Diphyllobothrium latum
Background
- A type of tapeworm infection
- D. latum and D. nihonkaiense are most common pathogens[1]
- 15-45 day latency period
- Found mostly in cold waters Palaearctic region and North America[1]
- Generally due to eating raw or undercooked fish.
- In US, Great Lakes and Alaska are most common locations.
Clinical Features
- Usually asymptomatic or mild GI symptoms[1]
- 20% of cases report diarrhea, abdominal pain or discomfort
- Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction
- Competes for absorption of vitamin B12 → can cause pernicious anemia
Differential Diagnosis
Diagnosis
- Stool sample - morphologic identification of eggs[1]
- Molecular (PCR) diagnosis also possible, but less used
Management
- Praziquantel 25 mg/kg x1 dose[1] OR
- Niclosamide 2 grams x1 dose
- Replace vitamin B12 if patient has megaloblastic anemia
Disposition
- Discharge