Which condition can be acquired from infected fish?

Which Condition Can Be Acquired from Infected Fish?

Diphyllobothrium latum is the condition that can be acquired from infected fish among the listed options. 1, 2, 3, 4

Understanding Fish-Borne Parasitic Infections

Diphyllobothrium latum (Option A)

Diphyllobothrium latum is a fish tapeworm that causes diphyllobothriasis in humans. This parasite is transmitted through:

• Consumption of raw or inadequately cooked fish containing the plerocercoid larvae 1, 2
• Common fish sources include pike, burbot, trout, perch, and salmon 1
• The parasite can grow to significant lengths in the human intestine, with reported cases of strobilas measuring up to 260 cm 4

Clinical presentation typically includes:

• Abdominal discomfort
• Diarrhea
• Passage of proglottids (tapeworm segments) in stool
• Some patients may be asymptomatic 4

Other Options (Not Fish-Borne)

Ancylostoma duodenale (Option B)

• This is a hookworm species that causes ancylostomiasis
• Transmission occurs through skin penetration by larvae in soil contaminated with human feces
• Not transmitted through fish consumption 5
• Common symptoms include wheeze, dry cough (Loeffler's syndrome), gastrointestinal symptoms, and anemia 5

Necator americanus (Option C)

• Another hookworm species causing necatoriasis
• Similar to Ancylostoma duodenale, it's transmitted through skin contact with contaminated soil
• Not transmitted through fish consumption 5
• Clinical presentation includes respiratory symptoms, gastrointestinal issues, and anemia 5

Paragonimus westermani (Option D)

• Causes paragonimiasis, a lung fluke infection
• Transmitted through consumption of raw or undercooked freshwater crabs and crayfish (not fish)
• Can also be acquired through ingestion of uncooked meat from paratenic hosts like wild boar 5
• Presents with respiratory symptoms, including cough with sputum and pleuritic chest pain 5

Diagnosis and Treatment of Diphyllobothrium latum

Diagnosis

• Identification of characteristic eggs or proglottids in stool
• Eggs are ovoid and operculated 4
• Molecular methods using DNA sequencing (nad1, cox1, and 5.8S rRNA genes) provide definitive species identification 2

Treatment

• Praziquantel is the drug of choice, typically administered as a single oral dose 2, 3, 4
• Alternative treatments include pumpkin seed powder and betel nut 1
• Follow-up stool examination to confirm clearance of infection

Prevention

To prevent Diphyllobothrium latum infection:

• Avoid consuming raw or undercooked freshwater or anadromous fish
• Ensure fish is cooked to an internal temperature of at least 145°F (63°C)
• Freezing fish at -4°F (-20°C) for at least 7 days also kills the parasite

Clinical Significance

The global increase in consumption of raw fish dishes (sushi, sashimi, ceviche, etc.) has led to the emergence of diphyllobothriasis in non-endemic areas 2, 4. Clinicians should consider this diagnosis in patients with gastrointestinal symptoms and a history of raw fish consumption, even in regions where the parasite is not traditionally endemic.