Parents of a young kid come up with a complaint of passing many worms in the stool (The picture of the parasite is provided below). The parasite was eradicated with Praziquantel treatment, however, initial treatment with Albendazole didn't work well. Could anyone help in identification of this parasite?
The image is not very informative - it might be an intestinal trematode?
like Dr Christian said,it looks like a trematode and more precisely to a liver fluke
humans do not pass liver flukes (as they are definitive hosts for same) in stool only eggs are passed in stool. Fasciola hepatica occurs in the liver of a definitive host and its lifecycle is indirect. It goes through may intermediate stages in environment as well as in its intermediate host that is fresh water snails Thereafter metacercariae are released from the freshwater snail as cercariae, and form cysts on various surfaces including aquatic vegetation. The mammalian host then eats this vegetation and can become infected. Humans can often acquire these infections through eating freshwater plants such as watercress. Inside the duodenum of the mammalian host, the metacercariae are released from within their cysts. From the duodenum, they burrow through the lining of the intestine and into the peritoneal cavity. They then migrate through the intestines and liver, and into the bile ducts. Inside the bile ducts, they develop into an adult fluke.
Hence not possible to identify by one picture alone . Probably a cross section and study under dissection microscope will be more informative.
yes i'm agree with you Nina but with the antihelminthic effect, this is not possible that parasite pass outside with the feces?because the form on the picture show a likeness to the liver fluke, doesn't
But still as I said before, it could be one of the >70 species of intestinal trematodes that can innfect humans
I agree, an intestinal trematode (Fasciolpsis buski being oe of the more common ones) is most likely.
I do not exclude a segment of the cestode needs a detailed anamnesis
Sorry, but cestode very unlikely. The proglottides of cestodes are more plain and flat.
It’s not segmented, so ruling out cestodes. It is most likely to be fasciolopsis buski. From the image it appears that the worm does not have an shoulder and worm passed in stool . Moreover, the worm got eradicated with praziquantel therapy
The liver complete liver flukes are expelled by pratiquantel after purgative 3-4 hrs. after Praziquantel was swolowed by humans. My own experiences.
This is true and I definitely recommend to use praziquantel in such cases (15–25 mg/kg body weight), mostly only once, but occasionally repeat treatment after 10 days or so. Niclosamide is an alternative.
I agree, the picture is not good but it looks like an intestinal trematode
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