Fasciolopsiasis

Fasciolopsis buski is a common parasite of pigs and humans in eastern and southern Asia

Eggs shed in stools and hatch in fresh water, followed by infection of snails and release of cercariae that encyst on aquatic plants

Humans are infected by eating uncooked plants, including water chestnuts, bamboo shoots, and watercress

Adult flukes mature in about 3 months and live in the small intestine attached to the mucosa, leading to local inflammation and ulceration

Infection is often asymptomatic, but eosinophilia may be marked

In symptomatic cases, after an incubation period of 1–2 mo, manifestations include epigastric pain and diarrhea

Uncommon findings

• Other gastrointestinal symptoms

• Ileus

• Edema

• Ascites

Diagnosis depends on finding characteristic eggs or, occasionally, adult flukes in the stools

Moderate eosinophilia is common

Illness > 6 months after travel to endemic area is unlikely

Praziquantel

• Drug of choice

• 25 mg/kg as a single dose

Triclabendazole and niclosamide are alternatives (for most species)