Diphyllobothrium is a genus of tapeworm which can cause Diphyllobothriasis in humans through consumption of raw or undercooked fish. The principal species causing diphyllobothriosis is Diphyllobothrium latum, known as the broad or fish tapeworm, or broad fish tapeworm. D. latum is a pseudophyllid cestode that infects fish and mammals. Other members of the genus Diphyllobothrium include Diphyllobothrium dendriticum.
Symptoms: symptoms can include abdominal discomfort, diarrhea, vomiting, and weight loss. Vitamin B12 deficiency leading to pernicious anemia may occur. Complications include intestinal obstruction and gall bladder disease caused by migration of proglottids. Sometimes pain above the stomach,loss of appetite,dizziness,insomnia,fits,malnutrition.
Diagnosis: Diagnosis is usually made by identifying proglottid segments, or characteristic eggs in the feces. These simple diagnostic techniques are able to identify the nature of the infection to the genus level, which is usually sufficient in a clinical setting. Another interesting potential diagnostic tool and treatment is the contrast medium, Gastrografin, introduced into the duodenum, which allows both visualization of the parasite, and has also been shown to cause detachment and passing of the whole worm.
Treament: The standard treatment for diphyllobothriasis, as well as many other tapeworm infections 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. Side effects of treatment: Praziquantel has few side effects, many of which are similar to the symptoms of diphyllobothriasis. They include malaise, headache, dizziness, abdominal discomfort, nausea, rise in temperature and occasionally allergic skin reactions. The side effects of Niclosamide are very rare, due to the fact that it is not absorbed in the gastrointestinal tract.
Epidemology: People at high risk for infection have traditionally been those who regularly consume raw fish. Many regional cuisines include raw or undercooked food, including sushi and sashimi in Japanese cuisine, carpaccio di persico in Italian, tartare maison in French-speaking populations, ceviche in Latin American cuisine and marinated herring in Scandinavia. The practice of eating raw fish in these and other dishes has brought diphyllobothriasis to new parts of the world and created new endemic foci of disease.