A case of Diphyllobothrium latum/nihonkaiense infection identified by capsule endoscopy in small intestine

Abstract

View Large Image Figure Viewer View Large Image Figure Viewer A 23-year-old woman was referred to our hospital for treatment of Diphyllobothrium latum/nihonkaiense infection. No particular abnormality was noted on the physical and blood examinations. Capsule endoscopy was performed before treatment, because about 3 weeks had passed after she expelled the proglottids. A scolex (A) at the upper small-intestinal mucosa was observed 2 hours and 3 minutes into the examination. A worm with numerous proglottids (B) was noted in the region over the lower small intestine at 4 hours and 44 minutes, and mature proglottids (C) were also found in the small intestine. No particular abnormality was seen in the small-intestinal mucosa. Praziquantel was administered, followed by ingestion of a cathartic (30 g magnesium sulfate and 300 mL water) 2 hours later. A worm about 3 m in length was expelled after 1 hour. The expelled worm had a scolex and eggs in the mature proglottids. It is possible that the infective source was raw salmon, which the patient had eaten several months earlier. Capsule endoscopy performed in this patient allowed observation of the worm without pain to the patient, and thus the method was useful for the diagnosis of the parasite, including observation of the scolex. View Large Image Figure Viewer