Microscopic identification of possible Clonorchis/Opisthorchis infection in two Ghanaian women with undiagnosed abdominal discomfort: two case reports

Journal of Medical Case Reports

Neils Ben Quashie²  Kwesi Prah Thomford³  Godwin Kwakye-Nuako¹  Richmond Afoakwah¹  Ama Kyeraa Thomford¹  Elvis Ofori Ameyaw¹  Johnson Nyarko Boampong¹  Kwame Kumi Asare¹ 

[1] Department of Biomedical and Forensic Sciences, University of Cape Coast, Cape Coast, Ghana;Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, P.O. Box, GP4236, Accra, Ghana;Centre for Scientific Research into Plant Medicine, P.O. Box 73, Mampong-Akwapim, Ghana

关键词: Trematodes;    Opisthorchiasis;    Malaria;    Clonorchiasis;   

Others  :  1180984
DOI  :  10.1186/1752-1947-8-369

 received in 2014-03-24, accepted in 2014-09-15,  发布年份 2014

【 摘 要 】

Introduction

The impact of foodborne trematode infections is gaining recognition worldwide. Clonorchiasis and opisthorchiasis are some of the most neglected tropical foodborne diseases that pose a significant threat to human health. Persistent or chronic infection of Clonorchis/Opisthorchis often leads to hepatobiliary diseases including cholangitis, cholelithiasis, cholecystitis, pancreatitis, hepatic fibrosis, cholangiocarcinoma and liver cancer. Two cases of Clonorchis/Opisthorchis infection in humans in the Central Region of Ghana are reported.

Case presentation

Eggs suspected to be from Clonorchis sinensis or Opisthorchis species were detected in the stools of a 29-year-old Ghanaian woman and an 18-year-old Ghanaian woman in two clinics in the Central Region of Ghana. The diagnosis was based on clinical symptoms as well as detection of the eggs of the trematode in the faeces of the patients using light microscopy after staining with Giemsa or Ziehl–Neelsen stains.

Conclusions

To the best of our knowledge these are the first documented cases of Clonorchis sinensis or Opisthorchis species infection in Ghana. The detection of this infection in these patients in Ghana should be of concern to clinicians because the infection can be easily misdiagnosed since the accompanying clinical symptoms are malaria-like. Consideration should therefore be given to Clonorchis sinensis and Opisthorchis species when diagnosing patients presenting with malaria-like symptoms.

【 授权许可】

   
2014 Asare et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Han S, Zhang X, Wen J, Li Y, Shu J, Ling H, Zhang F: A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China. PLoS One 2012, 7(10):e46977.
• [2]Sithithaworn P, Andrews RH, Van De N, Wongsaroj T, Sinuon M, Odermatt P, Nawa Y, Liang S, Brindley PJ, Sripa B: The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol Int 2012, 6:10-16.
• [3]Liu T: Disease and environment: implications of clonorchiasis infection in Taiwan and Mainland China. GIS in the Humanities and Social Sciences Conference. Taipei: Academia Sinica; 2009. [http://gis.rchss.sinica.edu.tw/gishs2009/ppt/T1001-P.pdf webcite]
• [4]Kim HG, Han J, Kim MH, Cho KH, Shin IH, Kim GH, Kim JS, Kim JB, Kim TN, Kim TH, Kim TH, Kim JW, Ryu JK, Moon YS, Moon JH, Park SJ, Park CG, Bang SJ, Yang CH, Yoo KS, Yoo BM, Lee KT, Lee DK, Lee BS, Lee SS, Lee SO, Lee WJ, Cho CM, Joo YE, Cheon GJ, et al.: Prevalence of clonorchiasis in patients with gastrointestinal disease: a Korean nationwide multicenter survey. World J Gastroenterol 2009, 15:86-94.
• [5]WHO: Report on Neglected Tropical Diseases: Working to Overcome the Global Impact of Neglected Tropical Diseases. 2010.
• [6]Hotez PJ: The Development Impact of the Neglected Tropical Diseases (NTDs). Population Division. Expert Paper No. 2011/1. New York: United Nations; 2011.
• [7]WHO: Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases – A Roadmap for Implementation. 2012.
• [8]Zhang Y, Chang QC, Zhang Y, Na L, Wang WT, Xu WW, Gao DZ, Liu ZX, Wanga CR, Zhu XQ: Prevalence of Clonorchis sinensis infection in freshwater fishes in north eastern China. Vet Parasitol 2014, 204:209-213.
• [9]Qian M, Chen Y, Liang S, Yang G, Zhou X: The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma. Infect Dis Poverty 2012, 1:4. BioMed Central Full Text
• [10]Cheesbrough M: District Laboratory Practice in Tropical Countries. 2nd edition. Cambridge, UK: Cambridge University Press; 2005:183-258.
• [11]Centers for Disease Control and Prevention (CDC): Recommendations of the International Task Force for Disease Eradication. MMWR 1993, 42(RR-16):1-21.
• [12]Marcos LA, Terashima A, Gotuzzo E: Update on hepatobiliary flukes: fascioliasis, opisthorchiasis and clonorchiasis. Curr Opin Infect Dis 2008, 21:523-530.
• [13]Schwartz DA: Cholangiocarcinoma associated with liver fluke infection: a preventable source of morbidity in Asian immigrants. Am J Gastroenterol 1986, 81:76-79.
• [14]Papachristou GI, Schoedel KE, Ramanathan R, Rabinovitz M: Clonorchis sinensis-associated cholangiocarcinoma: a case report and review of the literature. Dig Dis Sci 2005, 50:2159-2162.
• [15]Rohela M, Johari S, Jamaiah I, Init I, Lee SH: Acute cholecystitis caused by Clonorchis sinensis. Southeast Asian J Trop Med Public Health 2006, 37:648-651.
• [16]MacPherson DW, McQueen R: Cryptosporidiosis: multiattribute evaluation of six diagnostic methods. J Clin Microbiol 1993, 31:198-202.
• [17]Ortolani EL: Standardization of the modified Ziehl-Neelsen technique to stain oocysts of Cryptosporidium species. Rev Brazil J Vet Parasitol 2000, 9(1):29-31.
• [18]Kim BG, Kang DH, Choi CW, Kim HW, Lee JH, Kim SH, Yeo HJ, Lee SY: A case of clonorchiasis with focal intrahepatic duct dilatation mimicking an intrahepatic cholangiocarcinoma. Clin Endosc 2011, 44:55-58.
• [19]Sripa B, Kaewkes S, Sithithaworn P, Mairiang E, Laha T, Smout M, Bhudhisawasdi VC, Tesana S, Thinkamrop B, Bethony JM, Loukas A, Brindley PJ: Liver fluke induces cholangiocarcinoma. PLoS Med 2007, 4:e201. doi: 10.1371/journal.pmed.0040201
• [20]Qian M, Chen Y, Fang Y, Tan T, Zhu T, Zhou C, Wang G, Xu L, Zhou X: Epidemiological profile of Clonorchis sinensis infection in one community, Guangdong, People’s Republic of China. Parasit Vectors 2013, 6:194. BioMed Central Full Text
• [21]Gushulak BD, MacPherson DW: The basic principles of migration health: population mobility and gaps in disease prevalence. Emerg Themes Epidemiol 2006, 3:3. BioMed Central Full Text
• [22]Lee JJ, Jung BK, Lim H, Lee MY, Choi SY, Shin EH, Chai JY: Comparative morphology of minute intestinal fluke eggs that can occur in human stools in the republic of Korea. Korean J Parasitol 2012, 50:207-213.
• [23]Chen W, Wang X, Li X, Lv X, Zhou C, Deng C, Lei H, Men J, Fan Y, Liang C, Yu X: Molecular characterization of cathepsin B from Clonorchis sinensis excretory/secretory products and assessment of its potential for serodiagnosis of clonorchiasis. Parasit Vectors 2011, 4:149. BioMed Central Full Text
• [24]Qian MB, Yap P, Yang YC, Liang H, Jiang ZH, Li W, Utzinger J, Zhou XN, Keiser J: Accuracy of the Kato-Katz method and formalin-ether concentration technique for the diagnosis of Clonorchis sinensis, and implication for assessing drug efficacy. Parasit Vectors 2013, 6:315. BioMed Central Full Text
• [25]Hong S, Choiemail M, Kim C, Chung B, Ji Z: The Kato-Katz method is reliable for diagnosis of Clonorchis sinensis infection. Diagn Microbiol Infect Dis 2003, 47:345-347.