Praziquantelによって駆虫しえた多数寄生の横川吸虫症の一例

Abstract

Metagonimiasis yokogawai is one of the most common parasitic diseases affecting the gastrointestinal system in Japan. Most patients are usually asymptomatic and eggs from healthy carriers are found in stool. Infections of moderate to severe degree may cause gastrointestinal signs and symptoms such as colic pain, weight loss, profuse mucus or occasional bloody diarrhea. This paper describes a severe case infected with Metagonimus yokogawai. A 41-year-old male who lived in Yoshino town, Nara Prefecture, complained of low abdominal pain, diarrhea and weight loss. He often eats sashimi (sliced raw fish) of Plecoglssus altivelis, the second intermediate host of M. yokogawai. He visited a nearby clinic because of weight loss (-5 kg in 6 months) and severe diarrhea. Parasitic eggs were found in his stool, and he was referred to Nara Medical University. the eggs in the patient's stool were examined and the case was diagnosed as M. yokogawai infection. One day before treatment, his food intake was limited for the dose of examination of barium enema. On the day of treatment, he fasted except for water. he was treated with a single administration of praziquantel (50 mg/kg). Three hours after treatment, he was given magnesium sulfate (30 g) as a laxative in order to enhance defecation. More than 1,485 adult worms of M. yokogawai were found in this stool. In this case, side effects of praziquantel were not observed. Three weeks after treatment, stool examinations did not reveal any parasite eggs in his stool and he recovered completely with this medication.