Locally acquired infection with Dibothriocephalus nihonkaiense (=Diphyllobothrium nihonkaiense) in France: the importance of molecular diagnosis.

Diphyllobothriasis is a parasitic fish-borne disease caused by tapeworms of the genus Dibothriocephalus (=Diphyllobothrium). The majority of reported cases are attributed to D. latum, based on morphological identification of eggs or proglottids. However, numerous reports in recent years suggested that other Dibothriocephalus species could be involved in human infections, mainly after consumption of salmonid fish. Among these, D. nihonkaiense has been predominantly reported from Eastern Asia and probably underestimated in the rest of the world. We report here a clinical case of D. nihonkaiense in a French patient (without history of travel abroad) after consumption of salmon. Suspected on morphological characteristics, the final identification of D. nihonkaiense was performed using molecular methods by sequencing nad1, cox1, and 5.8S rRNA (containing ITS1 and 2) genes sequences. The patient was successfully treated by a single dose of praziquantel. Reports of diphyllobothriasis due to D. nihonkaiense are rare outside Asia, but worldwide demand of seafood could lead to the globalization of cases and reflect the need to monitor the distribution of Dibothriocephalus species. Thus, clinical parasitologists should be aware of this risk and able to raise the possibility of infections by non-endemic Dibothriocephalus species in order to use the proper molecular tools.

Diphyllobothrium nihonkaiense infection linked to chilled salmon consumption.

This is a case of a 40-year-old Japanese adult male who had acute onset watery diarrhoea with intermittent abdominal discomfort. Several days later, he found a 1 metre of tape-shaped object emerged from his anus and was eventually admitted to our hospital for further investigation. Stool examination revealed eggs of Diphyllobothrium with characteristic shape in his stool. After oral praziquantel administration, segments of proglottids were expelled from his anus. The proglottids were sent to the Infectious Disease Surveillance Centre of Japan, and DNA analysis of the proglottids proved to be those of Diphyllobothrium nihonkaiense. The patient confessed that he had an eating habit of chilled salmon. His diarrhoea and abdominal discomfort were completely diminished after 1 day of oral praziquantel administration. He was successfully discharged from the hospital a few days later admission without any complication of the disease and the side effect of treatment.

Difilobotríase: atualidades e perspectivas / Diphyllobothriasis: updates and perspectives

A difilobotríase é uma moléstia intestinal provocada por cestódeos do gênero Diphyllobothrium (tênia) que até pouco tempo havia poucos relatos em nosso país. Porém, em decorrência do aumento do consumo de peixes crus, mal cozidos ou defumados e da falta de cuidado nos seus preparos, vêm sendo identificados casos autóctones no Brasil. O número de pessoas parasitadas pelo platelminto difilobotríase, presente em várias regiões do mundo, vem aumentando desde 2003. A doença pode ser assintomática ou causar desconforto abdominal e interferir na absorção da vitamina B12, podendo causar anemia megaloblástica. Abster-se do consumo de pescado cru, defumado em temperaturas inadequadas ou mal cozido é a principal medida para a sua prevenção.

The intestinal diphyllobotriasis is a disease caused by Diphyllobothrium (cestodes of the genus Taenia [tapeworm]) that until recently had a few reports in our country. However, as a result of increased consumption of raw fish, soft-boiled or smoked and lack of care in their staging have been identified indigenous cases in Brazil. The number of people by the flatworm diphyllobotriasis parasitized, present in various regions of the world, comes increasing since 2003. The disease may be asymptomatic or cause abdominal discomfort and interferes in the absorption of vitamin B12, leading to megaloblastic anemia. Avoid from eating raw, smoked or soft-boiled fish is the primaries beware of their prevention.

Diphyllobothrium latum: a case of an incidental finding.

Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally, colonoscopy can also reveal unexpected findings, including parasitic infections, even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites, which can live for considerable periods of time in the human gastrointestinal tract. Fish tapeworm (Diphyllobothrium species) are endemic in various parts of the world, the commonest species being Diphyllobothrium latum. Humans are the main definitive host for D. Latum and the majority of individuals harbouring the parasite are asymptomatic, while 40% of infected individuals may have low vitamin B12 levels. We describe a case of D. latum infection found on routine colonoscopic screening for colorectal cancer in an asymptomatic patient, which was successfully treated with praziquantel. The infection likely arose following raw fish (sushi) consumption.

Diphyllobothriasis latum: the first child case report in Taiwan.

Diphyllobothriasis latum is an intestinal parasitosis caused by the ingestion of mostly raw fresh-water fish containing plerocercoids of Diphyllobothrium latum. We report an 8-year-old boy who came to our hospital with the complaint of a tapeworm hanging from the anus after defecation. The other symptom was mild abdominal cramping for a period of 1 year. The laboratory examination did not reveal anemia or vitamin B12 deficiency. Examination of gravid proglottids with rosette-like central uterus and typically operculated eggs of D. latum confirmed the diagnosis. The morphologic characters of proglottids and eggs size are compatible with D. latum. The patient had a history of eating uncooked fish for 1 year. Salmonids may be the infection source. He was treated with two doses of praziquantel and passed about 183 cm in length of all proglottids. There is a high prevalence of diphyllobothriasis latum in the northern temperate areas, but it is very rare in children. This patient is the first child case reported in Taiwan.

[Infestation with the tapeworm Diphyllobothrium latum after eating raw fish]. / Infestatie met de lintworm Diphyllobothrium latum na het eten van rauwe vis.

A 31-year-old man with no relevant medical history encountered a white, ribbon-shaped object, 15 cm long and approximately 1 cm wide, in his faeces. It turned out to be Diphyllobothrium latum, a tapeworm that has fish as the intermediate host. The patient had eaten raw fish and shellfish during a holiday in Brazil 5 months before. He recovered after a single dose of praziquantel.

Reappearance of human diphyllobothriasis in a limited area of Lake Como, Italy.

BACKGROUND: Very few sporadic cases of autochthonous diphyllobothriasis have been reported in Italy during the past 20 years, probably due to the drastic decrease or disappearance of some fish species, mainly Perca fluviatilis L., known as the intermediate host of the infective larval stage of this tapeworm. However, increasing consumption of raw or undercooked fish during the last years as influenced by Oriental cuisine, played an important role in a number of new single cases of the infection or microepidemics. PATIENTS: We describe six cases which were diagnosed within a period of 4 months, which all originated from the area of Lake Como (Lombardy region). All subjects had previously eaten raw perch fillets. Four individuals complained of gastrointestinal signs and symptoms, whereas two were asymptomatic. DISCUSSION: Parasitological diagnosis was achieved in four cases by recovery of typical operculated eggs in stool specimens; in two others by morphological features of proglottids recovered from feces. Treatment with niclosamide, as a single oral dose, cured the infection in all subjects. This is the first report of this infection in Italy in the last 10 years.

[New cases of Diphyllobothrium pacificum (Nybelin, 1931) Margolis, 1956 human infection in North of Chile, probably related with El Niño phenomenon, 1975-2000]. / Nuevos casos de infección humana por Diphyllobothrium pacificum (Nybelin, 1931) Margolis, 1956 en Chile y su probable relación con el fenómeno de El Niño, 1975-2000.

The effect of El Niño/ENSO on terrestrial atmosphere appears to be extremely clear. However there are outstanding evidences showing its effect on humans and their activities. In fact, prevalence of some parasitic infections have increased during El Niño phenomenon. The reasons for that are the migrations of sylvatic mammals, fishes and birds as well as by environmental contamination. In this report, we show evidence respect of new cases of human infection by Diphyllobothrium pacificum clearly associated with a cyclic manifestation of El Niño in the Chilean Pacific coast during 1975-2000.

Infección por helmintos parásitos en salmón coho, oncorhynchus kisutch, durante su retorno al río Simpson, Chile / Infection by parasitic helmiths in coho sallmon, oncorhynchus kisutch, during their return to Simpson river, Chile

Between may and july 1994, 17 adult returning salmons, oncorhynchus kisutch, were collected in the River Simpson, Chile. All fishes showed infection by plerocercoids of diphyllobothrium sp. in different locations: stomach, spleen, liver, mesenteries and gonads. Infection with larval cestodes of an unidentified species of phillobothriidae was determined in the intestine of seven (41,2 percent) salmons and its prevalences of infection showed significant differences between female and male salmons. The 94,4 percent of total plerocercoids of diphyllobothrium were isolated from the stomach wall. Prevalence and mean intensity of infection by diphyllobothrium sp. did not show significant differences between fishes of different sex

Difilobotriasis humana por diphyllobothrium pacificum: un nuevo caso en Antofagasta, norte de Chile / Diphyllobothrium pacificum human infection: report of one case

We report a 26 years old asymptomatic female that expelled spontaneously a 39 proglottid strobila. The taxonomic study of proglottids and eggs found in the stool examination concluded that the patient was infected by Diphyllobothrium pacificum. This infection was probably acquired by the ingestion of raw fish (Sciaena deliciosa) with lemon in a traditional plate called "cebiche". She was treated with a single dose of praziquantel in a dose of 10 mg/kg body weight. After 24 h of treatment there were no scolices on feces. The patient did not have anemia. All eight family members studied, did no have the infection. A follow up stool examination three months later remained negative

Diphyllobothriasis after eating raw salmon.

An 11-year-old boy in Hawaii passed mucus and a moving object in his stool. The object was identified as a segment of the fish tapeworm Diphyllobothrium species which is not indigenous to Hawaii. Diphyllobothrium ova were also found in the stool. The only raw fish he recalled eating in previous months were tuna sushi and lomi-lomi salmon which usually contains raw but previously frozen salmon. Of these two fish, only salmon which is not native to Hawaiian waters, has been incriminated as a significant source of diphyllobothrium fish tapeworm infection. Freezing kills this parasite, however, we speculate that the raw fish in the lomi-lomi salmon that our patient had eaten had not been pre-frozen or was not adequately pre-frozen. Eating raw salmon without certainty that it has been adequately pre-frozen carries the risk of diphyllobothriasis or fish tapeworm infection.

Single dose treatment with praziquantel for human Diphyllobothrium nihonkaiense infections.

Diphyllobothrium nihonkaiense is a large pseudophyllid cestode and one of the commonest parasites derived from fish in Japan. Three Japanese patients infected with D. nihonkaiense were treated with a single oral dose of 7, 23 or 25 mg/kg of praziquantel. All patients expelled the tapeworm with scolex, and no side effect was noted. This study indicates that single-dose treatment with praziquantel is effective against D. nihonkaiense infection.