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Studies on intestinal trematodes in Korea XI. Two cases of human infection by Heterophyes heterophyes nocens
Jong Yil Chai,Byong Seol Seo and Soon Hyung Lee
Department of Parasitology and Institute of Endemic Diseases, College of Medicine, Seoul National University, Korea.
Abstract
Two human cases of Heterophyes heterophyes nocens infection were proved by identifying adult worms after treatment with bithionol or praziquantel in 1983 in Korea. They are 37 (Case 1) and 24-year old (Case 2) males whose residence or native village is a southern coastal area in Kohung-gun, Chollanam-do. The Case 1 had the gastrointestinal symptoms such as epigastric pain and indigestion, and the Case 2 heart problems such as arrhythmia and ventricular premature beat in EKG and digestive symptoms such as diarrhea and abdominal pain. After the treatments, 35 and 67 specimens of H. heterophyes nocens respectively were collected from the diarrheal stools through stereomicroscopy. The Case 1 was concommitantly infected with Clonorchis sinensis and the case 2 with 3 other kinds of heterophyid flukes and with Diphyllobothrium latum. The cases said to have eaten raw brackish water fish such as mullets (Mugil cephalus), perches (Lateolabrax japonicus) and gobies (Acanthogobius flavimanus) which are the intermediate hosts of H. heterophyes nocens in Korea.
Figures
EXPLANATION FOR FIGURES Fig. 1. Adult of H. heterophyes nocens form Case 2. Note the relationship between ventral sucker and genital sucker (arrows). Unstained specimen (Scale: 0.1mm).
Fig. 2.Ibid from Case 1. Acetocarmine stained (Scale: 0.1mm).
Fig. 3. Ventral view of genital sucker. Formalin-fixed specimen (Scale: 20µm). The number of chitinous rodlets on gonotyl is about 58.
Fig. 4. Scanning electron microscopic view of genital sucker of a worm from Case 1 treated with bithionol. Note the protruded appearance of genital sucker with rodlets (arrows) on it (Scale: 10µm).
Fig. 5. An egg of H. heterophyes nocens in stool of Case 1 (Scale: 10µm). There is nearly no muskmelon pattern or wrinkling at its shell surface.
Fig. 6. Scanning electron microscopic view of an intrauterine egg of H. heterophyes nocens (Scale: 5µm). Note operculum at the upper end and relatively smooth shell surface.
Fig. 7.Ibid of C. sinensis (from a worm obtained by experimental infection with the metacercariae) (Scale: 5µm). Note the markedly rough shell surface in muskmelon pattern and compare with that of H. heterophyes nocens in Fig. 6.
Tables
Table 1 Measurements of adult *Heterophyes nocens in 2 cases (unit:mm)
Table 2 Comparison of the measurements of three species of the genus Heterophyes ocurring in man (size unit:mm)
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