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J Parasit Dis Diagn Ther 2017
Volume 2 Issue 3 Tropical Medicine 2017
Notes:
Page 50
September 7-8, 2017 | Edinburgh, Scotland
4th International Conference on
Tropical Medicine, Infectious Diseases & Public Health
ACASE REPORT OF ECHINOSTOMA
SPECIES FOR THE FIRST TIME IN NEPAL
Ranjit Shaha
aTribhuvan University, Nepal
Introduction: Echinostomiasis is an infection caused by
trematodes belonging to the genus Echinostoma. It can
infect both humans and animals. These intestinal flukes have
a three-host life cycle with snails or aquatic organisms as
intermediate host and humans and other animals as definitive
host. They infect the gastrointestinal tract of humans. With
light infection, patient may be asymptomatic. With heavy
infections, the worms can produce catarrhal inflammation
and mild ulceration and the patient may experience diarrhea
and abdominal pain. Infection occurs on consumption of
raw or undercooked (roasted) mollusks and are
reporting a case of a 62 years male from Gorkha, Nepal who
presented to TUTH on July 10, 2015 with the chief complain
upper abdominal pain and distension, vomiting on and off
for 3 to 4 months. He has history of consumption of alcohol,
roasted fish and snail and have had jaundice 3 times in the
past, the recent episode of jaundice being 3 to 4 months back.
Considering his symptoms of abdominal pain and jaundice,
he underwent endoscopy. On endoscopy, an adult flat worm
was seen in the intestine which was sent to microbiology
laboratory for further evaluation.
Method: The adult worm was received in our laboratory and
its morphological characteristics were studied. Since, the
worms was small it was pressed between two slides to study
its morphological characteristics. Three consecutive stool
samples were collected and processed for routine macroscopic
and microscopic examination. The size of the detected ova
was measured using cell sensation software version 1.12 for
DP73 camera installed to the Olympus BX53 microscope
used for the microscopy.
Result: The adult worm was flat leaf like, grayish in colour
measuring approximately 1 cm in length by 2 mm in breadth.
Microscopic examination of the wet mount of stool sample
revealed ellipsoidal, yellow-brown, eggs with somewhat
inconspicuous operculum measuring approximately 130 by
70 micrometer . On the basis of morphological appearance
of adult worm and characteristic feature of the detected ova
and its measurement, Echinostoma species was identified.
The photographic evidence of worm and eggs with the results
of measurement were then forwarded to CDC (Centre for
Disease Control and Prevention) which was later confirmed
to be that of Echinostoma species by CDC, Atlanta. Patient
was treated with praziquantel 40mg/kg (single dose), the drug
of choice for Echinostoma infection and stool examination
after 2 weeks did not show any ova of Echinostoma.
Biography
Ranjit Sah is a Resident at Institute of Medicine of Tribhuvan University Teaching
Hospital, Nepal. He has been undergoing researches regarding various clinical
cases during his study period. He has done research on differentiation of Taenia
species by simple ZN stain and the article was published in JIOM with title
“Identification of Taenia in a 6 year old child”. He has identified for the first
time cases in Nepal like Acanthamoeba in corneal scraping of a patient with
keratitis and Toxoxoplasma parasite (tachyzoite and bradyzoites) demonstrated
in vitreous fluid etc
Ranjit Shah, J Parasit Dis Diagn Ther 2017