DefinitionThis section has been translated automatically.
Intestinal trematode infection.
PathogenThis section has been translated automatically.
- Over 10 species of the family Heterophydiae are found in humans, most commonly Heterophyes heterophyes and Metagonimus yokogawai. These are 1-2 mm long hermaphroditic flukes, which occur in the small intestine of humans and various carnivorous mammals and birds.
- The eggs are excreted with the stool and are released into the water. The intermediate hosts are snails. Reproduction occurs via sporocyst and redia stages. Enzymation of cercaria swarming out of the snail in freshwater and brackish water fish; after ingestion of the fish, the metacercaria excrete in the small intestine and grow into adults in 1-2 weeks. The lifespan of the adults is a few months.
- Human infection by consumption of contaminated raw, cured or marinated fish.
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Occurrence/EpidemiologyThis section has been translated automatically.
Distribution mainly in East and Southeast Asia, Nile Delta, Iran, on the west coast of India as well as in Siberia, Israel, Spain and Balkan countries.
Clinical featuresThis section has been translated automatically.
- Mild infections usually proceed asymptomatically.
- In the case of a severe infection, there is mucous diarrhoea, severe abdominal pain, especially in the epigastrium, nausea and weight loss.
- In CNS infections, focal neurological symptoms with seizures and hemorrhages occur.
- In cardiac involvement: increasing heart failure, endocardial valve damage, embolisms with sudden cardiac death.
DiagnosisThis section has been translated automatically.
- Microscopic detection of the small, ca. 30 x 15 µm large, capped eggs in faeces.
- Enrichment by sedimentation method for the detection of weaker infections.
Complication(s)This section has been translated automatically.
Cerebral and cardiac complications.
TherapyThis section has been translated automatically.
- Praziquantel (Biltricide): Single dose of 20 mg/kg bw p.o.
- Alternative: Niclosamide and tetrachloroethylene.
Progression/forecastThis section has been translated automatically.
Good prognosis if no cerebral and cardiac complications occur.
ProphylaxisThis section has been translated automatically.
- Abstain from eating raw fish.
LiteratureThis section has been translated automatically.
- Chai JY, Song TE, Han ET et al (1998) Two endemic foci of heterophyids and other intestinal fluke infections in southern and western coastal areas in Korea. Korean J Parasitol 36:155
- Belizario VY Jr, Bersabe MJ, de Leon WU et al (2001) Intestinal heterophyidiasis: an emerging food-borne parasitic zoonosis in southern Philippines. Southeast Asian J Trop Med Public Health 32 (Suppl 2): 36
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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer