Intestinal capillariasis

Abstract

Intestinal capillariasis caused by Capillaria philippinensis appeared first in the Philippines and subsequently in Thailand, Japan, Iran, Egypt, and Taiwan, but most infections occur in the Philippines and Thailand. As established experimentally, the life cycle involves freshwater fish as intermediate hosts and fish-eating birds as definitive hosts. Embryonated eggs from feces fed to fish hatch and grow as larvae in the fish intestines. Infective larvae fed to monkeys, Mongolian gerbils, and fish-eating birds develop into adults. Larvae become adults in 10 to 11 days, and the first-generation females produce larvae. These larvae develop into males and egg-producing female worms. Eggs pass with the feces, reach water, embryonate, and infect fish. Autoinfection is part of the life cycle and leads to hyperinfection. Humans acquire the infection by eating small freshwater fish raw. The parasite multiplies, and symptoms of diarrhea, borborygmus, abdominal pain, and edema develop. Chronic infections lead to malabsorption and hence to protein and electrolyte loss, and death results from irreversible effects of the infection. Treatment consists of electrolyte replacement and administration of an antidiarrheal agent and mebendazole or albendazole. Capillariasis philippinensis is considered a zoonotic disease of migratory fish-eating birds. The eggs are disseminated along flyways and infect the fish, and when fish are eaten raw, the disease develops.

Emerging helminth zoonoses

“…Mebendazole, in a dose of 100 mg twice daily is an acceptable alternative, but needs to be given for 20 days, and relapses are more frequent with this drug [8].…”

Clinical features of human intestinal capillariasis in Taiwan

“…The delay was over a year in our cases. It has been found that Capillaria species are closely related to Trichuris and Trichinella species [1] , and the eggs of Trichuris trichiura and C. philippinensis are similar in appearance, although they can be differentiated by experienced observers [17] . Some individuals could be infected with both parasites, which further confuse the picture.…”

“…Capillaria species parasitize many classes of vertebrates, although only 4 species described have been found in humans, namely Capillaria phillippinensis, Capillaria plica, Capillaria aerophila, and Capillaria hepatica [1] . C. philippinensis is a tiny nematode that was first described in the 1960 s as the causative agent of severe diarrheal syndromes in humans.…”

Human intestinal capillariasis: diagnosis by jejunal fluid analysis obtained at enteroscopy and reversal of subtotal villous atrophy after treatment

“…6). P. philippinensis is a rare cause of malabsorption that occurs as a consequence of eating raw or insufficiently cooked fish harboring the larvae [1,2]. As the eggs of P. philippinensis are excreted sporadically in feces, multiple stool samples may be required to establish the diagnosis [2].…”

“…P. philippinensis is a rare cause of malabsorption that occurs as a consequence of eating raw or insufficiently cooked fish harboring the larvae [1,2]. As the eggs of P. philippinensis are excreted sporadically in feces, multiple stool samples may be required to establish the diagnosis [2]. In cases where stool samples fail to identify the parasite, enteroscopy and jejunal biopsy, as well as microscopic examination of the aspirated jejunal contents can help to establish the diagnosis [2].…”