Greetings from South Korea! This week's case shows an important parasite in this country, shown to be found in up to 8.4% of residents living along 5 major rivers in South Korea in a recent survey. What parasite is shown here?
Bonus questions: what are the potential health implications for patients with long-standing infection with this parasite?
6 comments:
Both eggs have an abopercular knob and an obvious operculum. So these could be eggs of either Clonorchis sinensis or Opisthorchis species (both liver flukes).
We can't differentiate based on morphology, but based on the patient being from/living in South Korea, we can likely narrow the identification down to Clonorchis sinensis, as Korea is an endemic region for this parasite. Whereas Opisthorichis viverrini is endemic to South East Asia (i.e Vietnam, Cambodia, Laos, Thailand).
Biliary complications can arise from long term Clonorchis sinensis infections, including cholangiocarcinoma.
Clonorchis sinensis eggs, a typical protrusion in the opposite site of the operculum is visible in an egg of the second picture. The Asian fluke provoke biliary injuries and complications as cholangitis, cholelithiasis, cholecystitis, and cholangiocarcinoma. Also pancreatitis
There’s a consensus in the comments so far. Geographic location tends to be more favorable for C. sinensis. The eggs of C. sinensis and Opistorchis spp. are difficult to differentiate morphologically. I learn that there is also a Metorchis sp. to further complicate the issue and remain to be further instructed.
Florida Fan
Purely based on morphology, lots of options remain (Clonorchis, Opisthorchis, Metagonimus,…), but I agree with Sam: on geographical grounds, I would favor Clonorchis sinensis. Long-term infection typically may result in cholangiocarcinoma.
No way! This parasite impacts 8.4% of residents near the major rivers? Given a large population size, that's an incredible impact to communities. It really gets me thinking about the facilities in place to address, treat, and prevent such contaminations. It also has me wondering about the factors at play for parasites to be mostly found in specific geographic locations. I assume similar ecological niches exist elsewhere -- I wonder if this parasite could cause an outbreak in these niches in other countries?
Great questions, Raul. Clonorchis uses a specific snail host, but it is true that the snail and parasite could be accidentally introduced into other areas. This is one reason why many countries perform careful inspection of imported goods. Despite these precautions, there is a long history of harmful parasites being spread throughout the world by humans. A recent parasite to be introduced into the United States is the long-horned tick, Haemaphysalis longicornis. Our public health system plays a crucial role in preventing parasitic infections. A fun bit of history: the US CDC was actually founded to eliminate malaria from the United States!
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