|
|
| (6 intermediate revisions by 3 users not shown) |
| Line 1: |
Line 1: |
| {{SI}}
| | #redirect:[[Opisthorchiasis]] |
| {{EH}}
| |
| | |
| == Overview ==
| |
| | |
| '''''Related Key Words and Synonyms:'''''
| |
| | |
| == Epidemiology and Demographics ==
| |
| O. viverrini is found mainly in northeast Thailand, Laos, and Kampuchea. O. felineus is found mainly in Europe and Asia, including the former Soviet Union.
| |
| | |
| == Risk Factors ==
| |
| | |
| == Screening ==
| |
| | |
| == Pathophysiology & Etiology==
| |
| '''Etiologic agent:'''
| |
| | |
| Trematodes (flukes) Opisthorchis viverrini (Southeast Asian liver fluke) and O. felineus (cat liver fluke).
| |
| | |
| | |
| '''Life cycle:'''
| |
| | |
| [[Image:Opisthorchis LifeCycle.gif|left|Life cycle of Opisthorchis]]
| |
| The adult flukes deposit fully developed eggs that are passed in the feces '''1'''. After ingestion by a suitable snail (first intermediate host) '''2''', the eggs release miracidia '''2a''', which undergo in the snail several developmental stages (sporocysts '''2b''', rediae '''2c''', cercariae '''2d'''). Cercariae are released from the snail '''3''' and penetrate freshwater fish (second intermediate host), encysting as metacercariae in the muscles or under the scales '''4'''. The mammalian definitive host (cats, dogs, and various fish-eating mammals including humans) become infected by ingesting undercooked fish containing metacercariae. After ingestion, the metacercariae excyst in the duodenum '''5''' and ascend through the ampulla of Vater into the biliary ducts, where they attach and develop into adults, which lay eggs after 3 to 4 weeks '''6'''. The adult flukes (O. viverrini: 5 mm to 10 mm by 1 mm to 2 mm; O. felineus: 7 mm to 12 mm by 2 mm to 3 mm) reside in the biliary and pancreatic ducts of the mammalian host, where they attach to the mucosa.
| |
| | |
| == Molecular Biology ==
| |
| | |
| == Genetics ==
| |
| | |
| == Natural History ==
| |
| | |
| == Diagnosis ==
| |
| Diagnosis is based on microscopic identification of eggs in stool specimens. However, the eggs of Opisthorchis are practically indistinguishable from those of Clonorchis.
| |
| | |
| === Differential Diagnosis ===
| |
| | |
| === History and Symptoms ===
| |
| Most infections are asymptomatic. In mild cases, manifestations include [[dyspepsia]], abdominal pain, [[diarrhea]] or [[constipation]]. With infections of longer duration, the symptoms can be more severe, and hepatomegaly and malnutrition may be present. In rare cases, cholangitis, cholecystitis, and chlolangiocarcinoma may develop. In addition, infections due to O. felineus may present an acute phase resembling Katayama [[fever]] ([[schistosomiasis]]), with fever, facial edema, [[lymphadenopathy]], arthralgias, rash, and [[eosinophilia]]. Chronic forms of O. felineus infections present the same manifestations as O. viverrini, with in addition involvement of the pancreatic ducts.
| |
| | |
| === Physical Examination ===
| |
| | |
| ==== Appearance of the Patient ====
| |
| | |
| ====Vital Signs====
| |
| | |
| ====Skin====
| |
| | |
| ==== Eyes ====
| |
| | |
| ==== Ear Nose and Throat ====
| |
| | |
| ==== Heart ====
| |
| | |
| ==== Lungs ====
| |
| | |
| ==== Abdomen ====
| |
| | |
| ==== Extremities ====
| |
| | |
| ==== Neurologic ====
| |
| | |
| ==== Other ====
| |
| | |
| === Laboratory Findings ===
| |
| | |
| ==== Electrolyte and Biomarker Studies ====
| |
| | |
| ==== Electrocardiogram ====
| |
| | |
| ==== Chest X Ray ====
| |
| | |
| ==== MRI and CT ====
| |
| | |
| ==== Echocardiography or Ultrasound ====
| |
| | |
| ==== Other Imaging Findings ====
| |
| | |
| === Other Diagnostic Studies ===
| |
| | |
| == Risk Stratification and Prognosis==
| |
| | |
| == Treatment ==
| |
| === Pharmacotherapy ===
| |
| | |
| ==== Acute Pharmacotherapies ====
| |
| Praziquantel is the drug of choice to treat Opisthorchiasis.
| |
| | |
| ==== Chronic Pharmacotherapies ====
| |
| | |
| === Primary Prevention ===
| |
| | |
| === Secondary Prevention ===
| |
| | |
| === Cost-Effectiveness of Therapy ===
| |
| | |
| === Future or Investigational Therapies ===
| |
| | |
| =="The Way I Like To Do It ..." Tips and Tricks From Clinicians Around The World==
| |
| | |
| ===Suggested Revisions to the Current Guidelines===
| |
| | |
| ==References==
| |
| #http://www.dpd.cdc.gov/dpdx/HTML/opisthorchiasis.htm
| |
| | |
| == Acknowledgements ==
| |
| The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
| |
| | |
| Initial content for this page in some instances came from [http://www.wikipedia.org Wikipedia]
| |
| | |
| '''List of contributors:'''
| |
| | |
| == Suggested Reading and Key General References ==
| |
| | |
| == Suggested Links and Web Resources ==
| |
| | |
| == For Patients ==
| |
| | |
|
| |
| | |
| ----
| |
| | |
| | |
| [[Category:DiseaseState]]
| |
| [[Category:Infectious disease]]
| |
| | |
| {{SIB}}
| |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |