Opisthorchis viverrini: Difference between revisions

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==Background==
==Background==
* a.k.a. "southeast asian liver fluke" (endemic)
 
* Trematode
[[File:Opisthorchis LifeCycle.gif|thumb|Lifecycle of Opisthorchis.]]
* Also within genus: opisthorchis felineus (Europe/Asia incl Russia) <ref name="CDC"> http://www.cdc.gov/dpdx/opisthorchiasis/ </ref>
*a.k.a. "southeast asian liver fluke" (endemic)
*Trematode
*Also within genus: opisthorchis felineus (Europe/Asia incl Russia) <ref name="CDC"> http://www.cdc.gov/dpdx/opisthorchiasis/ </ref>
 


===Life Cycle===
===Life Cycle===
* Eggs pass in feces --> freshwater snail ingestion --> larval trematode embeds in fish skin/flesh --> Fish consumed raw --> duodenal cyst and subsequent biliary infection
 
* Fluke count may effect clinical presentation (lower counts more asymptomatic)
*Eggs pass in feces → freshwater snail ingestion → larval trematode embeds in fish skin/flesh → Fish consumed raw → duodenal cyst and subsequent biliary infection
*Fluke count may effect clinical presentation (lower counts more asymptomatic)
 


===Risk Factors===
===Risk Factors===
* Exposure to endemic areas (see above)
 
* Consumption of raw/undercooked fish
*Exposure to endemic areas (see above)
*Consumption of raw/undercooked fish
 


===Clinical significance===
===Clinical significance===
* May have acute infectious phase
* Source of mild and moderate GI disease
* Chronic infection predisposes to cholangitis, cholcystitis, cholangiocarcinoma (rare)


==Clinical Presentation==
*May have acute infectious phase
* Mild: dyspepsia, diarrhea, abdominal pain, constipation
*Source of mild and moderate GI disease
* Moderate: hepatomegaly, malnutrition
*Chronic infection predisposes to cholangitis, cholcystitis, cholangiocarcinoma (rare)
* <I>Felineus</I> species may have an acute phase: alike to schistosomiasis (fever, facial edema, lymphadenopathy, arthralgias, rash, and eosinophilia) and involvement may extend to pancreatic duct in chronic cases
 
 
==Clinical Features==
 
*Mild: [[Special:MyLanguage/dyspepsia|dyspepsia]], [[Special:MyLanguage/diarrhea|diarrhea]], [[Special:MyLanguage/abdominal pain|abdominal pain]], [[Special:MyLanguage/constipation|constipation]]
*Moderate: [[Special:MyLanguage/hepatomegaly|hepatomegaly]], [[Special:MyLanguage/malnutrition|malnutrition]]
*<I>Felineus</I> species may have an acute phase: alike to [[Special:MyLanguage/schistosomiasis|schistosomiasis]] ([[Special:MyLanguage/fever|fever]], facial edema, [[Special:MyLanguage/lymphadenopathy|lymphadenopathy]], [[Special:MyLanguage/arthralgia|arthralgia]]s, [[Special:MyLanguage/rash|rash]], and [[Special:MyLanguage/eosinophilia|eosinophilia]]) and involvement may extend to pancreatic duct in chronic cases
 


==Differential Diagnosis==
==Differential Diagnosis==
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{{Helminth Types}}
{{Helminth Types}}
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==Diagnostic Evaluation==


==Evaluation==


==Management==  
 
* [[Praziquantel]], 75mg/kg/day orally for 2 days (adults/pediatric) with meal<ref name="CDC" />
==Management==
 
*[[Special:MyLanguage/Praziquantel|Praziquantel]], 75mg/kg/day orally for 2 days (adults/pediatric) with meal<ref name="CDC" />
or
or
* [[Albendazole]], 10mg/kg/day orally for 7 days (adults/pediatric) with meal [non-FDA alternative]<ref name="CDC" />
*[[Special:MyLanguage/Albendazole|Albendazole]], 10mg/kg/day orally for 7 days (adults/pediatric) with meal [non-FDA alternative]<ref name="CDC" />
 
*Identical to treatment for Clonorchis <ref name = "CDC2"> http://www.cdc.gov/dpdx/clonorchiasis/tx.html </ref>
*In cases of clonorchis in China, [[Special:MyLanguage/Trebindamine|Trebindamine]] 400mg once has less side effects and equal efficacy (not available in U.S.) <ref name="IDC"> http://pusware.com/testpus/bug_Clonorchis.html</ref> <ref name = "Trebindamine">http://www.ncbi.nlm.nih.gov/pubmed/23223597</ref>


* Identical to treatment for Clonorchis <ref name = "CDC2"> http://www.cdc.gov/dpdx/clonorchiasis/tx.html </ref>
* In cases of clonorchis in China, [[Trebindamine]] 400 mg once has less side effects and equal efficacy (not available in U.S.) <ref name="IDC"> http://pusware.com/testpus/bug_Clonorchis.html</ref> <ref name = "Trebindamine">http://www.ncbi.nlm.nih.gov/pubmed/23223597</ref>


==See Also==
==See Also==
*[[Helminth infections]]
 
*[[Special:MyLanguage/Helminth infections|Helminth infections]]
 


==References==
==References==
<references/>
<references/>


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[[Category:ID]]
[[Category:ID]]
[[Category:GI]]
[[Category:GI]]
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Latest revision as of 23:50, 4 January 2026


Background

Lifecycle of Opisthorchis.
  • a.k.a. "southeast asian liver fluke" (endemic)
  • Trematode
  • Also within genus: opisthorchis felineus (Europe/Asia incl Russia) [1]


Life Cycle

  • Eggs pass in feces → freshwater snail ingestion → larval trematode embeds in fish skin/flesh → Fish consumed raw → duodenal cyst and subsequent biliary infection
  • Fluke count may effect clinical presentation (lower counts more asymptomatic)


Risk Factors

  • Exposure to endemic areas (see above)
  • Consumption of raw/undercooked fish


Clinical significance

  • May have acute infectious phase
  • Source of mild and moderate GI disease
  • Chronic infection predisposes to cholangitis, cholcystitis, cholangiocarcinoma (rare)


Clinical Features


Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)


Evaluation

Management

  • Praziquantel, 75mg/kg/day orally for 2 days (adults/pediatric) with meal[1]

or

  • Albendazole, 10mg/kg/day orally for 7 days (adults/pediatric) with meal [non-FDA alternative][1]
  • Identical to treatment for Clonorchis [2]
  • In cases of clonorchis in China, Trebindamine 400mg once has less side effects and equal efficacy (not available in U.S.) [3] [4]


See Also


References

  1. ↑ 1.0 1.1 1.2 http://www.cdc.gov/dpdx/opisthorchiasis/
  2. ↑ http://www.cdc.gov/dpdx/clonorchiasis/tx.html
  3. ↑ http://pusware.com/testpus/bug_Clonorchis.html
  4. ↑ http://www.ncbi.nlm.nih.gov/pubmed/23223597
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