Ascaridiasi: che cos’è e come si trasmette
Table of Contents
Definizione
L’ascaridiasiè un’ infezione da ascaridi caratterizzata da segni polmonari (migrazione di larve e da disturbi gastrointestinali). La trasmissione avviene per via fecale-orale attraverso l’assunzione di acqua e alimenti contaminati da uova mature. L’ infestazione da ascaridi è diffusa in tutto il mondo, soprattutto nelle regioni a clima caldo-temperato. L’agente eziologico è l’Ascaris lumbricoides,un nematode a sessi separati di dimensioni notevoli. Il verme femmina può essere lungo fino a 30 cm con un diametro di 5 mm. Il maschio ha dimensioni più ridotte.
Eziologia
L’agente patogeno è un nematode,Ascaris lumbricoides.Una volta ingerite, le uova raggiungono l’intestino tenue dove si schiudono lasciando uscire la forma larvale (L3) che, dopo aver perforato la parete intestinale, raggiunge per via ematica il cuore destro e poi i polmoni. Nei capillari degli alveoli le larve si accrescono, infrangono i capillari e cadono negli alveoli polmonari. Risalgono quindi le vie respiratorie fino al retrobocca e, deglutite tornano definitivamente nell’intestino dove diventano adulti. Ogni femmina produce quotidianamente oltre 100.000 uova che vengono eliminate con le feci. Nell’ambiente le uova non sono subito infettanti, ma hanno bisogno di un periodo di maturazione della durata di circa 3-4 settimane.
Epidemiologia
L‘ascaridiasi frequente nel bambino, è estesa nel mondo intero, poiché le uova resistono alle variazioni di temperatura e alla essiccazione. E’ però più frequente nei climi caldi e umidi dove l’igiene è insufficiente e la diffusione può arrivare al 50%.
Quali soni i sintomi dell’ascaridiasi?
Durante la migrazione attraverso i polmoni, si possono osservare sintomi broncopolmonari più o meno marcati. Se numerose larve attraversano insieme i polmoni si può osservare la sindrome diLöffler con :
- Febbre
- Tosse
- Espettorazione mucosa
- Eosinofilia
- Opacità radiografiche fugaci
Più frequentemente l’infestazione provoca:
- Anoressia
- Dolori addominali
- Diarrea
- Prurito anale notturnoparticolarmente doloroso
- Possibilità divolvolo e occlusione intestinaleda una massa di ascaridi
- Raramente penetrazione dell’ascaride nellevie biliari(ittero, ascesso del fegato), nelcanale di Wirsung(pancreatite), nell’appendice(appendicite) nellacavità peritoneale(peritonite).
Manifestazioni allergiche:
- Febbre
- Eruzioni cutanee
- Orticaria
Migrazioni eccezionali:
- Invasioni delle meningi
- Della tiroide
- Della milza
- Della trachea (soffocamento)
- Dell’utero e delle tube
Come si fa la diagnosi dell’ascaridiasi?
Ricerca delle uova. Sono ellittiche e misurano da 30 -40 a 50-60 micron; possiedono a volte una capsula esterna densa e una capsula interna trasparente. Un buon metodo per ricercarle consiste nel mettere un pezzo di nastro adesivo trasparente sulla regione anale ed esaminarlo direttamente al microscopio su un vetrino. Si possono anche ricercare le uova nelle feci. Durante la migrazione polmonare, si possono trovare le uova nell ‘espettorato. Eosinifilia ematica: frequente durante la migrazione dell’ascaride.
Terapia
Tali parassiti si combattono principalmente tramite unacura antibioticama, quando quest’ultima non sortisce gli effetti sperati, l’individuo colpito potrebbe essere costretto a sottoporsi ad un intervento chirurgico. Tra i farmaci raccomandati dall’Organizzazione mondiale della sanità per il trattamento dell’ascaradiasi rientrano: albendazolo, mebendazolo, levamisolo e Pirantel Pamoato.
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