Diphyllobothrium latum

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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.
D. latum life cycle (Courtesy of CDC)
D. latum proglottids

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)

Trematodes (Flukes)

Nematodes (Roundworms)

Diagnostic 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

See Also

External Links

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 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.
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