A 65-year old Korean man, living in Mokpo-city, Jeollanam-do, Republic of Korea, visited a local clinic complaining of right upper quadrant pain and indigestion. At colonoscopy, he was diagnosed as having a carcinoma of the ascending colon, and thus, a palliative right hemicolectomy was performed. Subsequently, an adult fluke of Gymnophalloides seoi was incidentally found in a surgical pathology specimen of the lymph node around the colon. The worm was found to have invaded gut lymphoid tissue, with characteristic morphologies of a large oral sucker, a small ventral sucker, and a ventral pit surrounded by strong muscle fibers. This is the first reported case of mucosal tissue invasion by G. seoi in the human intestinal tract.
Trematode Infections/diagnosis/parasitology/*pathology ; Trematoda/*isolation & purification/ultrastructure ; Male ; Lymphoid Tissue/*parasitology ; Korea ; Intestinal Diseases, Parasitic/diagnosis/*parasitology/pathology ; Humans ; Colonic Diseases/*parasitology ; Colon/*parasitology/pathology/surgery ; Animals ; Aged

A 94-year-old female with end-stage renal disease presents with fever, fatigue, and hematochezia. She had previously resided in Hunan Province, China, and Myanmar, and she immigrated to Taiwan 30 years ago. Colonoscopy revealed a colonic ulcer. Biopsy of the colonic ulcer showed ulceration of the colonic mucosa, and many Paragonimus westermani-like eggs were noted. Serum IgG antibody levels showed strong reactivity with P. westermani excretory-secretory antigens by ELISA. Intestinal paragonimiasis was thus diagnosed according to the morphology of the eggs and serologic finding. After treatment with praziquantel, hematochezia resolved. The present case illustrates the extreme manifestations encountered in severe intestinal paragonimiasis.
Aged, 80 and over ; Animals ; Anthelmintics/therapeutic use ; Antibodies, Helminth/blood ; Antigens, Helminth/immunology ; Colonic Diseases/complications/drug therapy/*pathology ; Colonoscopy ; Enzyme-Linked Immunosorbent Assay ; Female ; Gastrointestinal Hemorrhage/complications/drug therapy/*pathology ; Humans ; Intestinal Diseases, Parasitic/complications/drug therapy/parasitology/*pathology ; Kidney Failure, Chronic/complications ; Paragonimiasis/complications/drug therapy/parasitology/*pathology ; Paragonimus westermani/*immunology ; Praziquantel/therapeutic use ; Taiwan ; Ulcer/complications/drug therapy/*pathology