The growing popularity of eating raw fish has resulted in increase of certain human parasitic infection, such as diphyllobothriasis. Even though, upper and lower gastrointestinal endoscopy reveal no specific abnormality, if a patient complains of persistent abdominal pain, we should consider the possibility of parasitic infection. Careful history taking and stool examination can avoid further invasive study. We report a case of Diphyllobothrium latum infection in a patient with vague abdominal pain who showed normal finding on endoscopy.
Abdominal Pain/*diagnosis ; Animals ; Anthelmintics/therapeutic use ; Diphyllobothriasis/*diagnosis/drug therapy/parasitology ; *Diphyllobothrium/isolation & purification ; Endoscopy, Gastrointestinal/methods ; Female ; Humans ; Middle Aged ; Praziquantel/therapeutic use

Diphyllobothrium latum and Diphyllobothrium nihonkaiense are the 2 reported main causes of human diphyllobothriasis in the Republic of Korea. However, the differentiation of these 2 species based on morphologic features alone is difficult. The authors used nucleotide sequencing of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene to diagnose Diphyllobothrium spp. Two patients visited the emergency room at Kyungpook National University Hospital on 3 April and 12 April 2013, respectively, with fragments of parasites found while defecating. The parasites were identified as Diphyllobothrium spp. based on morphologic characteristics, and subsequent cox1 gene sequencing showed 99.9% similarity (1,478/1,480 bp) with D. nihonkaiense. Our findings support the hypothesis that D. nihonkaiense is a dominant species in Korea.
Adult ; Animals ; Anthelmintics/therapeutic use ; Base Sequence ; DNA, Helminth/*genetics ; Diphyllobothriasis/*diagnosis/drug therapy ; Diphyllobothrium/*genetics ; Electron Transport Complex IV/*genetics ; Humans ; Male ; Middle Aged ; Mitochondria/enzymology ; Phylogeny ; Praziquantel/therapeutic use ; Republic of Korea ; Sequence Analysis, DNA ; Young Adult

Diphyllobothrium latum and Diphyllobothrium nihonkaiense are morphologically similar to each other, and only genetic method can differentiate clearly between the 2 species. A strobila of diphyllobothriid tapeworm discharged from a 7-year-old boy was analyzed to identify the species by mitochondrial cytochrome c oxidase subunit 1 (cox1) gene sequencing. He and his family (total 4 persons) ate slices of 3 kinds of raw fish 16 days before visiting our outpatient clinic. All family members complained of abdominal pain and watery diarrhea. They all expelled tapeworm strobilae in their stools. They were treated with a single oral dose of praziquantel and then complained of no more symptoms. The cox1 gene sequencing of the strobila from the boy revealed 99.9% (687/688 bp) similarity with D. nihonkaiense and only 93.2% (641/688 bp) similarity with D. latum. Thus, we assigned this tapeworm as D. nihonkaiense. This is the first report of D. nihonkaiense infection in a family in Korea, and this report includes the 8th pediatric case in Korea. The current report is meaningful because D. nihonkaiense infection within a family is rare.
Animals ; Anthelmintics/therapeutic use ; Child ; Diphyllobothriasis/*diagnosis/drug therapy/*parasitology ; Diphyllobothrium/*classification/enzymology/genetics/*isolation & purification ; Electron Transport Complex IV/genetics ; *Family Health ; Humans ; Korea ; Male ; Praziquantel/therapeutic use ; Sequence Analysis, DNA ; Treatment Outcome

Diphyllobothrium latum and Diphyllobothrium nihonkaiense are morphologically similar to each other, and only genetic method can differentiate clearly between the 2 species. A strobila of diphyllobothriid tapeworm discharged from a 7-year-old boy was analyzed to identify the species by mitochondrial cytochrome c oxidase subunit 1 (cox1) gene sequencing. He and his family (total 4 persons) ate slices of 3 kinds of raw fish 16 days before visiting our outpatient clinic. All family members complained of abdominal pain and watery diarrhea. They all expelled tapeworm strobilae in their stools. They were treated with a single oral dose of praziquantel and then complained of no more symptoms. The cox1 gene sequencing of the strobila from the boy revealed 99.9% (687/688 bp) similarity with D. nihonkaiense and only 93.2% (641/688 bp) similarity with D. latum. Thus, we assigned this tapeworm as D. nihonkaiense. This is the first report of D. nihonkaiense infection in a family in Korea, and this report includes the 8th pediatric case in Korea. The current report is meaningful because D. nihonkaiense infection within a family is rare.
Animals ; Anthelmintics/therapeutic use ; Child ; Diphyllobothriasis/*diagnosis/drug therapy/*parasitology ; Diphyllobothrium/*classification/enzymology/genetics/*isolation & purification ; Electron Transport Complex IV/genetics ; *Family Health ; Humans ; Korea ; Male ; Praziquantel/therapeutic use ; Sequence Analysis, DNA ; Treatment Outcome

Diphyllobothrium latum infections in 4 young Korean men detected from 2008 to 2012 are presented. Three were diagnosed based on spontaneously discharged strobila of the adult worm in their feces, and 1 case was diagnosed by finding the worm at colonoscopy examination in a local clinic. The morphologic characteristics of the gravid proglottid and eggs were consistent with D. latum. All patients were treated with praziquantel 15 mg/kg, and follow-up stool examinations were done at 2 months after the medication. The main clinical complaints were intermittent gastrointestinal troubles such as indigestion, abdominal distension, and spontaneous discharge of tapeworm's segments in their feces. The most probable source of infection was the flesh of salmon or trout according to a patient's past history. These are the 45th to 48th recorded cases diagnosed by the adult worm in the Republic of Korea since 1971.
Adolescent ; Adult ; Animals ; Anthelmintics/administration & dosage ; Colonoscopy ; Diphyllobothriasis/*diagnosis/drug therapy/parasitology/*pathology ; Diphyllobothrium/anatomy & histology/*isolation & purification ; Feces/parasitology ; Humans ; Male ; Microscopy ; Praziquantel/administration & dosage ; Republic of Korea ; Young Adult