Two cases of natural human infection by Echinostoma hortense

Abstract

Two cases of human Echinostoma hortense infection were found in Seoul Paik Hospital. Their stools revealed echinostomatid eggs. After treatment with praziquantel (single does of 10-12 mg/kg) and purgation with magnesium salt, total 21 flukes were collected in one case. The flukes were 5.9-7.5 mm long, had 27-28 collar spines around their head, laterally deviated ovary and two tandem testes. They were identified as E. hortense Asada, 1926. The cases are 38-year and 20-year old men residing in Seoul, whose hometown is Chungsong-gun and Seungju-gun, Kyongsangbuk-do respectively. They had eaten raw flesh of various kinds of fresh water fishes (both cases) and/or salamander (latter case), which are considered possible sources of this fluke infection. They experienced abdominal discomfort and/or diarrhea. Hematology revealed 22 percent eosinophilia in the latter case, but it became 5 percent after the treatment. Echinostomatid eggs were not found after the treatment in both cases. These are the 4th and 5th human cases of E. hortense infection in Korea.

A human infection of Echinostoma hortense in duodenal bulb diagnosed by endoscopy

“…In consideration of the pathologic findings, the symptoms experienced by the present patient, i.e., epigastric pain and abdominal discomfort, might be provoked by the abrasive action of E. hortense. The frequent symptoms reported by infected individuals, though not pathogen-specific, are abdominal pain, cramps, anorexia, postprandial burning, flatulence, and diarrhea (Lee et al, 1986a;Chai et al, 1994;Lee and Hong, 2002). It has also been suggested that chronic and severe infection may cause intestinal villous atrophy and lead to manifestations of malabsorption.…”

Foodborne Intestinal Flukes in Southeast Asia

“…Patients infected with echinostome species suffer from abdominal pain, diarrhea, tenesmus, easy fatiguability, loss of body weight, and urinary incontinence [1,2,73,380]. The severity of symptoms is generally stronger than those seen in other intestinal fluke infections, such as heterophyids [5].…”

Complete Mitochondrial Genome of <i>Echinostoma hortense</i> (Digenea: Echinostomatidae)

“…Among these genera, Echinostoma is the largest one, which constitutes 7 species, including E. hortense , E. angustitestis , E. cinetorchis , E. echinatum , E. ilocanum , E. macrorchis , and E. revolutum [ 2 ]. Although the majority of people infected by echinostomes have no obvious symptoms, severe infections may cause anorexia, lower extremity edema, anemia, weight loss, and dysplasia [ 3 ].…”

“…The adult worms of E. hortense often inhabit the small intestine of humans and many animals [ 3 ]. The parasitic fluke E. hortense was originally described from rats in Japan [ 4 ], and since then, it has been reported in South Korea and China [ 2 , 3 , 5 , 6 ].…”

“…The adult worms of E. hortense often inhabit the small intestine of humans and many animals [ 3 ]. The parasitic fluke E. hortense was originally described from rats in Japan [ 4 ], and since then, it has been reported in South Korea and China [ 2 , 3 , 5 , 6 ]. In addition to rats, it has also been found from cats, dogs, and pigs [ 6 - 8 ], and more importantly, there are many infected human cases in China, Japan, and South Korea [ 2 , 3 , 9 - 11 ].…”