Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Molecular Identification of Diphyllobothrium latum from a Pediatric Case in Taiwan

  • An, Yu-Chin (Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center) ;
  • Sung, Chia-Cheng (Departments of Pediatrics, Tri-Service General Hospital, National Defense Medical Center) ;
  • Wang, Chih-Chien (Departments of Pediatrics, Tri-Service General Hospital, National Defense Medical Center) ;
  • Lin, Hsin-Chung (Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center) ;
  • Chen, Kuang-Yao (Department of Parasitology, College of Medicine, Chang Gung University) ;
  • Ku, Fu-Man (Molecular Regulation and Bioinformatics Laboratory, Department of Parasitology, College of Medicine, Chang Gung University) ;
  • Chen, Ruei-Min (Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center) ;
  • Chen, Mei-Li (Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center) ;
  • Huang, Kuo-Yang (Graduate Institute of Pathology and Parasitology, National Defense Medical Center)
  • Received : 2017.06.11
  • Accepted : 2017.07.02
  • Published : 2017.08.31
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Abstract

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.

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References

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