Intestinal Fluke Infections

Intestinal flukes are mainly distributed in Asia. Humans acquire infection by eating raw aquatic plants; fish; or uncooked snails, snakes, or frogs containing metacercariae. Adult flukes of almost all species reside in the small bowel. Intestinal manifestations depend mainly on worm load. Light infection causes mild gastrointestinal symptoms, and heavy infection causes anemia, malabsorption, and protein-losing enteropathy. Rarely, the large fluke, F. buski, can cause small bowel obstruction or perforation. Extra-intestinal manifestations, caused by eggs entering the blood circulation and being deposited at ectopic organs, could be fatal. Eggs of intestinal flukes are difficult to differentiate from others in the same family or from liver flukes. Diagnosis is confirmed by identification of adult worms. Praziquantel is the drug of choice for treatment.