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Korean J Parasitol > Volume 32(3):1994 > Article

Brief Communication
Korean J Parasitol. 1994 Sep;32(3):201-204. English.
Published online Sep 20, 1994.  http://dx.doi.org/10.3347/kjp.1994.32.3.201
Copyright © 1994 by The Korean Society for Parasitology
A case of echinostomiasis with ulcerative lesions in the duodenum
J Y Chai,*1S T Hong,1S H Lee,1G C Lee,2 and Y I Min2
1Department of Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul 110-799, Korea.
Received July 09, 1994; Accepted August 04, 1994.

Abstract

Echinostomiasis is an endemic intestinal trematodiasis of humans in Korea. We observed a human case of Echinostoma hortense infection who had ulcerations on the duodenal mucosa. A 55-year old man living in Hamyang-gun, Kyongnam, complained of epigastric pain with hematemesis in April 1994. Endoscopy revealed lesions of early gastric cancer and duodenal ulcerations. A penetrating parasite into the duodenal mucosa was picked out, and identified as E. hortense. As the patient was treated with praziquantel 10 mg/kg single dose, 3 more E. hortense and 7 Metagonimus worms were recovered. This case demonstrates that echinostomiasis causes gross ulcerations in the duodenum.

Figures


Fig. 1
Fiberendoscopic wiews of the duodenum wall posterior to the bulb. A. moving worm (arrow) is penetration into the wall. B. The mucosal surface is obviously ulcerated after removal of the worm (arrow). Twon nearby ulcers are of same nature.


Figs. 2-4
Fig. 2. The worm removed from the duodenum by fiberscopy was identified as E. hortense. The worm was sectioned sagittally, showing head crown, large ventral sucker, uterine loop, ovary at equatorial dorsum, two testes at posterior body half, and vitelline follicles at ventral posterior body. Bar, 1 mm. Fig. 3. Magnified anterior end of the sectioned worm. The head crown (arrow) with collar spines (arrow heads) is well-developed, and tegumental spines are obvious. Fig. 4. three more E. hortense and 7 Metagonimus, Miyata type, were recovered from the case after praziquantel treatment. Gross view.

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