Causes and risk factors
D. latum lays eggs which pass from human feces into the freshwater. Here, the eggs hatch into free swimming larvae and are ingested by microcrustaceans. They are in turn ingested by fish. Diphyllobothriasis is caused when humans eat raw or undercooked fish containing larvae of tape worm Diphyllobothrium latum. It is the largest parasite of freshwater fish. It is found in cool lakes which are contaminated with sewage.
Clinical presentation
In most cases, the infection is asymptomatic. Mild symptoms include abdominal pain, nausea and vomiting, diarrhea, loss of appetite, or weight loss. The fish tapeworm takes up dietary vitamin B12. This causes deficiency of B12 leading to symptoms of megaloblastic anemia. Severe infection may lead to intestinal obstruction. Cholangitis, cholecystitis can occur.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Stool examination for egg, parasites, and worm segments is done. Routine hemogram is advised for anemia.
Treatment
Anti-helminthic, anti-parasitic medications are prescribed. Symptomatic treatment with analgesics, antiemetics, antidiarrheal may be needed. If there is megaloblastic anemia, doctor will advise vitamin B12 injections. Prevention is possible by avoiding eating raw, uncooked fish, or freshwater fish.
Other Modes of treatment
The other modes of treatment can also be effective in treating diphyllobothriasis. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating diphyllobothriasis.
