Diphyllobothrium latum: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnostic Evaluation==" to "==Evaluation==") |
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**20% of cases report diarrhea, abdominal pain or discomfort | **20% of cases report diarrhea, abdominal pain or discomfort | ||
*Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction | *Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction | ||
*Competes for absorption of vitamin B12 → can cause pernicious anemia | *Competes for absorption of vitamin B12 → can cause [[pernicious anemia]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
*Praziquantel 25mg/kg x1 dose<ref name="Scholz" /> '''OR''' | *[[Praziquantel]] 25mg/kg x1 dose<ref name="Scholz" /> '''OR''' | ||
**Niclosamide 2 grams x1 dose | **Niclosamide 2 grams x1 dose | ||
*Replace vitamin B12 if patient has megaloblastic anemia | *Replace [[vitamin B12]] if patient has megaloblastic anemia | ||
==Disposition== | ==Disposition== | ||
Revision as of 23:26, 22 December 2016
Background
- A type of tapeworm infection
- D. latum and D. nihonkaiense are most common pathogens[1]
- 15-45 day latency period
- Found mostly in cold waters Palaearctic region and North America[1]
- Generally due to eating raw or undercooked fish.
- In US, Great Lakes and Alaska are most common locations.
Clinical Features
- Usually asymptomatic or mild GI symptoms[1]
- 20% of cases report diarrhea, abdominal pain or discomfort
- Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction
- Competes for absorption of vitamin B12 → can cause pernicious anemia
Differential Diagnosis
Helminth infections
Cestodes (Tapeworms)
- Taenia saginata
- Taenia solium (Cysticercosis)
- Diphyllobothrium latum
- Hymenolepis nana
- Echinococcus granulosus
Trematodes (Flukes)
- Fasciola hepatica
- Fasciolopsis buski
- Opistorchis viverrini
- Schistosoma spp
- Chlonorchis sinensis
- Paragonimus spp.
Nematodes (Roundworms)
- Ascaris lumbricoides
- Enterobius vermicularis (Pinworm)
- Filarial worms
- Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
- Dracunculiasis
- Strongyloides stercoralis
- Trichuris trichiura (Whipworm)
- Anisakis
- Toxocara spp.
- Trichinosis
Evaluation
- Stool sample - morphologic identification of eggs[1]
- Molecular (PCR) diagnosis also possible, but less used
Management
- Praziquantel 25mg/kg x1 dose[1] OR
- Niclosamide 2 grams x1 dose
- Replace vitamin B12 if patient has megaloblastic anemia
Disposition
- Discharge