Presentation
A 38-year-old male presented, complaining of passing worms. He had a history of recent travel to Europe and South East Asia. Stools examination revealed typical D. latum eggs. [ncbi.nlm.nih.gov]
A male Taiwanese aged 30 years presented after passing a flat, white noodle-like worm. Strobila examination showed that most proglottids were wider than they were long, with the genital pore located at the posterior edge of the cirrus. [tmu.pure.elsevier.com]
An evaluation of hazards associated with human pathogenic bacteria considers bacteria naturally present in the aquatic environment and those present as a result of contamination with human or animal feces, giving particular attention to hazards associated [books.google.com]
The CDC describes the clinical presentation as follows: Migrating spargana cause various symptoms depending on the final location in the host. [outbreaknewstoday.com]
Entire Body System
- Anemia
This may lead to vitamin B12 deficiency and anemia. Most people who are infected have no symptoms. [nlm.nih.gov]
In one test, nearly half of the ingested vitamin was absorbed by D. latum in otherwise healthy patients, while 80-100% was absorbed by the worm in patients with anemia. It is not known why anemia occurs in some cases but not others. [monsterologist.blogspot.com]
When the infection is long - term patients may have megaloblastic anemia (pernicious anemia) Vitamin B12 deficiency. [ivami.com]
Cardiovascular
- Tachycardia
Symptoms may include: weak muscles numbness or tingling in hands and feet difficulty walking nausea decreased appetite weight loss irritability lack of energy or tiring easily (fatigue) diarrhea smooth and tender tongue increased heart rate (tachycardia [web.archive.org]
[…] range of neurological manifestations ranging from numbness to the fingers and toes, difficulty walking, mood changes, depression, memory loss, disorientation and, in severe cases, dementia. [1,2,3,4,6] Anemic features Pallor, glossitis, dyspnea and tachycardia [explainmedicine.com]
Skin
- Pruritus
Prevalence in the US: ∼ 40 million Primarily children 5–10 years of age Mode of transmission Initial infection: fecal-oral Reinfection: digital-oral after scratching anal region Clinical features Anal pruritus (especially at night) ♀ : vulvovaginitis, [amboss.com]
Neurologic
- Tingling
Symptoms may include: weak muscles numbness or tingling in hands and feet difficulty walking nausea decreased appetite weight loss irritability lack of energy or tiring easily (fatigue) diarrhea smooth and tender tongue increased heart rate (tachycardia [web.archive.org]
The migration in subcutaneous tissues is usually painless, but when spargana settle in the brain or spine a variety of neurological symptoms may occur, including weakness, headache, seizure, and abnormal skin sensations, such as numbness or tingling. [outbreaknewstoday.com]
Workup
However, the following day, before any of the workup was done, the patient passed a 75-cm flat worm. She took it to a laboratory where it was identified as Diphyllobothrium latum species segments. [cfp.ca]
Diagnostic imaging modalities - Not typically required, except as clinically indicated by other aspects of the presentation (eg, obstruction) Capsule endoscopy - Usually performed to evaluate unexplained anemia, with an unexpected discovery of worms See Workup [emedicine.com]
Serum
- Macrocytic Anemia
Leukocytosis and eosinophilia may occur; if the worm is located high enough in the alimentary canal, it may preempt the supply of vitamin B12 or alter its absorption, leading to hyperchromic macrocytic anemia resembling pernicious anemia, although the [medical-dictionary.thefreedictionary.com]
Hemoglobin level and hematocrit low or at the lower end with Mean cell volume above or at the higher end of the reference ranges is indicative of macrocytic anemia. [1,2,3,4] Stool examination for ova Identification of the operculated eggs in the stool [explainmedicine.com]
Treatment
Treatment Upon diagnosis, treatment is quite simple and effective. The standard treatment for diphyllobothriasis, as well as many other tapeworm infections is a single dose of Praziquantel, 5â€"10 mg/kg PO once for both adults and children. [monsterologist.blogspot.com]
Raymondo MLT CLS(M) Treatment Treatment is usually 10 to 25 mg/kg of praziquantel given as a single dose. 4 Stool culture for ova should be negative a week after treatment; occasionally a second dose might be needed. 6 While treatment is generally completed [cfp.ca]
Treatment Upon diagnosis, treatment is quite simple and effective. The standard treatment for diphyllobothriasis, as well as many other tapeworm infections is a single dose of praziquantel, 5–10 mg/kg orally once for both adults and children. [ipfs.io]
Successful treatment with a single oral dose of praziquantel (>10 mg · kg-1) was confirmed by negative stool examination over 60 d posttreatment. [ncbi.nlm.nih.gov]
Treatment is with single dose niclosamide. Synonym(s): Fish tapeworm infection dibothriocepheliasis 1 See also: Diphyllobothrium latum helminthiasis fish tapeworm anaemia vitamin b12 deficiency Reference(s): 1 diphyllobothriasis. (n.d.) [biology-online.org]
Prognosis
Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Diphyllobothriasis from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]
Prognosis Diphyllobothriasis carries an excellent prognosis. D latum is not invasive, and mortality due to diphyllobothriasis is rare. [emedicine.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Globally, new species have been discovered and the etiology of the disease may be changing. Human infections appear to be in decline but it is not clear if the sources of infection are also in decline or if public health awareness has improved. [ncbi.nlm.nih.gov]
(Etiology) Humans are infected by Diphyllobothriasis, when they eat raw or undercooked fish that contains fish tapeworm cysts (especially belonging to the tapeworm Diphyllobothrium latum) When an individual consumes the infected fish, the tapeworm larva [dovemed.com]
Epidemiology
The epidemiology and methods of prevention of diphyllobothriasis are discussed. [ncbi.nlm.nih.gov]
In the epidemiological history of infected patients is the ingestion of raw or marinated fish. Ingestion of marinated salmon or other fish usually present. [ivami.com]
Pathophysiology
Pathophysiology Adult Diphyllobothrium worms range from 1-12 m in length, have proglottids that are wider than their length, and discharge ovoid eggs that measure 60 µm X 40 µm. [thehealthscience.com]
Diphyllobothriasis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Diphyllobothriasis from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History [wikidoc.org]
Hosts begin to release eggs 5–6 weeks after infection.[7] Pathophysiology[edit] Tapeworms develop in the small intestine. Adults attach to the intestinal mucosa. [en.wikipedia.org]
Prevention
The epidemiology and methods of prevention of diphyllobothriasis are discussed. [ncbi.nlm.nih.gov]
Prevention Avoid ingestion of raw freshwater fish. Adequate cooking or freezing of freshwater fish will kill the encysted fish tapeworm larvae. [monsterologist.blogspot.com]
According to WHO guidelines for mass prevention campaigns, the use of praziquantel during lactation is encouraged. [cdc.gov]
Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Diphyllobothriasis history and symptoms On the Web Most recent articles Most cited articles Review articles CME Programs slides Images American [wikidoc.org]
These results suggest that D latum preferentially absorbs vitamin B-12 in the blood, preventing vitamin B-12-IF complexes from reaching receptors in the small bowel. [emedicine.medscape.com]