Opisthorchis viverrini: Difference between revisions
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===Risk Factors=== | ===Risk Factors=== | ||
* Exposure to endemic areas (see above) | |||
* Consumption of raw/undercooked fish | * Consumption of raw/undercooked fish | ||
===Clinical significance=== | ===Clinical significance=== | ||
Revision as of 21:15, 12 September 2015
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 Presentation
- 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
Diagnostic 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 400 mg once has less side effects and equal efficacy (not available in U.S.) [3] [4]