Clinical Features

While F. buski has been associated with severe illness, the majority of infections are mild or asymptomatic. Diarrhea, abdominal pain and even death have been attributed to infection with heavy worm burdens. In one of the few controlled trials, 28 Thai individuals with F. buski

Fig. 24.2 Adult intestinal trematodes. (A) Fasciolopsis buski, average size 20-75 x 8-20 mm. (B) Echinostoma malayanum, average size 2-20 x l-1.5mm. (C) Heterophyes heterophyes, average size 1-1.7 x 0.3-0.4mm. (D) Metagonimus yokogawai, average size 12.5 x 0.4-0.75mm. (E) Gastrodiscoides spp., average size 10 x 5mm. Photographs courtesy of Professor Prayong Radomyos, Faculty of Allied Health Sciences, Thammasat University, Thailand

Fig. 24.2 Adult intestinal trematodes. (A) Fasciolopsis buski, average size 20-75 x 8-20 mm. (B) Echinostoma malayanum, average size 2-20 x l-1.5mm. (C) Heterophyes heterophyes, average size 1-1.7 x 0.3-0.4mm. (D) Metagonimus yokogawai, average size 12.5 x 0.4-0.75mm. (E) Gastrodiscoides spp., average size 10 x 5mm. Photographs courtesy of Professor Prayong Radomyos, Faculty of Allied Health Sciences, Thammasat University, Thailand infection were compared to an uninfected group (Plaut et al., 1969). Gastrointestinal symptoms such as nausea, vomiting, anorexia, abdominal pain, diarrhea, melena and weight loss were present in 89% of infected subjects, but also in 82% of controls. No symptoms distinguish F. buski infection in the majority of individuals. While symptoms are generally mild, clinical manifestations may be more severe in children with heavy worm burdens. Shah et al. (1973) described an outbreak of F. buski in India, where 11 of 34 children died. The children who died had heavier infestations and suffered from diarrhea, anorexia, edema and emesis of flukes. While there are potential confounding causes of death in this study, it does appear that F. buski can occasionally cause significant morbidity and mortality (Shah et al., 1973).

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