temperature, it should be filtered and mixed with honey in equal proportions. Keep for 3 more days.

Babies up to a year old take 0.5 teaspoon, children under 10 years old - 1 dessert spoon, starting from 11 years old - a tablespoon. Drink 20 minutes before meals three times a day for 10 days. A week later, repeat the course of treatment.

1. Cucumber tincture- chop 200 g of ripe cucumbers that already have seeds. Place in an enameled container and pour boiling water. The remedy should be infused for 2 hours. Then it is filtered and stored in the refrigerator. During the day, the child should drink 0.5 liters of infusion, using it throughout the day.
2. - grind 100 g of peeled seeds in a mortar, add 25 g of honey and water each. Give the resulting mixture to the child in the morning on an empty stomach in small portions. He must eat everything in an hour.

For the preparation of folk recipes, shoots, leaves and aspen bark, dandelion root, mint, birch buds, celandine, centaury and other plants are still used. Before using a folk recipe, make sure that the child is not allergic to the ingredients.

Safe treatment always takes place under the supervision of a doctor. Giardiasis is a serious disease, so self-medication is contraindicated.

Diet for giardiasis

The basis of the child's diet should be cereals, dried fruits, bran, vegetable oils. Fruits can be given in a baked form. From drinks it is worth giving preference to sour juices, kefir. For the duration of the diet, children should not be given fatty and fried foods, even in small quantities.

Dietary nutrition will speed up the healing process. It should be followed throughout all stages of treatment: from preparatory to restorative.

What does Dr. Komarovsky say?

An interesting point of view on the question of whether giardiasis is so terrible is expressed by Dr. Evgeny Komarovsky. He hurries to reassure his parents and claims that you should first make sure that the disease is present, and then proceed to treatment, avoiding toxic drugs. More details of his recommendations are presented in the video.

Disease prevention

To minimize the risk of developing giardiasis in children, parents should monitor compliance with preventive measures:

Compliance with these rules reduces the risk of Giardia infection by 60%.

Wash vegetables and fruits thoroughly before giving them to your child.

• Sources of infection
• Symptoms of giardiasis
• Tests for the detection of Giardia
• Treatment of giardiasis
• Folk remedies for lamblia
• Doctors' opinions
• Prevention of giardiasis

Ways of infection with Giardia :

Symptoms of Giardia infection in children under 1 year of age and older

A baby affected by lamblia is quite difficult to tolerate this disease. How does this disease manifest itself in children under one year old and older children? The table below shows the signs of giardiasis in children under one year old and older children.

Table number 1. How to identify Giardia in children?

How to identify Giardia in a child: tests and examinations

Table number 2. What medical examinations will help identify Giardia in children?

The accuracy of one study is 50-80%. Therefore, it is advisable to take a stool test several times.

How to get rid of giardia 100% - treatment of giardiasis in children

Giardiasis is considered a hard-to-treat disease. But, doctors have found a way to successfully cope with this disease.

Effective drugs for removing Giardia from the body today are :

• Metronidazole.
• Furazolidone.
• Albendazole.
• Macmirror.
• Tinidazole.

Important!

The dosage of drugs is determined only by the doctor. It depends on age, weight and type of disease. Self-activity in resolving this issue by parents should be excluded, since the presented funds in case of an overdose can harm the baby.

How does the patient's well-being change during treatment for lamblia?

Effective folk remedies for Giardia for children

It should be noted right away that it is impossible to cure a child with only folk remedies for lambiosis. The alternative method can act as an additional treatment, and not the main one. Moreover, it is better to consult a doctor about this or that method of folk treatment that you have read. Nevertheless, among the people there are still effective methods of dealing with this disease.

Top 5 best folk recipes for giardiasis

cucumber drink

Fresh green cucumbers cut into pieces and pour boiling water. Leave to stand for a couple of hours. After expressing the liquid and giving the baby a drink during the day, at least 0.5 liters per day.

Aspen tincture

Take leaves, you can kidneys and even bark, pour boiling water and boil for 30 minutes on medium gas. After let it brew and give the baby 2 times a day for half a cup. The course lasts 14 days.

Dandelion root cocktail

Finely chopped roots are boiled for 15 minutes over low heat, after straining, give the solution to the baby 2 times a day. Drink calculation - 1 tsp. per 10 kg of the child's weight. By the way, such a decoction can be stored in the refrigerator for 2 days.

Bergamot oil

One drop of oil is dripped onto refined sugar and given to the baby on an empty stomach. The course of treatment is 7 days maximum.

Celandine tincture

The grass is crushed and poured with boiling water in a thermos. The decoction is insisted for two hours. After 1 st. l. give the baby twice a day. The course lasts 5 days. After a 2-day break, the course can be repeated again, but no more than 3 times.

Doctors advise after the end of the treatment period to use medicinal herbs that contribute to the improvement of the gastrointestinal tract. After the transfer of the disease, the child should be examined again, and anti-relapse therapy may be prescribed.

Opinions of doctors about the treatment of giardiasis

Giardiasis is a rather formidable disease, but today it is possible to cure this ailment, although this process is lengthy and can last from 10 to 17 days. There are always disputes about the methods of studying this disease, because there are a lot of diagnostic procedures, and in fact it is not so easy to detect Giardia.

Doctor Komarovsky about giardiasis:

Doctor Komarovsky about the prevention of giardiasis:

No one is immune from the fact that after 2 hours of antibiotic treatment, Giardia will not enter the body again and will not begin to multiply. Therefore, it is necessary to observe the culture of communication, hygiene and protect yourself and loved ones from external attacks, and not live in a constant struggle with cysts. Therefore, giardiasis, first of all, is the level of compliance with hygiene standards, and not an epidemic.

Also Dr. Komarovsky answers the most burning question people have about Giardia:

Is it worth treating giardiasis when cysts are carried? Some say that it is unreasonable to treat a person in the absence of complaints (that is, to actually treat the tests), others believe that many diseases are associated with Giardia, so it is necessary to treat. By the way, one of the hypotheses suggests that the presence of Giardia contributes to the development and severe course of allergic dermatitis (the very one that our people call diathesis), therefore, if there are signs of dermatitis, an examination for the presence of Giardia (well, treatment if detected) is mandatory (this I do not claim, but the authors of the hypothesis). Treatment of giardiasis is not difficult, as there are many effective drugs.

Candidate of Medical Sciences T. Yu. Bandurin:

Examination for giardiasis is indicated for the following conditions: the presence of diseases of the digestive tract, the tendency to their chronic course with frequent but moderate exacerbations; neurocirculatory dysfunction, especially in combination with gastrointestinal disorders; persistent blood eosinophilia; allergic manifestations.

There is one "natural" obstacle that makes it difficult to diagnose giardiasis - "the phenomenon of intermittent cystic discharge." A child infected with giardiasis does not secrete cysts every day - the interval in the allocation of cysts is 8-14 days, for laboratory confirmation of the diagnosis, some persistence should be shown. Repeated repeated microscopy of feces is recommended.

It is known that the creation of unfavorable conditions promotes cystation and the release of cysts. It was noted that when prescribing choleretic and antigiardiac drugs, cysts are found much more often.

Various preparations are used as means of "provocation", taking into account the age of the child, the severity of clinical manifestations and the presence of concomitant indications: infusion of corn stigmas, homeopathic preparation cholevit, macmiror, furazolidone, metronidazole. In a single examination, giardia cysts were found in 92.5% of children in whom giardiasis was clinically suspected. Thus, the implementation of simple rules can improve the diagnosis of giardiasis.

How to prevent giardia infection: prevention of giardiasis in children

Than for a long period to see how the baby suffers and suffers from giardiasis, it is better to prevent this disease. It is obvious that it is impossible to limit the crumbs from the outside world, as well as to protect it from the entry of cysts into the body by 100%. But, foresight does not hurt.

To reduce the risk of Giardia entering the baby's body, the following rules will help:

• Wash fruits and vegetables before eating.
• G give only boiled water to the miners.
• Any meat, fish can be heat treated.
• But, the most important thing is teach your baby to hygiene from a young age. Up to three years, all responsibility falls on the shoulders of parents, because they must carefully monitor the baby (what he eats, takes in his mouth, wash his hands after the street, cats and dogs). But already from the age of three, you can actively introduce an understanding of cleanliness into the crumbs, because he already understands you perfectly. Do not allow water to be swallowed in rivers, reservoirs, etc. Teach him to be careful.

Giardia in children is common and is a serious problem. The term "giardiasis" means protozoal invasion, which occurs in the body mainly with damage to the structures of the small intestine. The disease varies from subclinical forms to severe types of the disease, when Giardia affects not only the intestines, but also the liver tissues.

That is why in the international classification they use a different name - giardiasis.

The disease is spread across all continents. The highest degree of invasion falls on organized children's groups - over 35%. Giardia in a child and an adult can occur equally often.

Depending on what phenomena and signs form the clinical picture, the following forms of giardiasis in adult patients are distinguished:

• intestinal;
• hepatobiliary;
• pancreatic;
• asthenoneurotic nature;
• allergic;
• anemic;
• mixed.

Depending on the presence of abnormal manifestations, these types of diseases are distinguished.

1. Pathology without clinical symptoms is latent.
2. Pathology with clinical symptoms is manifest.

In 25%, only giardia carriers are observed. In this case, the pathological process, as such, is absent. In 50% of cases, subclinical forms of the disease are recorded. The remaining 25% are assigned to the manifest type of the disease.

As in the case of the "adult" classification, all forms of the disease are divided into two categories.

1. Giardia carriers (the complete absence of symptoms, but the person is actively spreading the pathogen into the environment).
2. A disease with pronounced symptoms (there are also intestinal and hepatic types of the disease).

From the standpoint of the symptomatic picture and the nature of the course of the disease, the following varieties of giardiasis are distinguished:

• painful;
• dyspeptic;
• allergic;
• dermatological;
• neurotic with asthenic syndrome;
• intoxication;
• mixed.

Giardia - special microorganisms

Giardia are single-celled life forms. Their body is symmetrical, rounded on one side and pointed on the opposite. Giardia have 4 flagella, through which they move in the body. The unicellular microorganism can also attach itself to any surface using a suction disk. Lamblia are in constant motion. The fixation process is a forced measure that they rarely resort to.

More about the development cycle

The causative agents of giardiasis can live almost everywhere - in water, in the ground, even in the air. The main intestinalis is the human gastrointestinal tract.

It is enough to swallow a dozen giardia and at the same time have an underestimated level of acidity of gastric juice in order to become infected with giardiasis.

The main ways of infection:

• water;
• contact household;
• food.

Many parents not only do not know how to treat Giardia in children, but do not even think about how relevant medical intervention is in this situation. It is important to understand what the essence of the pathogenic effect of lamblia on the body is.

Here are the main influencing factors.

Giardia in children provoke different symptoms. In many ways, the appearance of certain symptoms depends on the circumstances: the mass nature of the invasive process, the form of pathology, the individual characteristics of the patient, age, the basic properties of the immune system, the presence of concomitant pathologies of the digestive tract.

General symptoms

Common symptoms indicating the presence of active Giardia in the body:

• pain in the abdomen of an intense paroxysmal nature;
• nausea;
• gagging;
• lack of appetite;
• bloating;
• abnormally large amounts of intestinal gas.

In the smallest patients, the clinical picture can be very different. Giardiasis in children causes more unpleasant symptoms, and treatment should be started as early as possible.

The main clinical signs are:

• severe pain syndrome;
• total dysbacteriosis, which cannot be cured by “standard” methods”;
• chronic loose stools, often "foamy" in nature;
• complete loss of appetite;
• exhaustion;
• a sharp decrease in cognitive qualities;
• irritability;
• daytime sleep may be completely absent, and night rest is interrupted by constant whims;
• headache;
• dizziness.

Over time, a variety of allergic skin rashes can occur. The patient is susceptible to any form of hypersensitivity: from minor urticaria to chronic rhinitis, accompanied by total airway edema.

Nonspecific symptoms, often blurred clinical picture, many cases of asymptomatic course of the disease, as well as the banal carriage of the disease cause quite a few problems in the modern diagnosis of giardiasis. Sometimes the appearance of certain symptoms is incorrectly interpreted by diagnosticians.

As a result, children and adults can receive treatment from other specialists. Pulmonologists, dermatologists, allergists, neurologists or gastroenterologists will try to eliminate the completely different problem that is relevant at this particular moment.

In order to finally establish the diagnosis of "giardiasis", a procedure for determining antigens in feces (PCR technology) is carried out. The ELISA procedure in blood serum is also relevant. In some cases, they resort to the study of biopsy material obtained during the conduct of endoscopic examination.

Treatment of giardiasis in traditional ways

Diet

The patient is prescribed an optimal diet. The goal is to create the most unfavorable conditions in the digestive tract, preventing the activity of lamblia. The basis of the diet is cereals, bran, fresh vegetables, fruits, berries, vegetable oil. From foods rich in carbohydrates, you need to refuse. At least during active treatment.

Such a “format” of impact on the body is possible only in the case of interaction with adult patients or children of the older group.

Treatment usually consists of two courses. At the final stage, where the patient's body should begin to actively recover, drugs of choice from categories such as multivitamin complexes, enterosorbents, enzymes, adaptogens of plant origin, immunostimulants, phytotherapeutic agents are prescribed.

Folk remedies for lamblia

Alternative methods cannot replace medical treatment from a competent doctor, but can be used as ancillary methods.

1. Fresh plantain leaves are crushed into a pulp and mixed with an equal amount of honey. The composition is taken 1 tablespoon three times a day immediately before meals.
2. In milk (200 ml) add 1 crushed clove of garlic and drink.
3. 1 tablespoon of bearberry leaves is poured with boiling water (200 ml). The infusion is left for 30 minutes. During the day, the patient should drink the entire glass.

100 grams of pumpkin seeds should be ground to a homogeneous mass. About 25-35 grams of fresh linden honey is added to the resulting flour. In order for the mixture to acquire the desired consistency, a little water is added there (no more than 40 ml).

Everything is thoroughly mixed. The child is given the mixture on an empty stomach. He must eat everything. Then carry out a cleansing enema. It is advisable to carry out the procedure several times with an interval of 2-3 days.

Forecast and prevention of giardiasis in adults and children

The effectiveness of therapy for giardiasis depends on the stage and form of the disease, as well as on when the doctor was asked for help and how closely all the recommendations of the specialist were followed. Relapses can occur at any stage of life in all patients. No one has any specific immunity or protection.

Thus, Giardia in children and adults is a really serious disease that requires prompt and competent treatment. At the same time, doctors do not recommend relying on folk recipes, but are advised to seek qualified help at the first sign. This will prevent the development of complications.

Giardia can also settle in the small intestine, causing the onset and development of a disease called giardiasis.

What is lamblia?

Treatment regimen

Treatment of Giardia in children involves the use of a number of stages:

Treatment of lamblia in children according to Komarovsky

Dr. Komarovsky's approach to the treatment of this disease is somewhat different.

Furazolidone drug: how to take it?

Komarovsky believes that this drug should be given preference. The tool is quite old, reliable and proven. It is used not only in the treatment of giardiasis, but also in many other intestinal disorders.

According to the doctor, it is necessary to prescribe pills based on the body weight of the child. For every kilogram of weight, there should be 10 mg of this substance in active form. The course of taking the drug is 10 days. The multiplicity of reception is three times a day.

Children may not get sick, but be healthy carriers. Some experts believe that the treatment of carriage is possible with the help of diet.

In general, food should be fractional. Eat often, but little by little. Water with gas and sweet juices are completely excluded from the diet. According to Dr. Komarovsky, during treatment, the child must consume a large amount of fluid.

Treatment should begin immediately! Protect yourself and your loved ones!

Folk remedies for the treatment of giardiasis

Folk remedies against giardiasis:

• It will help with the disease of burnet in the form of a decoction. Grass roots are taken in the amount of two spoons and boiled water is poured in the amount of two glasses. After that, the mixture is aged on low heat with an exposure of 1/3 hour. Within 60 minutes, the composition is infused. The entire volume is divided into 4 parts and drunk during the day.
• Dandelion roots are a good remedy. They are also used as a decoction. A spoonful of medicinal raw materials is poured with boiling water in the amount of one glass and placed for a third of an hour in a water bath. The remedy is taken in equal parts during the day.
• In the same way, a decoction is prepared, where leaves and bark of an aspen tree act as medicinal raw materials. Take a decoction before meals.
• An excellent remedy is plantain in the form of leaves on honey. The proportions for cooking are the same. Reception is long, within a month. It is enough to take a teaspoon before meals.
• An old proven remedy is pumpkin seeds. They must be taken in an amount of 100 g and grind. To them you need to add honey and water, 25 ml each. The mixture is taken in full within an hour.

We have 2 dogs and a cat at home, we regularly carry out preventive measures against infection with helminths. We really like the remedy, because it is completely natural, and this is important for prevention."

How to accurately determine whether a child is infected with Giardia?

The research material is:

• blood;

Detection of Giardia in feces

The study of feces involves the use of the following methods:

After 2 weeks from the moment of infection, it is possible to detect antibodies in the child's blood. The accuracy of the method depends on how the laboratory is equipped and what qualifications its employees have.

It is possible to confirm the diagnosis with an accuracy of 100% by examining the gastric contents obtained by duodenal sounding. However, due to the complexity of the procedure in technical terms, for children, this method is not practiced.

A very effective diagnostic method is PCR, in which Giardia DNA is detected in biological substrates.

throat swab

Often, the disease can cause a child to develop a painful cough. The reason for it is an allergic reaction that occurs due to infection with Giardia.

Or from flagellated protozoa, it can last 3 months or even longer. It is always accompanied by sputum production.

Infection: step by step

Transfer factors can be:

• water from reservoirs and from the tap;
• use of shared toys;
• vegetables, fruits, greens in assortment;
• pets;
• sandbox play;
• having a bad habit of putting your hands in your mouth.

Once in the body, Giardia reach the small intestine, finding there comfortable conditions for their existence and development.

Failure to comply with elementary hygiene standards and rules contributes to infection with them.

The entry of protozoa into the body does not mean the mandatory development of the disease. If the body's defenses are at a fairly high level, it simply will not allow them to develop. The amount of lamblia that has entered the body also matters.

1. The child is lethargic and loses weight.
2. Severe diarrhea that is prolonged. The stool has an extremely unpleasant odor. Due to the large amount of undigested fats, it is very poorly washed off.
3. The temperature can rise up to 38 degrees.
4. Pain in the umbilical region.
5. Skin itching.
6. Dyspeptic phenomena in the form of nausea and vomiting.

Rice. 1. Giardia under a microscope: vegetative form (left photo) and cyst form (right photo).

The prevalence of giardiasis among children

It is believed that about 20% of the population and about 25% of children suffer from giardiasis on the globe. In the Russian Federation, about 130 thousand cases of the disease are registered annually, which is 95.0 per 100 thousand. The incidence of giardiasis in children is 3.7 times higher than that in adults and is 350.0 per 100 thousand of the population. Among all cases of giardiasis, children under 14 years old make up about 70%. Among them, up to 70% are children 3-4 years old. Boys get sick 2-3 times more often than girls.

Young children are most susceptible to the disease.

Rice. 2. Up to 200 million cases of giardiasis per year are registered in Africa, Asia and Latin America.

Rice. 3. Giardiasis in Africa, Asia, South America is the cause of chronic diarrhea leading to malnutrition, immunosuppression and disorders of the nervous system.

Epidemiology

In institutions where preschool children stay, as well as in families, Giardia is transmitted through the dirty hands of parents, relatives, staff and the children themselves, toys, furniture, carpets, doorknobs, pots and toiletries. The habit of keeping fingers in the mouth, biting nails, pencils and pens contributes to the spread of infection.

The factors for the spread of giardiasis are:

• unfiltered water (from open reservoirs and pools),
• soil contaminated or fertilized by human feces,
• poorly washed greens grown on soil fertilized with human feces,
• dishes that are not subjected to heat treatment (for example, salads, puddings, etc.).

The incidence of giardiasis in children increases in the warm season - in spring, summer and autumn.

Low sanitary culture and non-compliance with basic hygiene rules contribute to the spread of giardiasis among children and adults.

Rice. 4. The most common outbreaks of giardiasis are waterborne.

Rice. 5. The water of open reservoirs and pools is a factor in the transmission of infection in children.

Rice. 6. The habit of keeping fingers in the mouth, biting nails, pencils and pens contributes to the spread of infection.

Giardia - causative agents of giardiasis

Rice. 7. Giardia are pear-shaped, 4 pairs of flagella, 2 nuclei. The axial rod divides the cell into two parts.

Rice. 8. With the help of a suction disk, Giardia attaches to the epithelial cells of the villi of the small intestine.

Rice. 9. Giardia move with the help of 4 pairs of flagella.

Rice. 10. Giardia cysts are round in shape, have 2 nuclei (immature forms) and 4 nuclei (mature forms), a thick outer shell, as if detached from the cell. Sufficiently stable in the environment.

Giardia life cycle

How does giardiasis develop in a child

Giardiasis in children manifests itself in the form of dyspepsia, pain syndrome, astheno-neurotic reactions and allergies. In 50% of cases, giardiasis manifests itself simultaneously with dyspeptic, pain and astheno-neurotic syndromes.

Pain (in 81% of cases) and dyspepsia (in 77% of cases) are leaders in the clinical picture of the disease. Asthenoneurotic syndrome develops in 64% of cases, and allergy in 32%.

Giardiasis in children can be secretive, asymptomatic or have a manifest course. The disease manifests itself in the intestinal form, but extraintestinal forms of the disease are sometimes recorded.

Sometimes giardiasis in children occurs in an acute form according to the type. Vomiting, diarrhea and fever are the main symptoms of this form of giardiasis. There is dehydration and rapid weight loss.

Giardiasis proceeds in stages, has an incubation period, a period of manifest manifestations, a period of chronicity and convalescence (recovery). Intestinal manifestations have an undulating course, and the symptoms of intoxication and allergic manifestations are constantly increasing.

Children and adults are at high risk of reinfection.

Rice. 13. Giardia (photo taken with a scanning microscope).

Intestinal lesion

Symptoms of giardiasis in children at different ages manifest themselves in different ways:

• In children 2-3 years old, dyspeptic and allergy symptoms come to the fore. Asthenoneurotic syndrome is extremely rare.
• In children aged 4-7 years, dyspeptic disorders also come to the fore, pain is recorded in 70% of cases, reactive pancreatitis is recorded in half of the children of this age, and pathology of the gastroduodenal zone develops in 38% of cases.
• In children 8-12 years old, biliary dyskinesia joins the above symptoms. Reactive pancreatitis (70%) is more often recorded. The pathology of the gastroduodenal zone is dominant.
• In children aged 13-15 years, against the background of dyspeptic disorders, the leading place is occupied by pain syndrome.

Symptoms of giardiasis in children under one year old

With giardiasis in children under one year old, there is bloating and difficulty in passing gases. Fecal matter is frothy and has a sour odor. In the feces, abundant mucus and "white lumps" of bile salts. As a result of constant irritation with liquid sour stools, swelling and redness appear around the anus. The child screams, worries, pulls his legs. Then there is an alternation of constipation and diarrhea. The stool has a fetid odor, splattering and frothy. The putrefactive microflora in the feces indicates the development of dysbacteriosis. Despite diarrhea, children often develop normally and gain weight.

Disorders in the work of other digestive organs

• With giardia intoxication, the liver increases. Its edge protrudes from under the costal arch from 2 to 4 cm, elastic and painless. By the end of 5 - 7 days, the size of the liver is normalized.
• Biliary dyskinesia (insufficient or excessive flow of bile) with giardiasis is reflex in nature.
• With the development of inflammation in the duodenum, the pressure in the main pancreatic duct increases. Increased activity of proteolytic enzymes leads to inflammation of the organ.
• Indigestion is functional in nature.

Rice. 14. Giardia under a microscope.

Intoxication syndrome

Rice. 15. Intoxication is a characteristic sign of an infectious disease.

Astheno-neurotic syndrome

In 50% of cases in children with giardiasis, three main clinical syndromes are determined simultaneously: dyspeptic, pain and asthenoneurotic.

Rice. 16. Headaches and tearfulness are symptoms of astheno-neurotic syndrome.

Rice. 17. The "marble" pattern of the skin indicates the reaction of the autonomic nervous system to the development of the infectious process.

Allergy

Allergic reactions in children appear regardless of the severity and severity of the infectious process. This is confirmed by an increase in the level of IgE and IgM immunoglobulins, as well as eosinophils in the patient's blood. Skin lesions in the form of atopic dermatitis are most often recorded with giardiasis (70% of cases), less often with enterobiasis (16% of cases) and ascariasis (3% of cases). In children under one year old, allergic manifestations are very diverse - from an itchy rash to eczematous lesions.

Rice. 18. Atopic dermatitis can be a manifestation of giardiasis in children.

Skin lesion

In chronic forms of giardiasis in children and adults, the skin is often affected:

• It is manifested by pallor of the skin, especially the face, with normal hemoglobin numbers, which is probably due to spasm of blood vessels.
• In the first years of the disease, uneven skin coloration is noted.
• In children and adolescents, the red border of the lips of varying severity is affected. Peeling and dryness are noted, in severe cases - cheilitis (inflammation of the mucous membrane and red border). With cheilitis, cracks, seizures and peeling of the area around the mouth appear.
• Hair becomes thinner, their growth slows down, they acquire a different color.

Rice. 19. Cheilitis often occurs in children and adolescents with giardiasis.

Immunity in giardiasis

During the period of the disease, cellular and humoral immunity develops in the patient's body. The immune system is not strong. Remains after the disease up to 6 months, in some cases - longer. In individuals with IgA immunoglobulin deficiency, the disease becomes persistent.

Diagnosis of giardiasis in children

The absence of pathogomonic symptoms greatly complicates the diagnosis of giardiasis. Subject to examination:

• children with diseases of the gastrointestinal tract, prone to chronic course, moderately severe frequent exacerbations;
• children with diseases of the gastrointestinal tract and neurocirculatory dysfunction;
• children with diseases of the gastrointestinal tract and persistent eosinophilia;
• children with diseases of the gastrointestinal tract and allergic reactions.

Immunological methods

• insufficient study of the pathogenic properties of lamblia;
• not all children have antibodies (antibodies are rarely found in children with lymphatic-hypoplastic diathesis);
• antibodies may not be detected in children with ineffective humoral defense mechanisms, in which giardiasis often takes a protracted course.

The diagnosis of giardiasis is based on the detection of vegetative forms of giardia in the duodenal contents or cysts in liquid or formed feces.

Detection of cystic and precystic forms of Giardia in feces is carried out using microscopy of an unstained (native) smear, microscopy of a stained smear with Lugol's solution, enrichment methods followed by microscopy. Precistic forms are found in liquid, unformed feces.

Difficulties in applying microscopic examination:

• Outside the body, cysts “shrink”, their shell becomes uneven and merges with detritus, therefore, warm feces are needed for research, which parents cannot always collect from a child at the right time, so preservative solutions are used.

Rice. 23. Damaged villi of the intestinal epithelium in giardiasis (studies of biopsy material).