Opisthorchis viverrini: Difference between revisions
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==Background== | ==Background== | ||
* a.k.a. "southeast asian liver fluke" (endemic) | [[File:Opisthorchis LifeCycle.gif|thumb|Lifecycle of Opisthorchis.]] | ||
* Trematode | *a.k.a. "southeast asian liver fluke" (endemic) | ||
* Also within genus: opisthorchis felineus (Europe/Asia incl Russia)<ref name="CDC"> http://www.cdc.gov/dpdx/opisthorchiasis/ </ref> | *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 | *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) | *Fluke count may effect clinical presentation (lower counts more asymptomatic) | ||
===Risk Factors=== | ===Risk Factors=== | ||
*Exposure to endemic areas (see above) | |||
* Exposure to endemic areas (see above) | *Consumption of raw/undercooked fish | ||
===Clinical significance=== | ===Clinical significance=== | ||
* Source of | *May have acute infectious phase | ||
* Chronic infection predisposes to cholangiocarcinoma | *Source of mild and moderate GI disease | ||
*Chronic infection predisposes to cholangitis, cholcystitis, cholangiocarcinoma (rare) | |||
==Clinical | ==Clinical Features== | ||
*Mild: [[dyspepsia]], [[diarrhea]], [[abdominal pain]], [[constipation]] | |||
*Moderate: [[hepatomegaly]], [[malnutrition]] | |||
*<I>Felineus</I> species may have an acute phase: alike to [[schistosomiasis]] ([[fever]], facial edema, [[lymphadenopathy]], [[arthralgia]]s, [[rash]], and [[eosinophilia]]) and involvement may extend to pancreatic duct in chronic cases | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Helminth Types}} | |||
==Management== | ==Evaluation== | ||
* Praziquantel, 75mg/kg/day orally for 2 days (adults/pediatric) with meal<ref name="CDC" /> | |||
==Management== | |||
*[[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" /> | *[[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> | *Identical to treatment for Clonorchis <ref name = "CDC2"> http://www.cdc.gov/dpdx/clonorchiasis/tx.html </ref> | ||
* In cases of clonorchis in China, Trebindamine | *In cases of clonorchis in China, [[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> | ||
== | ==See Also== | ||
*[[Helminth infections]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Tropical Medicine]] | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:GI]] | [[Category:GI]] | ||
Latest revision as of 22:19, 8 July 2021
Background
- 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
- Mild: dyspepsia, diarrhea, abdominal pain, constipation
- Moderate: hepatomegaly, malnutrition
- Felineus 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
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
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]