Answer to Parasite Case of the Week 610: Brachylaima cribbi, a parasitic trematode found only in Australia to date. B. cribbi infects land snails and slugs as first/second intermediate hosts, and employs a wide range of mammals, reptiles, birds and amphibians as definitive hosts. The first human infections were published in 1996 by Dr. Andrew Butcher, who also wrote an excellent review on this parasite. Dr. Butcher recently passed away, and so I am dedicating this post to him and his important work. Humans become infected after ingesting undercooked snails. The main symptoms that have been reported with infection are watery, mucoid diarrhea, abdominal pain, anorexia, and weight loss.
The eggs of this parasite are quite interesting in that they are small (only ~30 μm long), have an inconspicuous operculum, and are flattened on one side. They also have an abopercular knob or thickening. The eggs are usually fertile when seen in stool, with a well-developed miracidium. However, infertile eggs have also been seen in chronic infections; they are smaller and lack an internal miracidium. We can see both fertile and infertile eggs in this case: