Answer to Case 699

Answer:Clonorchis sinensis/Opisthorchiseggs. The location (South Korea) is consistent withC. sinensis.As noted by Sam, " Both eggs have an abopercular knob and an obvious operculum. So these could be eggs of eitherClonorchis sinensisorOpisthorchisspecies (both liver flukes). We can ' t differentiate based on morphology, but based on the patient being from/living in South Korea, we can likely narrow the identification down toClonorchis sinensis, as Korea is an endemic region for this parasite. WhereasOpisthorichis viverriniis endemic to South East Asia (i.e, Vietnam, Cambodia, Laos, Thailand). Biliary complications can arise from long termClonorchis sinensisinfections, including cholangiocarcinoma. "  Other complications, as noted by Eddy Martinez, are cholangitis, cholelithiasis, cholecystitis, and pancreatitis. The shouldered operculum and small size of the eggs (around 30 micrometers long) are nicely appreciated in this case:The eggs ofMetagonimus yokogawaiandHeterophyes heterophyesalso have a similar appearance and should be considered in the differential diagnosis. They are not found in South Korea, however, and can be excluded in this case.
Source: Creepy Dreadful Wonderful Parasites - Category: Parasitology Source Type: blogs