Clonorchis sinensis

Background

• AKA oriental liver fluke, found in Asia
• Transmitted by ingestion of infected, undercooked fish, crabs, or crayfish
• Infect liver, gallbladder, bile ducts
• Fluke can live in a person for 25-30 years if left untreated

humans can get by eating raw or undercooked fish, crabs, or crayfish from areas where the parasite is found. Found across parts of Asia, Clonorchis is also known as the Chinese or oriental liver fluke. Liver flukes infect the liver, gallbladder, and bile duct in humans. While most infected persons do not show any symptoms, infections that last a long time can result in severe symptoms and serious illness. Untreated, infections may persist for up to 25–30 years, the lifespan of the parasite. Diagnosis of Clonorchis infection is based on microscopic identification of the parasite’s eggs in stool specimens.

Clinical Features

• Usually asymptomatic
• Abdominal pain, diarrhea, [[constipation
• Long-term infection can result in severe illness
  • Hepatomegaly
  • Malnutrition
  • Increased risk of cholangiocarcinoma and hepatic cancers due to inflammation

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
  • Schistosomiasis
• Chlonorchis sinensis
• Paragonimus spp.

Nematodes (Roundworms)

• Ascaris lumbricoides
• Enterobius vermicularis (Pinworm)
• Filarial worms
  • Loa Loa
  • Onchocerciasis
  • Lymphatic filariasis (Elephantiasis)
    • Wuchereria bancrofti
    • Brugia malayi
    • Brugia timori
• Hookworm
  • Necator americanus
  • Ancylostoma duodenale
  • Cutaneous larva migrans (Ancylostoma braziliense)
• Dracunculiasis
• Strongyloides stercoralis
• Trichuris trichiura (Whipworm)
• Anisakis
• Toxocara spp.
• Trichinosis

Evaluation

• Definitive diagnosis made by identification of eggs and flukes in stool

Management

• Praziquantel 25mg/kg PO q8h x 2 days

Disposition

• Discharge, likely