The skin may have urticarial rashes, urticaria, traces of scratching. Palpation of the abdomen reveals pain in the epigastrium, characteristic of gastric localization, rumbling, diffuse sensitivity with signs of the intestinal form. Sometimes symptoms of an acute abdomen are determined. Mandatory visual assessment of vomit, feces. Laboratory research . In a general clinical blood test, 30% of patients (more often with symptoms of stomach damage) show leukocytosis and eosinophilia. There is an increase in the level of total Ig E, a transient increase in the activity of ALT and AST.
With inflammation of the gallbladder, the level of alkaline phosphatase, total and direct bilirubin increases, with pancreatitis there are high numbers of amylase, the level of urine diastase. In the coprogram - creatorrhea, steatorrhea, leukocytes, erythrocytes. Identification of infectious agents. Microscopy of feces, vomiting to confirm anisakiasis is uninformative.
The diagnostic level of sIgE in plasma is reached only by 4-6 weeks of infection. Highly specific basophil transformation test with colchicine. simplex extract; skin prick tests are used. With histological materials, a PCR study is being carried out, and the possibility of using immune blotting is being studied.
Instrumental Methods. Chest x-ray is essential for differential diagnosis of allergic symptoms; in a study using barium, thread-like filling defects, swelling of colchicine membrane of the stomach, and narrowing of the intestinal lumen are revealed.
Gloperba pills - segmental edema of the intestinal wall with proximal dilatation without complete intraluminal occlusion, ascites; according to EFGDS - point erosion, manifestations, inffiltration, swelling of the mucosa, anisakid larvae.
Differential diagnosis is carried out with other helminthic invasions, especially nematodes, but since their symptoms are similar, the main role is given to laboratory and instrumental research.
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Salmonellosis always proceeds with fever, characteristic abundant stools in the form of swamp mud. Colchicine pills poisoning has a rapid onset with repeated vomiting, loose stools, temperature reaction of the body, and rapid dehydration. In cholera, first there is a breakdown of the stool, then symptoms of dysfunction of the stomach, stools resemble rice water.
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Patients can only receive outpatient treatment if they are mild or asymptomatic. A general regimen is prescribed, a diet with mechanical sparing - coarse fiber, alcohol, fried, fatty foods, seasonings, marinades are excluded. It is recommended to increase the amount of liquid consumed, preferably boiled water.
Since the larvae in the human body do not live long, the main importance is attached to the prevention of complications of parasitic invasion. There are data on the effectiveness of some essential oils (chamomile, thyme, peppermint), wood creosote in animal models. To date, the treatment of anisakiasis is carried out by the following methods:
Patients with intense abdominal pain may be hospitalized for differential diagnosis with surgical Colchicine pathology; such patients are forbidden to take water and food for the period of examination.
Etiotropic therapy. In fact, not developed, the most effective drugs were albendazole, mebendazole, thiabendazole, used in short courses. Modern studies have shown that the effectiveness of albendazole and analogues depends on the pH of gastric juice, the more acidic the environment, the worse the drug dissolves and the less larvocidal effect it has. Extraction of larvae is possible during CT examination using gastrografin. Pathogenetic treatment.
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Justified the use of detoxification, desensitizing therapy with infusion of antihistamines, corticosteroids. In some cases, oral administration of desloratadine with prednisolone led to a complete cure without the use of anthelmintic drugs. Symptomatic therapy.