Fasciolopsiasis B66.5

Fasciolopsis buski, the largest intestinal fluke found in humans.

Adults: longitudinally oval, 5-7 cm long, 1-2 cm wide.

Lives in the small intestine of man and pig.

Transmission by consumption of fresh water plants contaminated with cercaria, consumption of contaminated salads or vegetables or drinking water contaminated with cercaria.

Mirazidium develops in water from eggs within 4-8 weeks, hatches and penetrates small water snails of the genera Lymnaea, Segmentina, Hippeutis and Gyraulus. In the snails, the development into cercaria takes place, which, after release, enzymatically decompose on the aquatic plants. In the duodenum, the metacercaria excise and mature into adults.

Preparation time: approx. 3 months. Life span: approx. 1 year.

Endemic in central and southern China, Taiwan, Thailand, Myanmar, Laos, Bangladesh, India, sporadically in Japan, Malaysia, Philippines.

Reservoir is man and pig. Snails are intermediate hosts.

The prevalence is highest in children.

In the majority of cases mild and asymptomatic course.

Typical course with diarrhoea, cramp-like abdominal pain mainly in the epigastrium, pain on fasting, improvement of symptoms after ingestion of food.

Occasional skin involvement with acute, localized or generalized itchy papules and wheals. Duration: About 1 week. Generalization after sensitization by repeated exposure is possible.

The stools are foul-smelling and some undigested food is excreted.

In children: weight loss, vomiting, exudative enteropathy, enteral protein loss, marked malabsorption with edema, ascites, ileus and anasarca.

Microscopy with detection of capped eggs in faeces.

In case of pronounced infections, detection of adults in the stool.

Praziquantel (Biltricide): Single treatment with 75 mg/kg Kg p.o. divided into 3 doses for 1-3 days.

Alternatively: Niclosamide 150 mg/kg Kg p.o. to a maximum of 6 g on 2 days

Alternative: Tetrachloroethylene 0,1 mg/kg Kg p.o. as ED.

Avoid the consumption of raw aquatic plants and their fruits.

Boiling of water nuts.

1. Maclean JD (2006) Liver, lung, and intestinal fluke infections. In: Guerrant, RL, Walker, DH, Weller, PF (Eds) Tropical Infectious Diseases: Principles, Pathogens and Practice, 2nd ed., p. 1349 Churchill Livingstone, Philadelphia
2. Saurabh K et al (2017) Fasciolopsiasis in children: Clinical, sociodemographic profile and outcome.
   Indian J Med Microbiol 35:551-554.