Parasites
While
a number of intestinal parasites are responsible for producing periodic
diarrhoea and malabsorption states in humans, only those responsible for a
specialised condition referred to as “Japanese restaurant syndrome” will be
discussed here.
Raw
fish (popular culinary delicacy in Japanese cuisine).
·
Roundworm (Eustrongylidis anisakis)
·
Fish tapeworm (Diphyllobothrium species)
Anisakiasis or
Eustrongylidiasis—After an interval of 1 to 2 hours following consumption of
fish, the following symptoms occur: nausea, vomiting, and crampy abdominal
pain. Perforation of intestinal wall is possible due to inva-sion of larvae,
resulting in severe localised abdominal pain mimicking appendicitis. Diagnosis
can be established by visual inspection of larvae on endoscopy, laparotomy, or
pathological examination.
Diphyllobothriasis or Fish tapeworm
disease—After an interval of 1 to 2 weeks following consumption of fish, the
following symptoms occur: nausea, vomiting, abdominal cramps, flatulence,
diarrhoea, and megaloblastic anaemia.
Diagnosis can be made by
identification of tapeworm proglottids in stool.
Niclosamide,
praziquantel, or paromomycin may be effective.
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