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CLONORCHIS SINENSIS Becky Koehler Emma Lee Shaler WHAT IS IT? Human liver fluke Found in bile duct and gall bladder Feeds on the bile Acquired by eating fresh water fish (raw, undercooked) containing fluke larvae HOSTS Definitive: Variety of mammals, including humans, swine and rodents (zoonosis). 1st Intermediate: Snails 2nd Intermediate: Freshwater fish GEOGRAPHIC RANGE Japan, China, Taiwan and Southeast Asia and even some in the United States. Common among Asian immigrants. MORPHOLOGY Hermaphrodite Unsegmented Leaf- shaped Bilaterally symmetrical excretory system Bear 2 suckers Ventral Oral Oblong shaped Flat (platyhelminthes) 10-25 mm in length CLINICAL SIGNS Dwells in the bile ducts, causing inflammatory reaction, hyperplasia and sometimes carcinoma of bile ducts. Adult metacercariae is capable of consuming all bile produced by the liver, therefore, preventing the human host to digest (especially fats). Obstruction of bile duct by parasite or eggs leads to biliary obstruction and cholangitis. CLINICAL SIGNS (CONT.) Acute Abdominal pain, nausea, diarrhea, eosinophilia and loss of appetite Long-standing infections can be fatal Incubation period: viable; depends on the number of worms present DIAGNOSIS/TREATMENT Microscopic demonstration of eggs in stool. Duodenal aspirate-most diagnostic method Adult fluke can be recovered during surgery. Treated with Praziquantel (drug of choice) or albendazole. INTERESTING FACTS Believed to be the third most prevalent worm parasite in the world! Currently infecting approximately 30,000,000 humans!! The adult liver fluke can live in the bile ducts from anywhere between 30-40 years! LIFE CYCLE ADULT FLUKE