Capillaria philippinensis
Capillaria philippinensis is a parasitic nematode responsible for causing intestinal capillariasis in humans. This condition is primarily found in Southeast Asia, particularly in the Philippines from which the parasite derives its name, and has also been reported in various other regions including parts of Africa and the Middle East. The disease is characterized by severe abdominal symptoms, malabsorption, and can lead to cachexia and death if left untreated.
Life Cycle
The life cycle of Capillaria philippinensis involves both definitive and intermediate hosts. Humans become infected by consuming raw or undercooked freshwater fish that harbor the infective larvae. Once ingested, the larvae mature into adult worms in the small intestine. The female worms lay eggs, which are then excreted in the feces. If these eggs reach freshwater, they are ingested by the intermediate host, usually small freshwater fish, where they hatch and develop into infective larvae, thus completing the cycle.
Symptoms and Diagnosis
The symptoms of intestinal capillariasis include chronic diarrhea, abdominal pain, borborygmi (rumbling noises produced by gas in the intestine), and weight loss. In severe cases, the disease can lead to protein and electrolyte imbalance, malabsorption, and cachexia.
Diagnosis is typically made by the microscopic identification of Capillaria philippinensis eggs or adult worms in stool samples. Endoscopy can also be used to visualize and sometimes retrieve adult worms from the small intestine.
Treatment
Treatment of intestinal capillariasis involves the administration of antiparasitic medications, with albendazole or mebendazole being the drugs of choice. Nutritional support and management of complications such as electrolyte imbalance are also important aspects of treatment.
Prevention
Preventive measures include educating at-risk populations about the dangers of consuming raw or undercooked freshwater fish. Improving sanitation and waste disposal systems to prevent the contamination of water bodies with human feces is also crucial.
Epidemiology
While Capillaria philippinensis infection was initially thought to be confined to the Philippines, cases have been reported in various other countries, indicating a wider distribution of the disease. The true prevalence of the disease is difficult to ascertain due to underreporting and the lack of comprehensive surveillance systems in many endemic areas.
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Contributors: Prab R. Tumpati, MD