Clonorchis sinensis and Fasciolopsis buski: Liver and Intestinal Fluke Infections

Clonorchis sinensis (Oriental Liver Fluke)

• Endemic regions: East Asia (China, Korea, Vietnam).
• Transmission: Consumption of raw or undercooked freshwater fish containing metacercariae.
• Pathology: Adult flukes reside in bile ducts, causing inflammation, epithelial hyperplasia, and cholangitis.
• Symptoms: Right upper quadrant pain, diarrhea, fatigue, fever, jaundice, hepatomegaly.
• Complications: Cholangiocarcinoma (bile duct cancer), cirrhosis, cholelithiasis.
• Diagnosis: Ova in stool (egg detection), serology (ELISA), imaging showing dilated bile ducts.
• Treatment: Praziquantel 25 mg/kg three times daily for 1 day (cure rate >90%).

Fasciolopsis buski (Giant Intestinal Fluke)

• Endemic regions: Southeast Asia, Indian subcontinent.
• Transmission: Raw aquatic plants (water chestnut, lotus, bamboo) harboring metacercariae.
• Pathology: Adults attach to duodenal/jejunal mucosa, causing inflammation and malabsorption.
• Symptoms: Abdominal pain, diarrhea, edema (from hypoalbuminemia), weight loss, anemia.
• Complications: Intestinal obstruction, perforation, hemorrhage.
• Diagnosis: Large operculated eggs in stool.
• Treatment: Praziquantel 25 mg/kg three times daily for 1 day.

Prevention Strategies

• Thorough cooking of fish and aquatic plants.
• Improved sanitation, snail control (intermediate hosts), health education.