Clonorchis sinensis

Background

• AKA oriental liver fluke, found in Asia
• Transmitted by ingestion of infected, undercooked fish, crabs, or crayfish
• Infect liver, gallbladder, bile ducts
• Fluke can live in a person for 25-30 years if left untreated

Clinical Features

• Usually asymptomatic
• Abdominal pain, diarrhea, constipation
• Long-term infection can result in severe illness
  • Hepatomegaly
  • Malnutrition
  • Increased risk of cholangiocarcinoma and hepatic cancers due to inflammation

Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

• Taenia saginata
• Taenia solium (Cysticercosis)
• Diphyllobothrium latum
• Hymenolepis nana
• Echinococcus granulosus

Trematodes (Flukes)

• Fasciola hepatica
• Fasciolopsis buski
• Opistorchis viverrini
• Schistosoma spp
  • Schistosomiasis
• Chlonorchis sinensis
• Paragonimus spp.

Nematodes (Roundworms)

• Ascaris lumbricoides
• Enterobius vermicularis (Pinworm)
• Filarial worms
  • Loa Loa
  • Onchocerciasis
  • Lymphatic filariasis (Elephantiasis)
    • Wuchereria bancrofti
    • Brugia malayi
    • Brugia timori
• Hookworm
  • Necator americanus
  • Ancylostoma duodenale
  • Cutaneous larva migrans (Ancylostoma braziliense)
• Dracunculiasis
• Strongyloides stercoralis
• Trichuris trichiura (Whipworm)
• Anisakis
• Toxocara spp.
• Trichinosis

Evaluation

• Definitive diagnosis made by identification of eggs and flukes in stool

Management

• Praziquantel 25mg/kg PO q8h x 2 days

Disposition

• Discharge, likely