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{{Infobox_Disease
__NOTOC__
| Name          = {{PAGENAME}}
{{Diphyllobothriasis}}
| Image          =
| Caption        =
| DiseasesDB    = 29539
| ICD10          = {{ICD10|B|70|0|b|65}}
| ICD9          = {{ICD9|123.4}}
| ICDO          =
| OMIM          =
| MedlinePlus    = 001375
| eMedicineSubj  = med
| eMedicineTopic = 571
| MeshID        = D004169
}}
'''Diphyllobothriasis''' is the infection caused by [[Diphyllobothrium]].


{{SI}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{EH}}


==Geographic distribution==
{{CMG}}; {{AE}} {{KD}}, {{MMF}}
Diphyllobothriasis occurs in areas where lakes and rivers coexist with human consumption of raw or undercooked freshwater fish.  Such areas are found in the Northern Hemisphere (Europe, newly independent states of the former Soviet Union (NIS), North America, Asia) (particularly in Japan (because of Sushi or Sashimi)), Uganda, Peru (because of Ceviche) Chile.


Around mid-twentieth in Japan before advancements in refrigeration, many sushi/sashimi connoisseurs suffered great morbidity and mortality from Diphyllobothrium after eating unrefrigerated sashimi. After developments in parasitology, many scientists came to realise that the primary cause for this burden was due to the relatively favourable parasite breeding conditions that raw fish offered.
{{SK}} Fish tapeworm infection, Broad tapeworm infection, Diphyllobothrium latum infection, Diphyllobothrium infection, Diphyllobothrium nihonkaiense infection, Diphyllobothrium dendriticum infection, Diphyllobothrium cameroni infection, Diphyllobothrium cordatum infection, Diphyllobothrium hians infection, Diphyllobothrium lanceolatum infection, Diphyllobothrium orcini infection, Diphyllobothrium pacificum infection, Diphyllobothrium stemmacephalum infection, Diphyllobothrium scoticum infection


The disease is rare in the United States, however, it was once more common and was referred to as "Jewish housewife's disease" because Jewish housewives preparing the traditional "gefilte fish" tended to taste the fish before it was cooked.
==[[Diphyllobothriasis overview|Overview]]==


==Clinical features==
==[[Diphyllobothriasis historical perspective|Historical perspective]]==
Diphyllobothriasis can last for decades if untreated.  Most infections are asymptomatic.  Manifestations may include abdominal discomfort, diarrhea, vomiting and weight loss.  Vitamin B12 deficiency with subsequent [[megaloblastic anemia]] may occur, but has not for several decades in ''D. latum'' infections, possibly because of improved [[nutrition]]. In one test, nearly half of the ingested vitamin was absorbed by ''D. latum'' in otherwise healthy patients, while 80-100% was absorbed by the worm in patients with anemia.  It is not known why anemia occurs in some cases but not others.  Massive infections may result in intestinal obstruction.  Migration of proglottids can cause [[cholecystitis]] or [[cholangitis]].


Females cases are disproportionately reported, most likely due to the higher likelihood for them to be involved in meal preparation, rather than any [[sexual dimorphism|morphological differences]].
==[[Diphyllobothriasis classification|Classification]]==


==Diagnosis==
==[[Diphyllobothriasis pathophysiology|Pathophysiology]]==
Microscopic identification of eggs in the stool is the basis of specific diagnosis.  Eggs are usually numerous and can be demonstrated without concentration techniques.  Examination of proglottids passed in the stool is also of diagnostic value.
 
==[[Diphyllobothriasis causes|Causes]]==


Diagnostic tool:
==[[Diphyllobothriasis differential diagnosis|Differentiating Diphyllobothriasis from other Diseases]]==
* [[Microscopy]]
* Morphologic comparison with other intestinal parasites


Though it is difficult to identify the eggs or proglottids to the species level, the distinction is of little medical importance because, like most adult tapeworms in the intestine, all members of this genus respond to the same drugs.
==[[Diphyllobothriasis epidemiology and demographics|Epidemiology and Demographics]]==


==Treatment==
==[[Diphyllobothriasis risk factors|Risk Factors]]==
[[Praziquantel]] and [[niclosamide]] are historical treatments that should no longer be used as first line therapy in developed countries; they result in destruction and disintegration of the worm which may make it impossible to confirm that the scolex (head of the worm) has been passed (the only way to confirm cure).  Praziquantel or niclosamide should only be used in situations when [[endoscopy]] is not available or is not possible.


The preferred treatment for all tapeworm infections is injection of [[diatrizoic acid]] into the [[duodenum]], which causes the worm to detach and be passed whole.<ref>{{cite journal | author=Waki K, Oi H, Takahashi S, ''et al.'' | title=Successful treatment of ''Diphyllobothrium latum'' and ''Taenia saginata'' infection by intraduodenal 'Gastrografin' injection | journal=Lancet | year=1986 | volume=2 | pages=1124&ndash;6 }}</ref>
==[[Diphyllobothriasis screening|Screening]]==


==Prevention==
==[[Diphyllobothriasis natural history|Natural History, Complications and Prognosis]]==
Avoid ingestion of raw freshwater fish. Adequate cooking or freezing of freshwater fish will kill the encysted fish tapeworm larvae.  Also, because human feces is an important mechanism for spreading eggs, proper disposal of sewage can cut down on infection of fish and thus of humans.


==References==
==Diagnosis==
{{reflist}}
[[Diphyllobothriasis history and symptoms| History and Symptoms]] | [[Diphyllobothriasis physical examination | Physical Examination]] | [[Diphyllobothriasis laboratory tests|Laboratory Findings]] | [[Diphyllobothriasis X ray|X Ray]] | [[Diphyllobothriasis CT scan|CT scan]] | [[Diphyllobothriasis MRI|MRI]] | [[Diphyllobothriasis ultrasound|Ultrasound]] | [[Diphyllobothriasis other imaging findings|Other imaging findings]] | [[Diphyllobothriasis other diagnostic studies|Other diagnostic studies]]


==External links==
==Treatment==
* http://www.dpd.cdc.gov/dpdx/HTML/Diphyllobothriasis.htm
[[Diphyllobothriasis medical therapy|Medical Therapy]] | [[Diphyllobothriasis surgery| Surgery]] | [[Diphyllobothriasis primary prevention|Primary prevention]] | [[Diphyllobothriasis secondary prevention|Secondary prevention]]


{{SIB}}
==Case Studies==
[[Category:Disease]]
[[Diphyllobothriasis case study one|Case#1]]


{{Helminthiases}}
{{Helminthiases}}
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[[Category:Disease]]
[[Category:Foodborne illnesses]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]

Latest revision as of 21:23, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2], Furqan M M. M.B.B.S[3]

Synonyms and keywords: Fish tapeworm infection, Broad tapeworm infection, Diphyllobothrium latum infection, Diphyllobothrium infection, Diphyllobothrium nihonkaiense infection, Diphyllobothrium dendriticum infection, Diphyllobothrium cameroni infection, Diphyllobothrium cordatum infection, Diphyllobothrium hians infection, Diphyllobothrium lanceolatum infection, Diphyllobothrium orcini infection, Diphyllobothrium pacificum infection, Diphyllobothrium stemmacephalum infection, Diphyllobothrium scoticum infection

Overview

Historical perspective

Classification

Pathophysiology

Causes

Differentiating Diphyllobothriasis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT scan | MRI | Ultrasound | Other imaging findings | Other diagnostic studies

Treatment

Medical Therapy | Surgery | Primary prevention | Secondary prevention

Case Studies

Case#1

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