eMedicine Specialties > Infectious Diseases > Parasitic Infections

Trematode Infection: Follow-up

Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath, Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India
Coauthor(s): Thomas J Marrie, MD, Chair, Professor, Department of Medicine, Division of Infectious Diseases, University of Alberta College of Medicine; Shekhar Koirala, MD, Vice Chancellor, Department of Medicine, BP Koirala Institute of Health, Dharan, Nepal
Contributor Information and Disclosures

Updated: Jun 30, 2008

Follow-up

Further Inpatient Care

  • Anemia may be treated with iron supplements and vitamins, which may be administered orally to facilitate iron absorption.

Further Outpatient Care

  • Further outpatient care includes health education. Thorough cooking of fish and aquatic vegetables, fruits, and plants is necessary to prevent ingestion of infective forms of the parasite.

Transfer

  • Transfer if access to specialized health care services is lacking.

Deterrence/Prevention

  • Elimination of molluscan hosts to control infection with schistosomes and intestinal, liver, and lung flukes
  • Proper sanitary disposal of human and pig excreta to avoid water contamination
  • Chemotherapy of infected persons
  • Avoidance of consumption of contaminated water, water plants, fruits, fish, crab, and raw liver
  • Thorough cleaning and washing of raw vegetables and aquatic fruits to prevent infection with intestinal flukes
  • Thorough cooking of water-grown vegetables before eating
  • Cooking of crab and crayfish before eating to prevent infection with lung flukes

Complications

  • Schistosomiasis
    • Cor pulmonale
    • Portal hypertension
    • Urinary bladder carcinoma
  • Lung flukes
    • Lung abscess
    • Pleural effusion
    • Ectopic lesions in the brain
  • Liver flukes
    • Intercurrent bacterial infections
    • Less commonly, pancreatitis in fascioliasis8
    • Anemia
    • Recurrent pyogenic cholangitis and cholangiocarcinoma in clonorchiasis
  • Intestinal flukes: Asthenia with ascites in fasciolopsiasis

Prognosis

  • Prognosis is excellent in patients with mild-to-moderate trematode infection, with early disease, and/or without severe complications.
  • Patients with heavier worm infection are less likely to improve, and the outcome in such infections may be serious and fatal.

Patient Education

  • Avoidance of high-risk food habits: Inform patients about the danger of eating raw or undercooked vegetables and fish and the importance of cleaning, washing, and adequately cooking vegetables and fish or raw liver.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider the diagnosis of trematode infection in appropriate patients who present with nonspecific findings and a history of travel or residence in the areas endemic for trematode diseases
 


More on Trematode Infection

Overview: Trematode Infection
Differential Diagnoses & Workup: Trematode Infection
Treatment & Medication: Trematode Infection
Follow-up: Trematode Infection
Multimedia: Trematode Infection
References
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Further Reading

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Keywords

trematode infection, trematodiasis, parasites, parasite infection, parasitemia, flukes, blood fluke, lung fluke, liver fluke, intestinal fluke, Paragonimus westermani, P westermani, Clonorchis sinensis, C sinensis, Fasciola hepatica, F hepatica, Opisthorchis viverrini, O viverrini, Fasciolopsis buski, F buski, Heterophyes heterophyes, H heterophyes, Metagonimus yokogawai, M yokogawai, Schistosoma mekongi, S mekongi, Schistosoma intercalatum, S intercalatum, Fasciola gigantica, F gigantica, Echinostoma ilocanum, E ilocanum, Opisthorchis felineus, O felineus, Schistosoma species, schistosomes, Oriental lung fluke, giant intestinal fluke, schistosomiasis, freshwater snails, watercress, fresh-water snails, fresh water snails, pulmonary paragonimiasis, paragonimiasis, swimmer's itch, swimmer itch, cercarial dermatitis, Katayama syndrome, fascioliasis, clonorchiasis, schistosomal infection, fasciolopsiasis, heterophyiasis, metagonimiasis, pyogenic cholangitis, hemiplegia, cephalgia, paresis,cholangiocarcinoma, bilharzia, fasciolosis

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Contributor Information and Disclosures

Author

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath, Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India
Subhash Chandra Parija, MBBS, MD, PhD, FRCPath is a member of the following medical societies: Indian Academy of Tropical Parasitology, Indian Association of Biomedical Scientists, Indian Association of Medical Microbiologists, Indian Association of Pathologists and Microbiologists, Indian Medical Association, Indian Society for Parasitology, National Academy of Medical Sciences, India, and Royal College of Pathologists
Disclosure: Jawaharlal Institute of Postgraduate Medical education & Research , Pondicherry , India Salary Employment

Coauthor(s)

Thomas J Marrie, MD, Chair, Professor, Department of Medicine, Division of Infectious Diseases, University of Alberta College of Medicine
Thomas J Marrie, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, Canadian Infectious Disease Society, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Shekhar Koirala, MD, Vice Chancellor, Department of Medicine, BP Koirala Institute of Health, Dharan, Nepal
Disclosure: Nothing to disclose.

Medical Editor

Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians 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

Ronald A Greenfield, MD, Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine
Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubicin  Speaking and teaching

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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