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General Reference

Nejm 1984;310:298

Pathophys and Cause

Cause:Clonorchis sinensis

Pathophys:Adults survive 30+ years causing fibrosing response

Epidemiology

Embryonated egg in feces is ingested by snail where becomes a miracidium, then a sporocyst, and eventually redia (2nd site of multiplication); then evolves to free-swimming cercaria, which penetrate under fish scales and are ingested, mature into adults, which migrate to bile ducts

Animal reservoirs, dogs and cats. Common wherever poorly cooked fish eaten, esp Far East

Signs and Symptoms

Si:Mild hepatitis

Lab and Xray

Lab:Bact:Stool smear shows embryonated eggs, also in duodenal aspirates

Treatment

Rx:Praziquantel 25 mg/kg tid × 1 d (Ann IM 1989;110:290)