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| Fasciolopsis buski adult Image/CDC DPDx |
An11-year-old boy from India, with no symptoms of parasitic infection,was surprised and startled his parents when he woke up one morning to vomit outfour live fasciolopsiasis, or Fasciolopsis buski adults.
The case waspublished in the journal, the Annalsof Tropical Medicine and Public Health on Oct. 8.
According to thereport, his parents took the expelled worms to the pediatrician, which werereferred to the department of microbiology for identification. What they foundwere was a adult fluke that was dorsoventrally flattened, non-segmented,and flesh- colored. It measured about 34 mm x 20 mm in size (about 1 and 1/3 inchesby 3/4 of an inch).
Two suckerswere seen; ventral and oral, and the ventral sucker was relativelyprominent about 2 mm in size. The worm was fleshy and nearly oval in shape withthe anterior end narrower and the posterior end broadly rounded. There was nocephalic cone present.
Based onthese morphological characteristics, the wormwas identified as Fasciolopsis buski.
The boy hadno specific symptoms prior to this event, except occasionalabdominaldiscomfort, nausea, and mild distension.
The boy wastreated with nitazoxanide 250 mg twice-daily for 5 days. After 2 weeks oftreatment, stool samples were examined but did not show any evidence of anyparasite or ova.
Fasciolopsisbuski is the largest intestinal fluke in humans. It causes a parasiticdisease called fasciolopsiasis. It is found in Asia and the Indiansubcontinent, especially in areas where humans raise pigs and consumefreshwater plants.
InIndia, F. buski infestation has been reported mainly from Bihar,Uttar Pradesh, and Maharashtra and sporadically from other states like Assamand West Bengal. It is usually seen in rural areas where water plantsare eaten raw according to the case report authors.
See F. buski’s lifecycle here.
The pathologyof fasciolopsiasis can be described as: more worms , more disease, butusually asymptomatic.
Large numberof worms attached to the mucosa can cause bleeding,inflammation andulceration. In addition, large numbers may block the intestinal lumen.
Hunger pains,abdominal distention, increased appetite, diarrhea andfoul-smelling greenish-yellow stools may be seen.
The mostimportant plants involved in human infection are water caltrop (seea picture of water caltrops) and water chestnuts where themetcercariae are found on the outer shell.
The outercover is peeled off with the teeth and the metcercariae arereleased into the mouth.
Praziquantelis the drug of choice.
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