Opisthorchis viverrini: Difference between revisions
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* a.k.a. "southeast asian liver fluke" (endemic) | * a.k.a. "southeast asian liver fluke" (endemic) | ||
* Trematode | * Trematode | ||
* Also within genus: opisthorchis felineus (Europe/Asia incl Russia)<ref name="CDC"> http://www.cdc.gov/dpdx/opisthorchiasis/ </ref> | * Also within genus: opisthorchis felineus (Europe/Asia incl Russia) <ref name="CDC"> http://www.cdc.gov/dpdx/opisthorchiasis/ </ref> | ||
===Life Cycle=== | ===Life Cycle=== | ||
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===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 Presentation== | ==Clinical Presentation== | ||
* 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, arthralgias, rash, and eosinophilia) and involvement may extend to pancreatic duct in chronic cases | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
==Diagnostic Evaluation== | |||
==Management== | ==Management== | ||
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* 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 400 mg 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> | * In cases of clonorchis in China, Trebindamine 400 mg 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> | ||
==References== | ==References== | ||
Revision as of 21:14, 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
- Consumption of raw/undercooked fish
- Exposure to endemic areas (see above)
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]