Echinostomiasis ("spiny mouth") is caused by a genus of intestinal trematode (fluke) with multiple species. The normal life cycle involves snails, a second intermediary aquatic host and a final host (aquatic birds, rats, dogs).
Endemic area: China, Indonesia, Korea, Malaysia, Philippines, Taiwan, Thailand
The main risk factor is eating raw or undercooked:
(1) fish
(2) molluscs
(3) snails
Infection can be reduced by not using untreated feces as a fertilizer.
Clinical findings:
(1) asymptomatic if low worm burden
(2) diarrhea
(3) abdominal discomfort
(4) anorexia
(5) occult blood in stool
Laboratory findings:
(1) eosinophilia
(2) eggs in the stool
(3) identification of adult worms in the stool after treatment
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