Background. Fasciolopsiasis, infection of humans and swine by the largest of intestinal trematode Fasciolopsis buski (F. buski). The adult worms, 2–7.5 cm (0.8–3 inches) long, attach themselves to the tissues of the small intestine of the host by means of ventral suckers; the sites of an attachment may later ulcerate and form abscesses. In the early stage of the infection, there is usually abdominal pain, as well as diarrhea and nausea alternating with constipation.
Epidemiology. F. buski is found throughout the Asia and the Indian subcontinent, including southern China, Taiwan, Bangladesh, India, Indonesia, Thailand, Malaysia, Sumatra, Cambodia, Philippines, Vietnam, Laos, and Myanmar. This disease is especially in areas where humans raise pigs and consume freshwater plants. Pigs are important reservoirs of the infection, although dogs and rabbits also can be infected. Children, who tend to eat plants with encysted cercariae, have the highest prevalence rates.
Pathology and Symptoms. Most infections are asymptomatic. Abscesses develop at the site of attachment to the intestinal mucosa in the duodenum and jejunum and those infected may complain of epigastric pain indistinguishable from peptic ulcer disease. Large numbers of flukes in the intestine may cause ileus or intermittent obstruction.
Diagnosis. The diagnosis is made by identification of large (135 × 80 µm), operculated eggs in stool or more rarely of the adult flukes, in the stool or vomitus is the basis of a specific diagnosis. The eggs are indistinguishable from those of Fasciola hepatica.
Clinical Presentation. Most infections are light and asymptomatic. In heavier infections, symptoms include diarrhea, abdominal pain, fever, ascites, anasarca, and intestinal obstruction.
Treatment. The drug of choice for children and adults is praziquantel, administered as 75 mg/kg/day divided into 3 doses. A simple but effective preventive measure is the immersion of aquatic foods in boiling water.
References:
Tikkanen, A. The Editors of Encyclopaedia Britannica. Available from: https://www.britannica.com/science/fasciolopsiasis
Centers for Disease Control and Prevention. Fasciolopsiasis[Updated: December 8, 2017]Available from:https://www.cdc.gov/dpdx/fasciolopsiasis/index.html
