This trematode infects the bile ducts. Infection occurs through consumption of encysted metacercariae in raw, dried, or pickled fish imported from endemic areas, which include Japan, Korea, China, Taiwan, and Vietnam.
Light infection is usually asymptomatic. Most pathologic manifestations result from inflammation and intermittent obstruction of the biliary ducts. In the acute phase, abdominal pain, nausea, diarrhea, and eosinophilia can occur. In long-standing infections cholangitis, cholelithiasis, pancreatitis, biliary obstruction, portal fibrosis, and cholangiocarcinoma can develop.
Praziquantel (25 mg/kg tid x 1 day, adult dose) is considered the most effective drug. Natural agents include elecampane, costus, and quassia.
Clonorchis sinensis
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