Published On: Sun, Oct 14th, 2012

Indian boy vomits out 4 live Fasciolopsis buski flukes according to case report

An 11-year-old boy from India, with no symptoms of parasitic infection, was surprised and startled his parents when he woke up one morning to vomit out four live fasciolopsiasis, or Fasciolopsis buski adults.

The case was published in the journal, the Annals of Tropical Medicine and Public Health on Oct. 8.

Fasciolopsis buski adult fluke Image/CDC DPDx

Fasciolopsis buski adult fluke Image/CDC DPDx

According to the report, his parents took the expelled worms to the pediatrician, which were referred to the department of microbiology for identification. What they found were was a adult fluke that was dorsoventrally flattened, non-segmented, and flesh- colored. It measured about 34 mm x 20 mm in size (about 1 and 1/3 inches by 3/4 of an inch).

Two suckers were seen; ventral and oral, and the ventral sucker was relatively prominent about 2 mm in size. The worm was fleshy and nearly oval in shape with the anterior end narrower and the posterior end broadly rounded. There was no cephalic cone present.

Based on these morphological characteristics, the worm was identified as Fasciolopsis buski.

The boy had no specific symptoms prior to this event, except occasionalabdominal discomfort, nausea, and mild distension.

The boy was treated with nitazoxanide 250 mg twice-daily for 5 days. After 2 weeks of treatment, stool samples were examined but did not show any evidence of any parasite or ova.

Fasciolopsis buski is the largest intestinal fluke in humans. It causes a parasitic disease called fasciolopsiasis. It is found in Asia and the Indian subcontinent, especially in areas where humans raise pigs and consume freshwater plants.

In India, F. buski infestation has been reported mainly from Bihar, Uttar Pradesh, and Maharashtra and sporadically from other states like Assam and West Bengal. It is usually seen in rural areas where water plants are eaten raw according to the case report authors.

See F. buski’s life cycle here.

The pathology of fasciolopsiasis can be described as: more worms , more disease, but usually asymptomatic.

Map showing geographical distribution of flatworm Fasciolopsis buski. Public domain image/Redecke via Wikimedia Commons

Map showing geographical distribution of flatworm Fasciolopsis buski. Public domain image/Redecke via Wikimedia Commons

Large number of worms attached to the mucosa can cause bleeding, inflammation and ulceration. In addition, large numbers may block the intestinal lumen.

Hunger pains, abdominal distention, increased appetite, diarrhea and foul-smelling greenish-yellow stools may be seen.

The most important plants involved in human infection are water caltrop  (see a picture of water caltrops) and water chestnuts where the metcercariae are found on the outer shell.

The outer cover is peeled off with the teeth and the metcercariae are released into the mouth.

Pigs are reservoir hosts.

Praziquantel is the drug of choice.

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About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He is also the Editor-in-Chief of the website, Outbreak News Today.

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