Diphyllobothrium latum: Difference between revisions
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==Background== | ==Background== | ||
[[File:Dlatcycle.png|thumb|D. latum life cycle (Courtesy of CDC)]] | |||
[[File:Dlprog.JPG|thumb|D. latum proglottids]] | |||
[[File:PMC4675927 kjped-58-451-g001.png|thumb|Diphyllobothrium latum]] | |||
*A type of [[tapeworm]] infection | *A type of [[tapeworm]] infection | ||
*''D. latum'' and ''D. nihonkaiense'' are most common pathogens<ref name="Scholz">Scholz T, Garcia HH, Kuchta R, Wicht B. Update on the Human Broad Tapeworm (Genus Diphyllobothrium), Including Clinical Relevance. Clinical Microbiology Reviews. 2009;22(1):146-160. doi:10.1128/CMR.00033-08.</ref> | |||
**15-45 day latency period | |||
*Found mostly in cold waters Palaearctic region and North America<ref name="Scholz" /> | |||
**Generally due to eating raw or undercooked fish. | |||
**In US, Great Lakes and Alaska are most common locations. | |||
==Clinical Features== | ==Clinical Features== | ||
*Usually asymptomatic | *Usually asymptomatic or mild GI symptoms<ref name="Scholz" /> | ||
**20% of cases report diarrhea, abdominal pain or discomfort | |||
*Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction | *Rarely, migrating proglottids can cause cholangitis, cholecystitis, or intestinal obstruction | ||
*Competes for absorption of vitamin B12 | *Competes for absorption of vitamin B12 → can cause [[pernicious anemia]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Helminth Types}} | |||
== | ==Evaluation== | ||
[[File:PMC4675927 kjped-58-451-g002.png|thumb|Abdominal CT showing multiple reactive mesenteric lymph nodes (arrows) in a patient with ''diphyllobothrium latum'' infection.]] | |||
*Stool sample - morphologic identification of eggs<ref name="Scholz" /> | |||
**Molecular (PCR) diagnosis also possible, but less used | |||
==Management== | ==Management== | ||
*Praziquantel | *[[Praziquantel]] 25mg/kg x1 dose<ref name="Scholz" /> '''OR''' | ||
* | **Niclosamide 2 grams x1 dose | ||
*Replace [[vitamin B12]] if patient has megaloblastic anemia | |||
==Disposition== | ==Disposition== | ||
*Discharge | |||
==See Also== | ==See Also== | ||
*[[ | *[[Helminth infections]] | ||
*[[Parasitic | *[[Parasitic diseases]] | ||
*[[Travel | *[[Travel medicine]] | ||
==External Links== | ==External Links== | ||
== | |||
==References== | |||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Tropical Medicine]] | ||
Latest revision as of 20:19, 28 September 2022
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
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
- Stool sample - morphologic identification of eggs[1]
- Molecular (PCR) diagnosis also possible, but less used
Management
- Praziquantel 25mg/kg x1 dose[1] OR
- Niclosamide 2 grams x1 dose
- Replace vitamin B12 if patient has megaloblastic anemia
Disposition
- Discharge