Diphyllobothrium Infection

Pathophysiology: Infection with Diphyllobothrium latum is often asymptomatic and long-lasting (decades). Infected persons may experience abdominal pain, vomiting, diarrhea, and weight loss. In some infections there may be a severe Vitamin B12 deficiency and anemia caused by obstruction of Vitamin B12 absorption coupled with high absorption rates by the tapeworm. Infection occurs by ingesting plerocercoids in undercooked or raw fish. The plerocercoid passes undigested through the stomach as the fish tissue is digested away. The plerocercoid develops into an adult in the small intestine where it attaches to the mucosa. The proglottids mature and eggs are produced in as few as 2 weeks. Worms may contain 3,000 proglottids and reach lengths over 10 meters. Microscopy of Diphyllobothrium latum indicates Immature eggs are released from gravid proglottids and passed in the feces in very large numbers - up to 1,000,000 eggs may be produced per day by one worm! Spent proglottids may also be passed. The life cycle continues to a first intermediate host (copepod) and second intermediate host (fish)

Symptoms: Many asymptomatic treatments are observed. However, some of the common symptoms are abdominal discomfort, diarrhea, vomitings, weight loss, loss of memory, malnutrition etc. Treatment: The standard treatment for diphyllobothriasis, is a single dose of Praziquantel, 5?10 mg/kg PO once for both adults and children. An alternative treatment is Niclosamide, 2 g PO once for adults or 50 mg/kg PO once. This infection can be prevented by not eating raw or uncooked fish.

The incidence of diphyllobothriasis in the Belgium has been declining, but the growing popularity of Japanese sushi and sashimi has the potential to increase the frequency of infection. Diphyllobothriasis is a worldwide disease that affects people near fresh water and appropriate intermediate hosts. Diphyllobothriasis has no reported age predilection or sexual predilection. In addition, it has no known racial predilection, except as would be expected on the basis of geographic and cultural factors.