Genera involved: Carneophallus Haplorchis, Heterophyidae, Metagonimus, Stellantchasmus
Endemic areas: Southeast Asia, Hawaii, Siberia, Turkey, Balkans
Risk factors:
(1) eating fish, shrimps or other aquatic foods that are raw, poorly cooked, salted or pickled
(2) eating insect larvae
Clinical findings:
(1) asymptomatic
(2) abdominal discomfort or colic
(3) diarrhea, which may be intermittent
(4) intermittent neurasthenia or lethargy
Laboratory findings:
(1) eosinophilia
(2) occult or gross blood in stool
(3) parasite eggs in stool (may be missed since the daily number shed is small)
(4) adult flukes in stool (often overlooked since only 1-7 mm in length), often after therapy or indicative of heavy infection
(5) positive serology
