Diphyllobothriasis Clinical Presentation
- Author: Derek Ryan Linklater, MD; Chief Editor: Burke A Cunha, MD more...
History
Most persons with diphyllobothriasis are asymptomatic.
Among symptomatic persons, the following symptoms are most common:[1]
- Indigestion/dyspepsia
- Passage of proglottids
Other, less common, symptoms of diphyllobothriasis include the following:
- Fatigue
- Diarrhea
- Dizziness
- Weakness (rare)
- Numbness of extremities
- Sensation of hunger
- Pruritus ani
Physical
D latum has an unusual affinity for vitamin B-12, and symptoms of diphyllobothriasis clinically resemble those of megaloblastic anemia. Most patients with diphyllobothriasis have no signs of illness because significant anemia affects less than 2% of persons infected with D latum. The following physical findings associated with diphyllobothriasis are rare and are most likely related to underlying nutritional anemia:
- Pallor
- Glossitis
- Dyspnea
- Tachycardia
- Weakness
- Hypesthesia
- Paresthesias
- Disturbances of movement and coordination
Causes
Diphyllobothriasis is caused by ingestion of raw or undercooked infected fish and subsequent intestinal infection.
Lee EB, Song JH, Park NS, et al. A case of Diphyllobothrium latum infection with a brief review of diphyllobothriasis in the Republic of Korea. Korean J Parasitol. Sep 2007;45(3):219-23. [Medline].
Koontz F, Weinstock JV. The approach to stool examination for parasites. Gastroenterol Clin North Am. Sep 1996;25(3):435-49. [Medline].
Hirata M, Yamaguchi Y, Ikei Y, et al. A case of Diphyllobothrium latum/nihonkaiense infection identified by capsule endoscopy in small intestine. Gastrointest Endosc. Jul 2006;64(1):129; discussion 130. [Medline].
Butt AA, Aldridge KE, Sanders CV. Infections related to the ingestion of seafood. Part II: parasitic infections and food safety. Lancet Infect Dis. May 2004;4(5):294-300. [Medline].
Jong EC, McMullen R. Travel medicine problems encountered in emergency departments. Emerg Med Clin North Am. Feb 1997;15(1):261-81. [Medline].
Juckett G. Common intestinal helminths. Am Fam Physician. Nov 15 1995;52(7):2039-48, 2051-2. [Medline].
MacPherson DW. Intestinal parasites in returned travelers. Med Clin North Am. Jul 1999;83(4):1053-75. [Medline].
Pearson RD, Hewlett EL. Niclosamide therapy for tapeworm infections. Ann Intern Med. Apr 1985;102(4):550-1. [Medline].
Schantz PM. Tapeworms (cestodiasis). Gastroenterol Clin North Am. Sep 1996;25(3):637-53. [Medline].
Tanowitz HB, Weiss LM, Wittner M. Diagnosis and treatment of intestinal helminths. I. Common intestinal cestodes. Gastroenterologist. Dec 1993;1(4):265-73. [Medline].
Thielman NM, Guerrant RL. Persistent diarrhea in the returned traveler. Infect Dis Clin North Am. Jun 1998;12(2):489-501. [Medline].
Wolfe MS. Eosinophilia in the returning traveler. Med Clin North Am. Jul 1999;83(4):1019-32, vii. [Medline].

