Opisthorchis viverrini
Background
- a.k.a. "southeast asian liver fluke" (endemic)
- Trematode
- Also within genus: opisthorchis felineus (Europe/Asia incl Russia)[1]
Life Cycle
- Eggs pass in feces --> freshwater snail ingestion --> larval trematode embeds in fish skin/flesh --> Fish consumed raw --> duodenal cyst and subsequent biliary infection
- Fluke count may effect clinical presentation (lower counts more asymptomatic)
Risk Factors
- Consumption of raw/undercooked fish
- Exposure to endemic areas (see above)
Clinical significance
- Source of acute cholangitis
- Chronic infection predisposes to cholangiocarcinoma
Clinical Presentation
Differential Diagnosis
Management
- Praziquantel, 75mg/kg/day orally for 2 days (adults/pediatric) with meal[1]
or
- Albendazole, 10mg/kg/day orally for 7 days (adults/pediatric) with meal [non-FDA alternative][1]
- Identical to treatment for Clonorchis [2]
- In cases of clonorchis in China, Trebindamine 400 mg once has less side effects and equal efficacy (not available in U.S.) [3] [4]