eMedicine Specialties > Infectious Diseases > Parasitic Infections

Diphyllobothriasis: Differential Diagnoses & Workup

Author: Derek Ryan Linklater, MD, Assistant Professor of Military and Emergency Medicine, F Edward Hebert School Of Medicine; Assistant Clinical Professor of Emergency Medicine, Texas A&M Health Science Center College of Medicine; Clinical Instructor of Pediatrics, Baylor College of Medicine
Coauthor(s): Coburn H Allen, MD, Assistant Professor, Department of Pediatrics, Section of Emergency Medicine and Section of Infectious Diseases, Baylor College of Medicine; Consulting Staff, Texas Children's Hospital
Contributor Information and Disclosures

Updated: Sep 26, 2008

Differential Diagnoses

Anemia
Folic Acid Deficiency
Hypothyroidism
Megaloblastic Anemia
Pernicious Anemia

Other Problems to Be Considered

Beef tapeworm and pork tapeworm infections
Vitamin B-12 deficiency

Workup

Laboratory Studies

  • Microscopic stool examination for ova and parasites2
  • Complete blood cell count
    • Hemoglobin and hematocrit levels may be below or at the lower end of the reference range.
    • The mean cell volume may be above or at the higher end of the reference range.
    • Eosinophilia may be present.
  • Peripheral smear
  • Vitamin B-12 level
  • Folate level

Imaging Studies

  • No imaging studies are required to evaluate diphyllobothriasis, unless otherwise clinically indicated by the patient's presentation.

Other Tests

  • Cases of diphyllobothriasis have been successfully identified using capsule endoscopy.3 This procedure is painless and may provide useful adjunctive information for the treatment of this disease.

Procedures

  • No procedures are required in the workup of diphyllobothriasis.

More on Diphyllobothriasis

Overview: Diphyllobothriasis
Differential Diagnoses & Workup: Diphyllobothriasis
Treatment & Medication: Diphyllobothriasis
Follow-up: Diphyllobothriasis
References
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References

  1. 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].

  2. Koontz F, Weinstock JV. The approach to stool examination for parasites. Gastroenterol Clin North Am. Sep 1996;25(3):435-49. [Medline].

  3. 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].

  4. 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].

  5. Jong EC, McMullen R. Travel medicine problems encountered in emergency departments. Emerg Med Clin North Am. Feb 1997;15(1):261-81. [Medline].

  6. Juckett G. Common intestinal helminths. Am Fam Physician. Nov 15 1995;52(7):2039-48, 2051-2. [Medline].

  7. MacPherson DW. Intestinal parasites in returned travelers. Med Clin North Am. Jul 1999;83(4):1053-75. [Medline].

  8. Pearson RD, Hewlett EL. Niclosamide therapy for tapeworm infections. Ann Intern Med. Apr 1985;102(4):550-1. [Medline].

  9. Schantz PM. Tapeworms (cestodiasis). Gastroenterol Clin North Am. Sep 1996;25(3):637-53. [Medline].

  10. Tanowitz HB, Weiss LM, Wittner M. Diagnosis and treatment of intestinal helminths. I. Common intestinal cestodes. Gastroenterologist. Dec 1993;1(4):265-73. [Medline].

  11. Thielman NM, Guerrant RL. Persistent diarrhea in the returned traveler. Infect Dis Clin North Am. Jun 1998;12(2):489-501. [Medline].

  12. Wolfe MS. Eosinophilia in the returning traveler. Med Clin North Am. Jul 1999;83(4):1019-32, vii. [Medline].

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Further Reading

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Keywords

diphyllobothriasis, tapeworm infection, flatworm infection, Diphyllobothrium latum, D latum, bothriocephaliasis, cestodes, cestode infection, cestodiasis, tapeworms, flatworms, intestinal parasites, Diphyllobothrium worms

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Contributor Information and Disclosures

Author

Derek Ryan Linklater, MD, Assistant Professor of Military and Emergency Medicine, F Edward Hebert School Of Medicine; Assistant Clinical Professor of Emergency Medicine, Texas A&M Health Science Center College of Medicine; Clinical Instructor of Pediatrics, Baylor College of Medicine
Derek Ryan Linklater, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Coburn H Allen, MD, Assistant Professor, Department of Pediatrics, Section of Emergency Medicine and Section of Infectious Diseases, Baylor College of Medicine; Consulting Staff, Texas Children's Hospital
Coburn H Allen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Medical Editor

Mark Raymond Wallace, MD, Infectious Disease Fellowship Director, Orlando Regional Healthcare; Clinical Professor of Medicine, Florida State University
Mark Raymond Wallace, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Thomas M Kerkering, MD, Chief of Infectious Diseases, Virginia Tech, Carilion School of Medicine, Roanoke, Virginia
Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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