+1 (629)348-3199A CASE REPORT OF ECHINOSTOMA SPECIES FOR THE FIRST TIME IN NEPAL
4th International Conference on Tropical Medicine, Infectious Diseases & Public Health
September 7-8, 2017 | Edinburgh, Scotland
Ranjit Shah
Tribhuvan University, Nepal
Posters & Accepted Abstracts : J Parasit Dis Diagn Ther
Abstract:
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 fish.We 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.
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