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Fasciolopsiasis

Fasciolopsiases

Fasciolopsiasis is a parasitic infection caused by Fasciolopsis buski and is considered to be most prevalent in countries of Southeast Asia. The clinical presentation depends on the severity of infection, ranging from asymptomatic to life-threatening intestinal inflammation and bleeding. The diagnosis rests on the ability to detect F. buski eggs in stool through microbiological studies, but a high index of suspicion is necessary.


Presentation

Fasciolopsiasis, denoting an intestinal infection by the trematode parasite Fasciolopsis buski, is regarded as a rare clinical entity in medical practice, but many reports have emphasized its frequent misdiagnosis and rather high prevalence rates [1] [2]. Studies show that between 25-50% of children harbor this parasite in countries such as China and Thailand [1]. F. buski lives in two hosts - humans and pigs, and it enters the human body after ingestion of contaminated food [3] [4]. Raw freshwater and aquatic plants (water chestnut, bamboo, lotus, water caltrops, hyacinth, etc.) are the principal sources of F. buski, but direct contact with infected pigs is also a potential mode of transmission [3] [5]. Signs and symptoms seem to correlate directly with the severity of infection [4] [6]. Milder cases are usually asymptomatic, whereas a range of gastrointestinal complaints - abdominal pain, nausea, vomiting, and diarrhea, may be seen in patients who ingest a large number of eggs [4] [5] [6] [7]. In addition, fever, edema (principally of the face and lower extremities), often as a result of an allergic reaction, and headaches are common symptoms [5] [6]. When the patients are suffering from a severe infestation, the gastrointestinal tract can be severely damaged due to erosions, ulceration and severe inflammation that could result in bleeding and become life-threatening [5] [6]. Furthermore, altered consciousness and multiorgan failure, although rare, have been reported [5]. For this reason, an early diagnosis is pivotal.

Malnutrition
  • Fasciolopsiasis is aggravated by social and economic factors such as poverty, malnutrition, an explosively growing free-food market, a lack of sufficient food inspection and sanitation, other helminthiases, and declining economic conditions.[ncbi.nlm.nih.gov]
  • Protein-energy malnutrition (PEM) and tuberculosis were well-associated comorbid conditions in this study. Polyparasitism was an important finding, Hymenolepis nana being the most common associated parasite.[ncbi.nlm.nih.gov]
  • All these factors contribute to vicious cycle of protein-energy malnutrition (PEM). F. buski is a well-known endemic parasite of Southeast Asia region.[ijmm.org]
  • Anemia, edema, retardation of growth, severe malnutrition, chronic cough, dermatitis, potbelly, and ascites are very common in areas where helminthic infections are predominant.[ajtmh.org]
Pallor
  • Physical examination showed pallor, multiple cervical and inguinal lymph nodes and hepatosplenomegaly. Laboratory investigations showed that she had iron deficiency anemia. There was leukocytosis and a raised ESR.[ncbi.nlm.nih.gov]
Turkish
  • Look up "fasciolopsiasis" at Merriam-Webster Look up "fasciolopsiasis" at dictionary.com In other languages: Spanish French Italian Portuguese Romanian German Dutch Swedish Russian Polish Czech Greek Turkish Chinese Japanese Korean Arabic Advertisements[wordreference.com]
Aspiration
  • […] tuberculosis in patients was established after assessing history of contacts with Koch's patients, abnormal X-ray film (hilar shadow, cavity and hilar lymphadenopathy), positive Mantoux test and demonstration of acid-fast bacilli in the sputum or gastric aspirate[ijmm.org]
Chronic Cough
  • Anemia, edema, retardation of growth, severe malnutrition, chronic cough, dermatitis, potbelly, and ascites are very common in areas where helminthic infections are predominant.[ajtmh.org]
Diarrhea
  • The symptoms include diarrhea, abdominal pain, fever, ascites, anasarca and intestinal obstruction.[wikidata.org]
  • Side effects were mild and transient and consisted of headache, dizziness, nausea, sleepiness, abdominal discomfort, anorexia, diarrhea, epigastric pain, vomiting and lassitude.[ncbi.nlm.nih.gov]
  • […] of the genus "Fasciolopsis" and characterized by abdominal pain and diarrhea: common in the Far East. (22 of 29 words, pronunciation) dictionary.infoplease.com/fasciolopsiasis[memidex.com]
  • These pathologies cause insidious onset diarrhea. These are usually watery in nature. Diarrhea may be alternating with constipation and hunger pangs.[explainmedicine.com]
  • In heavy infections, symptoms can include abdominal pain, chronic diarrhea, anemia, ascites, toxemia, allergic...[encyclo.co.uk]
Abdominal Pain
  • The symptoms include diarrhea, abdominal pain, fever, ascites, anasarca and intestinal obstruction.[wikidata.org]
  • Abdominal pain, diarrhoea, mucosal ulceration, intestinal obstruction, anasarca, and even fatality are described following heavy infestation.[ncbi.nlm.nih.gov]
  • Malabsorption may lead to steatorrhea as well. [1,2,3,4,5] Abdominal pain Abdominal pain may be attributed to several causes. Severe parasitic load can cause widespread intestinal erosions, ulceration and rarely perforations.[explainmedicine.com]
  • […] of the genus "Fasciolopsis" and characterized by abdominal pain and diarrhea: common in the Far East. (22 of 29 words, pronunciation) dictionary.infoplease.com/fasciolopsiasis[memidex.com]
  • However, abdominal pain and diarrhea can occur 1 or 2 months after infection. With heavy infections Fasciolopsis flukes can cause intestinal obstruction, abdominal pain, nausea, vomiting, and fever. Praziquantel is the drug of choice for treatment.[omicsonline.org]
Intestinal Perforation
  • Fasciolopsiasis is by no means rare but its presentation as a case of intestinal perforation is extraordinary.[ncbi.nlm.nih.gov]
  • In such cases severe abdominal pain in the periumbilical area is accompanied by constipation and/ or poor appetite, nausea and vomiting. [1,2,3] Abdominal swelling Severe inflammation of the intestinal wall and rarely intestinal perforation cause inflammatory[explainmedicine.com]
  • A recent case report provides evidence of heavy infestation as a risk factor for intestinal perforation. Symptoms abdominal pain, diarrhea, intestinal obstruction, abdominal pain, nausea, vomiting, and fever.[bioinfo.bisr.res.in]
  • Fasciolopsiasis presenting as intestinal perforation: A case report. Trop Gastroenterol 2009;30:40-1. 18. Karthikeyan G, Ramkumar V, Kumar SP, Ramkumar S, Selvamani S, Vetriveeran B, et al.[ijmm.org]
Periumbilical Pain
  • A 5 year old girl hailing from Keraniganj, presented with the complaints of fever, periumbilical pain and vomiting. In vomitus, Fasciolopsis buski worm in adult form was identified by naked eye examination.[ncbi.nlm.nih.gov]
Abdominal Distension
  • Case report A 10-year-old boy from Barabanki district of Uttar Pradesh, India, presented with history of central abdominal pain and abdominal distension for 3 days and fever for 2 days.[tropicalgastro.com]
Hepatomegaly
  • Clinically she was pale and had hepatomegaly. Microcytic hypochromic anaemia with normal liver function test was found on lab investigation.[ncbi.nlm.nih.gov]
  • Flatulence, fatigue, dyspepsia, right upper quadrant abdominal pain, anorexia, and mild hepatomegaly occur in approximately 5 to 10% of infections ( 91 ).[doi.org]
Pruritus
  • Abdominal pain, biliary colic, fever, nausea, pruritus, vomiting, weakness, and liver enlargement following treatment have been reported.[doi.org]
Hunger
  • Diarrhea may be alternating with constipation and hunger pangs. Malabsorption may lead to steatorrhea as well. [1,2,3,4,5] Abdominal pain Abdominal pain may be attributed to several causes.[explainmedicine.com]
Facial Edema
  • Generalized allergic reaction is characterized by a facial edema. [2,4,5] Hives Generalized toxic and allergic reactions causes red, itchy, raised areas of skin that appear in varying shapes and sizes. [2,5] History of travel to endemic araes The patient[explainmedicine.com]

Workup

To identify F. buski as the causative agent of the patient's symptoms, a detailed clinical investigation must be conducted. A thorough patient history, especially about recent travel to Southeast Asia (or if they are residents of the area) and contact with pigs or ingestion of local aquatic plants, is of importance for gaining sufficient evidence to make a presumptive diagnosis. Physical examination may reveal typical symptoms, after which microbiological studies, the cornerstone of infectious disease diagnostics, are necessary. At this moment, fasciolopsiasis is diagnosed by identifying F. buski eggs or adult worms in the intestinal lumen by obtaining a stool sample, but some reports claim that the worms can be sometimes found in vomit during the presence of symptoms [4] [5]. Alternatively, drug-induced expulsion using praziquantel has been described as a useful method for detection of worms [4]. A useful indicator of a parasitic infection, in addition to microbiological studies, is the presence of eosinophilia (both relative and absolute number) in the complete blood count (CBC) [5], suggesting that this test might be of great benefit in the initial workup. Imaging studies, such as computed tomography (CT), ultrasonography, and even upper endoscopy have been reported as a useful method in solidifying the diagnosis of fasciolopsiasis [5].

Fasciolopsis Buski
  • Infection by Fasciolopsis buski (disorder) Infectious Disease by Fasciolopsis Infection by Fasciolopsis buski edit English fasciolopsiasis A parasitic helminthiasis infectious disease that involves parasitic infection of the intestine by Fasciolopsis[wikidata.org]
  • Infestation by the zoonotic trematode Fasciolopsis buski (fasciolopsiasis) is seen in several parts of South-East Asia.[ncbi.nlm.nih.gov]
  • In vomitus, Fasciolopsis buski worm in adult form was identified by naked eye examination. In stool, ova of Fasciolopsis buski were also observed under microscope. Clinically she was pale and had hepatomegaly.[ncbi.nlm.nih.gov]
  • Convert to ICD-10-CM : 121.4 converts directly to: 2015/16 ICD-10-CM B66.5 Fasciolopsiasis Approximate Synonyms Infection by Fasciolopsis buski Applies To Infection by Fasciolopsis (buski) Intestinal distomiasis ICD-9-CM Volume 2 Index entries containing[icd9data.com]
  • Found on fasciolopsiasis noun infestation with the large intestinal fluke Fasciolopsis buski; common in eastern Asia Found on Fasciolopsiasis Fasciolopsiasis: Infection with Fasciola flukes such as Fasciolopsis buski. See: Fasciolopsis.[encyclo.co.uk]
Acid-Fast Bacilli in the Sputum
  • Evidence of tuberculosis in patients was established after assessing history of contacts with Koch's patients, abnormal X-ray film (hilar shadow, cavity and hilar lymphadenopathy), positive Mantoux test and demonstration of acid-fast bacilli in the sputum[ijmm.org]

Treatment

  • Praziquantel is the drug of choice for treatment. Treatment is effective in early or light infections. Heavy infections are more difficult to treat.[en.wikipedia.org]
  • The authors recommend a single dose of praziquantel in a dosage of 15 mg/kg of body weight for the treatment of parasitosis.[ncbi.nlm.nih.gov]
  • After treatment with Praziquantel, all of them passed the parasite in their stool for the next 2-3 days.[ncbi.nlm.nih.gov]
  • The authors recommend a single dose of 15 mg/kg of praziquantel at bed time for the treatment of fasciolopsiasis.[ncbi.nlm.nih.gov]

Prognosis

  • Cholangiocarcinoma is a tumor with extremely poor prognosis: bile duct surgery is difficult, and many patients suffer a painful death ( 39, 96, 97 ).[doi.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • […] builder options Subheadings: analysis anatomy and histology blood cerebrospinal fluid chemically induced classification complications congenital diagnosis diagnostic imaging diet therapy drug therapy economics embryology enzymology epidemiology ethnology etiology[ncbi.nlm.nih.gov]
  • Further details regarding the etiology, diagnosis, and management of cholangiocarcinoma and clonorchiasis were described in a recent review ( 14 ).[doi.org]

Epidemiology

  • However, in view of changing epidemiological profile, these risk factors were not universally associated with all patients. Our few cases belonged to high-income family who do not have these risk factors associated.[ijmm.org]
  • To better understand their significance, each chapter covers the biology, mechanisms of pathogenesis, epidemiology, treatment, and inactivation of these parasites.[books.google.de]
  • London Pharmaceutical press pg. 922 Plaut et al., 1969 A clinical study of Fasciolopsis buski infection in Thailand, Transactions of the Royal Society of Tropical Medicine and Hygiene, 1969 , vol. 63 (pg. 470 - 478 ) Sadun and Maiphoom, 1953 Studies on epidemiology[doi.org]
  • Epidemiological study of Fasciolopsis Buski in Palghar Taluk. Indian J Public Health. 1972; 16 :3–6. 8. Kumari N, Kumar M, Rai A, Acharya A. Intestinal trematode infection in North Bihar. JNMA J Nepal Med Assoc. 2006; 45 :204–6. 9.[tropicalgastro.com]
  • It provides balanced coverage of specific groups of microorganisms and the work-up of clinical specimens by organ system, and also discusses the role of the microbiology laboratory in regard to emerging infections, healthcare epidemiology, and bioterrorism[books.google.es]
Sex distribution
Age distribution

Prevention

  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.[dpd.cdc.gov]
  • How can fasciolopsiasis be prevented? Cook all aquatic plants well before eating them (in boiling water). In endemic areas, prevent fecal contamination (from humans or pigs) of water where aquatic plants are grown.[cdc.gov]
  • A simple but effective preventive measure is the immersion of aquatic foods in boiling water. This article was most recently revised and updated by Amy Tikkanen, Corrections Manager.[britannica.com]
  • Prevention is especially important. There are no vaccines for parasitic diseases. Some medicines are available to treat parasitic infections.[icdlist.com]
  • Infection can be prevented by immersing vegetables in boiling water for a few seconds to kill the infective metacercariae, avoiding the use of untreated feces ("nightsoil") as a fertilizer, and maintenance of proper sanitation and good hygiene.[en.wikipedia.org]

References

Article

  1. Graczyk TK, Gilman RH, Fried B. Fasciolopsiasis: is it a controllable food-borne disease? Parasitol Res. 2001;87(1):80-83. .
  2. Fiamma M, Longoni SS, Ngo TM, et al. Fasciolopsis buski infection in a Vietnamese pregnant woman with systemic lupus erythematosus. J Infect Dev Ctries. 2015;9(6):670-673.
  3. Rohela M, Jamaiah I, Menon J, Rachel J. Fasciolopsiasis: a first case report from Malaysia. Southeast Asian J Trop Med Public Health. 2005;36(2):456-458
  4. Achra A, Prakash P, Shankar R. Fasciolopsiasis: Endemic focus of a neglected parasitic disease in Bihar. Indian J Med Microbiol. 2015;33(3):364-368.
  5. Cao Y-H, Ma Y-M, Qiu F, Zhang X-Q. Rare cause of appendicitis: Mechanical obstruction due to Fasciolopsis buski infestation. World J Gastroenterol. 2015;21(10):3146-3149.
  6. Keiser J, Utzinger J. Food-Borne Trematodiases. Clin Microbiol Rev. 2009;22(3):466-483.
  7. Bhattacharjee HK, Yadav D, Bagga D. Fasciolopsiasis presenting as intestinal perforation: a case report. Trop Gastroenterol. 2009;30(1):40-41.

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Last updated: 2019-07-11 21:50