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Diphyllobothriasis

Fish Tapeworm


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]
  • The CDC describes the clinical presentation as follows: Migrating spargana cause various symptoms depending on the final location in the host.[outbreaknewstoday.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]
  • 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]
Plethora
  • Image/hk.on.cc The story, accompanied by a plethora of X-rays or related scans, tells of a man who body was overtaken with what appears to be the spargana of a Cestode, or tapeworm parasite.[outbreaknewstoday.com]
Abdominal Tenderness
  • These are important findings in terms of diagnosis. [1,2,3,4,5] Abdominal tenderness This may or may not be demonstrated in the epigastric region and is due to local allergic reaction of the intestine and rarely may be attributed to intestinal obstruction[explainmedicine.com]
  • tenderness Abdominal distention Peritoneal signs See Presentation for more detail.[emedicine.com]
Abdominal Cramps
  • The other symptom was mild abdominal cramping for a period of 1 year. The laboratory examination did not reveal anemia or vitamin B12 deficiency.[ncbi.nlm.nih.gov]
Epigastric Pain
  • Although many carriers are asymptomatic, overt clinical manifestations of diphyllobothriasis can include diarrhea, epigastric pain, nausea and vomiting. There are no reports of anaemia associated with any of the northern species except D. latum.[ncbi.nlm.nih.gov]
Distractibility
  • Despite only mild physical symptoms, the pilot's psychological distress and distraction from knowing about the meters-long tapeworm was significant. Prompt treatment was paramount to resumption of military operations.[ncbi.nlm.nih.gov]
  • DISCUSSION: Despite only mild physical symptoms, the pilot’s psychological distress and distraction from knowing about the meters-long tapeworm was significant. Prompt treatment was paramount to resumption of military operations.[ingentaconnect.com]
Neglect
  • Tapeworm Diphyllobothrium dendriticum (Cestoda)--neglected or emerging human parasite?. PLoS Negl Trop Dis. 2013. 7 (12):e2535. [Medline]. Kuhn JA, Knudsen R, Kristoffersen R, Amundsen PA.[emedicine.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]
Macrocytosis
  • Peripheral smear demonstrating macrocytosis (unless also iron deficient) and hypersegmented polymorphonuclear neutrophils Vitamin B-12 level of less than 150 pmol/L and total serum homocysteine level of more than 13 µmol/L or methylmalonic acid level[emedicine.com]

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.[en.wikipedia.org]
  • 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 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 "10Â mg/kg PO once for both adults and children.[monsterologist.blogspot.com]
  • 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]

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]
  • His research interests focus on the epidemiology and pathogenesis of helminthic diseases.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • 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]
  • […] raw seafood as part of ethnic foods, wider and faster food distribution networks, and, possibly, fish aquaculture, diphyllobothriasis seems to be extending its traditional geography and resurging, particularly with species other than D latum. [5, 6] Pathophysiology[emedicine.com]

Prevention

  • The epidemiology and methods of prevention of diphyllobothriasis are discussed.[ncbi.nlm.nih.gov]
  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.[dpd.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]
  • Preventive public education has been generally inadequate, and the food and restaurant industry has generally been slow to adopt recommendations for freezing of fish. Simple icing of fish is insufficient to prevent infection.[emedicine.com]

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