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Causal Agent

The trematode Heterophyes heterophyes, a minute intestinal fluke.

Life Cycle:

Life cycle of Babesia microti

Adults release embryonated eggs each with a fully-developed miracidium, and eggs are passed in the host's fecesThe number 1 . After ingestion by a suitable snail (first intermediate host), the eggs hatch and release miracidia which penetrate the snail’s intestineThe number 2. Genera Cerithidia and Pironella are important snail hosts in Asia and the Middle East respectively. The miracidia undergo several developmental stages in the snail, i.e. sporocystsThe number 2a, rediaeThe number 2b, and cercariaeThe number 2c. Many cercariae are produced from each redia. The cercariae are released from the snailThe number 3 and encyst as metacercariae in the tissues of a suitable fresh/brackish water fish (second intermediate host)The number 4. The definitive host becomes infected by ingesting undercooked or salted fish containing metacercariaeThe number 5. After ingestion, the metacercariae excyst, attach to the mucosa of the small intestineThe number 6 and mature into adults (measuring 1.0 to 1.7 mm by 0.3 to 0.4 mm)The number 7. In addition to humans, various fish-eating mammals (e.g., cats and dogs) and birds can be infected by Heterophyes heterophyes The number 8.

Life cycle image and information courtesy of DPDx.

Geographic Distribution

Egypt, the Middle East, and Far East.

Clinical Presentation

The main symptoms are diarrhea and colicky abdominal pain. Migration of the eggs to the heart, resulting in potentially fatal myocardial and valvular damage, has been reported from the Philippines. Migration to other organs (e.g., brain) has also been reported.

Laboratory Diagnosis

The diagnosis is based on the microscopic identification of eggs in the stool. However, the eggs are indistinguishable from those of Metagonimus yokogawai and resemble those of Clonorchis and Opisthorchis.


For more information view the source:Center for Disease Control

Recommended Test:Full GI Panel

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