A Hospital-Based Study of Intestinal Capillariasis in Thailand: Clinical Features, Potential Clues for Diagnosis, and Epidemiological Characteristics of 85 Patients

Lakkhana Sadaow Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;
Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Oranuch Sanpool Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;
Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Pewpan M. Intapan Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;
Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Wattana Sukeepaisarnjaroen Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

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Thidarat K. Prasongdee Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;
Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Wanchai Maleewong Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;
Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Intestinal capillariasis caused by Capillaria philippinensis, a fish-borne nematode, is an important, emerging zoonotic helminthiasis. Cases may be fatal if suitable treatment is not administered in time. We reported a hospital-based study of 85 cases in Thailand, most of which were in the northeast. All patients had a history of eating raw or insufficiently cooked fresh water fish or prawns. The clinical manifestations are characterized by chronic diarrhea, borborygmi, abdominal pain, marked weight loss, muscle weakness, fatigue, dizziness, anorexia, and edema, as well as protein and electrolyte loss. Fecal examination revealed C. philippinensis in all patients. Although 16 of the total of 85 (18.8%) cases were initially found to be negative for C. philippinensis using fecal examination, further examination using an immunoblotting technique found them to be positive for the IgG antibody against Trichinella spiralis larval antigen. One day after administration of 400 mg of albendazole, eggs and/or larvae and/or adult C. philippinensis were found in 16 fecal samples. After treatment with mebendazole (200 mg twice a day for 30 days) or albendazole (200 mg twice a day for 10 days), all 85 patients recovered. The potential clues for diagnosis are clinical manifestations, history of eating raw contaminated food, and positive serological test, and fecal examinations under professional. Administration of anthelminthic drugs stimulates the excretion of larvae, eggs, and/or adult worms and can be used as a supportive method for the diagnosis of intestinal capillariasis in areas where serological test is not available.

Author Notes

Address Correspondence to Pewpan M. Intapan, Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. E-mail: pewpan@kku.ac.th

Financial support: This study was supported by a TRF Senior Research Scholar Grant, Thailand Research Fund grant number RTA5880001; the Faculty of Medicine, Khon Kaen University (TR57201 and AS58302) through W. M. and P. M. I. L. S. was partial supported by the Faculty of Medicine, Khon Kaen University (IN60209). O. S. was supported by Scholarship under the Post-Doctoral Training Program from Research Affairs and Graduate School, Khon Kaen University (58101).

Authors’ addresses: Lakkhana Sadaow, Oranuch Sanpool, Pewpan M. Intapan, Thidarat K. Prasongdee, and Wanchai Maleewong, Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mails: sadaow1986@gmail.com, sanpoolor@yahoo.com, pewpan@kku.ac.th, thidpr@kku.ac.th, and wanch_ma@kku.ac.th. Wattana Sukeepaisarnjaroen, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mail: wattanasukee@yahoo.com.

  • 1.

    McCarthy J, Moore TA, 2000. Emerging helminth zoonoses. Int J Parasitol 30: 13511360.

  • 2.

    Chitwood MB, Valesquez C, Salazar NG, 1968. Capillaria philippinensis sp. n. (Nematoda: Trichinellida), from the intestine of man in the Philippines. J Parasitol 54: 368371.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Beaver PC, Jung RC, Cupp EW, 1984. Aphasmid nematodes. Beaver PC, Jung RC, Cupp EW, eds. Clinical Parasitology, 9th edition. Philadelphia, PA: Lea & Febiger, 231252.

    • PubMed
    • Export Citation
  • 4.

    Belizario VY Jr, Totañes G, de Leon FI, Migriño WU, JR Jr, Macasaet LY, 2010. Intestinal capillariasis, western Mindanao, the Philippines. Emerg Infect Dis 16: 736738.

  • 5.

    Chichino G, Bernuzzi AM, Bruno A, Cevini C, Atzori C, Malfitano A, Scaglia M, 1992. Intestinal capillariasis (Capillaria philippinensis) acquired in Indonesia: a case report. Am J Trop Med Hyg 47: 112.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Soukhathammavong P et al. 2008. Three cases of intestinal capillariasis in Lao People’s Democratic Republic. Am J Trop Med Hyg 79: 735738.

  • 7.

    Cross JH, 1992. Intestinal capillariasis. Clin Microbiol Rev 5: 120129.

  • 8.

    Chen CY, Hsieh WC, Lin JT, Liu MC, 1989. Intestinal capillariasis: report of a case. Taiwan Yi Xue Hui Za Zhi 88: 617620.

  • 9.

    Kang G, Mathan M, Ramakrishna BS, Mathai E, Sarada V, 1994. Human intestinal capillariasis: first report from India. Trans R Soc Trop Med Hyg 88: 204.

  • 10.

    Hoghooghi-Rad N, Maraghi S, Narenj-Zadeh A, 1987. Capillaria philippinensis infection in Khoozestan province, Iran: case report. Am J Trop Med Hyg 37: 135137.

  • 11.

    Youssef FG, Mikhail EM, Mansour NS, 1989. Intestinal capillariasis in Egypt: a case report. Am J Trop Med Hyg 40: 195196.

  • 12.

    Mansour NS, Anis MH, Mikhail EM, 1990. Human intestinal capillariasis in Egypt. Trans R Soc Trop Med Hyg 84: 114.

  • 13.

    Dronda F, Chaves F, Sanz A, Lopez-Velez R, 1993. Human intestinal capillariasis in an area of nonendemicity: case report and review. Clin Infect Dis 17: 909912.

  • 14.

    Austin DN, Mikhail MG, Chiodini PL, Murray-Lyon IM, 1999. Intestinal capillariasis acquired in Egypt. Eur J Gastroenterol Hepatol 11: 935936.

  • 15.

    Pradatsundarasar A, Pecharanond K, Chintanawongs C, Ungthavorn P, 1973. The first case of intestinal capillariasis in Thailand. Southeast Asian J Trop Med Public Health 4: 131134.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Sanpakit S, Suksungvol S, Bhaibulaya M, 1974. Intestinal capiliariasis from Saraburi province, Thailand: report on the second case. J Med Assoc Thai 57: 458460.

  • 17.

    Prakitrittranon W, Eua-Ananta YU, Dhiensiri T, Bhaibulaya M, 1980. Intestinal capillariasis from Maha Sarakham province, northeast Thailand: report of a case. Southeast Asian J Trop Med Public Health 11: 496497.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Benjanuwattar T, Morakote N, Somboon P, Sivasomboon B, 1990. Intestinal capillariasis: indigenous cases from Chiang Mai and Phayao provinces, Thailand. J Med Assoc Thai 73: 414417.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Chunlertrith K, Mairiang P, Sukeepaisarnjaroen W, 1992. Intestinal capillariasis: a cause of chronic diarrhea and hypoalbuminemia. Southeast Asian J Trop Med Public Health 23: 433436.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Sangchan A, Wongsaensook A, Kularbkaew C, Sawanyawisuth K, Sukeepaisarnjaroen W, Mairiang P, 2007. The endoscopic-pathologic findings in intestinal capillariais: a case report. J Med Assoc Thai 90: 175178.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Saichua P, Nithikathkul C, Kaewpitoon N, 2008. Human intestinal capillariasis in Thailand. World J Gastroenterol 14: 506510.

  • 22.

    Elkins DB, Haswell-Elkins M, Anderson RM, 1986. The epidemiology and control of intestinal helminths in the Pulicat Lake region of southern India. I. Study design and pre- and post-treatment observations on Ascaris lumbricoides infection. Trans R Soc Trop Med Hyg 80: 774792.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Intapan PM, Maleewong W, Sukeepaisarnjaroen W, Morakote N, 2006. Potential use of Trichinella spiralis antigen for serodiagnosis of human capillariasis philippinensis by immunoblot analysis. Parasitol Res 98: 227231.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Lu LH, Lin MR, Choi WM, Hwang KP, Hsu YH, Bair MJ, Liu JD, Wang TE, Liu TP, Chung WC, 2006. Human intestinal capillariasis (Capillaria philippinensis) in Taiwan. Am J Trop Med Hyg 74: 810813.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Dorny P, Praet N, Deckers N, Gabriel S, 2009. Emerging food-borne parasites. Vet Parasitol 163: 196206.

  • 26.

    Paulino GB Jr, Wittenberg J, 1973. Intestinal capillariasis: a new cause of a malabsorption pattern. Am J Roentgenol Radium Ther Nucl Med 117: 340345.

  • 27.

    Kunaratanapruk S, Iam-Ong S, Chatsirimongkol C, 1981. Intestinal capillariasis: the first endemic in Thailand. Ramathibodi Med J 4: 209213.

  • 28.

    Kunaratanapruk S, Iam-Ong S, Chatsirimongkol C, Dhirasut C, Laohanuwat C, 1983. Intestinal capillariasis: a report of 100 cases. Ramathibodi Med J 6: 253258.

  • 29.

    Pathanacharoen S, Tansuphaswaddikul S, Manutstitt S, Thanangkul B, 1983. Intestinal capillariasis: a review and report of three cases. Ramathibodi Med J 6: 277283.

  • 30.

    Bhaibulaya M, Benjapong W, Noeypatimanond S, 1977. Infection of Capillaria philippinensis in man from Phetchabun province, northern Thailand: a report of the fifth case. J Med Assoc Thai 60: 507509.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Wilairatana P, 1994. Capillariasis with chronic intestinal pseudo-obstruction. Southeast Asian J Trop Med Public Health 25: 600602.

  • 32.

    Wongsawasdi L, Ukarapol N, Lertprasertsuk N, 2002. The endoscopic diagnosis of intestinal capillariasis in a child: a case report. Southeast Asian J Trop Med Public Health 33: 730732.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Bhaibulaya M, Indra-Ngarm S, Ananthapruti M, 1979. Freshwater fishes of Thailand as experimental intermediate hosts for Capillaria philippinensis. Int J Parasitol 9: 105108.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Limsrivilai J, Pongprasobchai S, Apisarnthanarak P, Manatsathit S, 2014. Intestinal capillariasis in the 21st century: clinical presentations and role of endoscopy and imaging. BMC Gastroenterol 14: 207.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Rana SS, Bhasin DK, Bhatti HS, Gupta K, Gupta R, Nada R, Nagi B, Sinha SK, Singh K, 2009. Human intestinal capillariasis: diagnosis by jejunal fluid analysis obtained at enteroscopy and reversal of subtotal villous atrophy after treatment. Endoscopy 41 (Suppl 2): E102E103.

    • PubMed
    • Search Google Scholar
    • Export Citation
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