Diphyllobothriasis differential diagnosis

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

Overview

Enterobiasis must be differentiated from threadworm infections like taeniasis, hymenolepiasis, and schistosomiasis.

Differentiating diphyllobothriasis from other diseases

! style="background:#4479BA; color: #FFFFFF;" |Nematode ! style="background:#4479BA; color: #FFFFFF;" |Transmission ! style="background:#4479BA; color: #FFFFFF;" |Direct Person-Person Transmission ! style="background:#4479BA; color: #FFFFFF;" |Duration of Infection ! style="background:#4479BA; color: #FFFFFF;" |Pulmonary Manifestation ! style="background:#4479BA; color: #FFFFFF;" |Location of Adult worm(s) ! style="background:#4479BA; color: #FFFFFF;" |Treatment |- | align="center" style="background:#DCDCDC;" |Ascaris lumbricoides |Ingestion of infective ova |No |1-2 years |

• Löffler's syndrome (usually about 9-12 days after exposure to ova)
• Cough
• Substernal discomfort
• Crackles
• Wheezing
• Transient opacities

|Free in the lumen of the small bowel (primarily jejunum) |

• Albendazole

• Mebendazole

• Pyrantel pamoate

• Ivermectin

• Levamisole

• Piperazine

|- | align="center" style="background:#DCDCDC;" |Trichuris trichiura (whipworm) |Ingestion of infective ova |No |1-3 years |

• No pulmonary migration, therefore, no pulmonary manifestation

|Anchored in the superficial mucosa of cecum and colon |

• Albendazole

• Mebendazole

|- | align="center" style="background:#DCDCDC;" |Hookworm (Necator americanus and Ancylostoma duodenale) |Skin penetration by filariform larvae |No |

• 3-5 years (Necator)
• 1 year (Ancylostoma)

|

• Löffler's syndrome
• Transient opacities

|Attached to the mucosa of mid-upper portion of the small bowel |

• Albendazole

• Mebendazole

• Levamisole

• Pyrantel pamoate

|- | align="center" style="background:#DCDCDC;" |Strongyloides stercoralis |Filariform larvae penetrate skin or bowel mucosa |Yes |

• Lifetime of the host

|

• Löffler's syndrome
• Chronic cough
• Pneumonia or sepsis in hyperinfection

|Embedded in the mucosa of the duodenum, jejunum |

• Ivermectin
• Albendazole
• Thiabendazole

|- | align="center" style="background:#DCDCDC;" |Enterobius vermicularis (pinworm) |Ingestion of infective ova |Yes |

• 1-month

|

• Extraintestinal migration is very rare

|Free in the lumen of cecum, appendix, adjacent colon |

• Albendazole
• Mebendazole
• Pyrantel pamoate
• Ivermectin
• Levamisole
• Piperazine

|}