Dicrocoelium dendriticum: An Unusual Parasitological Diagnosis in a Reference International Health Unit

Zaira Moure Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Francesc Zarzuela Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.
Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Mateu Espasa Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.
Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Diana Pou Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Nuria Serre-Delcor Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Begoña Treviño Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Cristina Bocanegra Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Israel Molina Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.
Department of Infectious Diseases, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Tomas Pumarola Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Elena Sulleiro Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.
Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain.

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Finding Dicrocoelium dendriticum eggs in human feces is exceptional and there are few prevalence data available. True infection occurs after accidental ingestion of ants containing metacercariae and spurious infection through the consumption of infected animal liver. Differential diagnosis between true and pseudo-infections is performed through stool examination after a diet free of liver. In addition, microscopy can help to differentiate the type of infection. We report six cases, all from sub-Saharan Africa, detection of this fluke at the Tropical Medicine Unit Vall d'Hebron-Drassanes (Barcelona, Spain). Dicrocoelium dendriticum transit eggs were visualized in five cases and there were no subsequent visualizations after diet, which reinforces that all these cases were false parasitism. In one case, few embryonated eggs were observed and the patient was treated for a possible true parasitism. There is a need to investigate the prevalence of D. dendriticum in our country focusing on the distinction between true and spurious infections.

Author Notes

* Address correspondence to Zaira Moure, Department of Microbiology, Vall d'Hebron Universitary Hospital, P. de la Vall d'Hebron 119-129, 08035 Barcelona, Spain. E-mail: zmoure@vhebron.net

Authors' addresses: Zaira Moure, Francesc Zarzuela, Mateu Espasa, Tomas Pumarola, and Elena Sulleiro, Department of Microbiology, Vall d'Hebron University Hospital (HUVH), Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain, E-mails: zaira_moure@hotmail.com, francesc.bcn.ics@gencat.cat, mespasa@vhebron.net, tpumarola@vhebron.net, and esulleir@vhebron.net. Diana Pou, Nuria Serre-Delcor, Begoña Treviño, Cristina Bocanegra, and Israel Molina, Department of Infectious Diseases, Tropical Medicine Unit Vall d'Hebron-Drassanes, Universitat Autònoma de Barcelona, PROSICS, Barcelona, Spain, E-mails: dpou.bcn.ics@gencat.cat, nserre.bcn.ics@gencat.cat, btrevino.bcn.ics@gencat.cat, cristinabocanegra@gmail.com, and imolina@vhebron.net.

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