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Diphyllobothrium pacificum Infection is Seldom Associated with Megaloblastic Anemia

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  • Department of Microbiology, School of Sciences, and Center for Global Health–Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru

Twenty cases of Dyphillobothrium pacificum (fish tapeworm) infections were prospectively studied to determine whether this tapeworm is associated with megaloblastic anemia, as commonly reported for D. latum infections. The most frequent symptoms were fatigue and mild abdominal pain, which were identified in approximately 66.6% of the 18 patients interviewed. Fourteen patients received treatment with niclosamide and all were cured. The other six patients spontaneously eliminated the tapeworms. One patient, who also had chronic diabetes and gastric atrophy, had low vitamin B12 levels and megaloblastic anemia. In all other patients, including three other patients with anemia, baseline vitamin B12 levels were in the reference range and did not significantly change when re-assessed three months later. Unlike D. latum, infection with D. pacificum is seldom associated with megaloblastic anemia or vitamin B12 deficit.

Author Notes

* Address correspondence to Hector H. Garcia, Department of Microbiology, School of Sciences, and Center for Global Health, Universidad Peruana Cayetano Heredia. H. Delgado 430, SMP, Lima 31, Peru. E-mail: hgarcia@jhsph.edu

Financial support: This study was supported by the John C. Fogarty Foundation–National Institutes of Health training grant TW001140. Hector H. Garcia is supported by a Wellcome Trust International Senior Research Fellowship in Public Health and Tropical Medicine.

Authors' addresses: Juan A. Jimenez and Ricardo Gamboa, Microbiology and Center for Global Health–Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: jajch@hotmail.com and rgamboa@peruresearch.org. Silvia Rodriguez and Hector H. Garcia, Microbiology and Center for Global Health–Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, and Cestodes Research Department, Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru, E-mails: silvia@peruresearch.com and hgarcia@jhsph.edu. Lourdes Rodriguez, Infectious Disease, Hospital Nacional Guillermo Almenara Irigoyen, ESSALUD, Lima, Peru, E-mail: lourdesrod@gmail.com.

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