A Case of Endoscopically Treated Laryngopharyngitis Resulting fromClinostomum complanatumInfection

Abstract

A 46-year-old woman visited our hospital presenting throat pain and globus sensation. The symptoms occurred seven days after eating raw perch and mullet. An endoscopy under sedation showed a fluke-with an approximate length of 4.8 mm and width of 1.5 mm-on the left aryepiglottic fold, with active motility on the mucosa. It was extracted from the larynx using biopsy forceps and was identified as Clinostomum complanatum. To the best of our knowledge, this is the second reported case of human infection with Clinostomum complanatum diagnosed and treated by an endoscopy in Korea. Endoscopy is a useful tool in the diagnosis and treatment of patients at risk for parasitic infections complaining of throat pain. (Korean J Gastroenterol 2017;69:177-180)

First Report of Clinostomum complanatum (Trematoda: Digenea) in European Perch (Perca fluviatilis) from an Italian Subalpine Lake: A Risk for Public Health?

“…The present study shows that Perca fluviatilis is a suitable intermediate host for C. complanatum. Because the parasite is described as a zoonotic agent, knowing its prevalence and distribution range is of particular importance for the local economy and for consumer health [6,[8][9][10]22].…”

“…C. complanatum is a fish-borne zoonotic parasite responsible for Halzoun syndrome, a rare disease transmitted after consumption of raw or undercooked freshwater fish infected with metacercariae [6][7][8][9]. In accidental human infections, C. complanatum attaches to the mucous membrane of the throat and generally causes acute pharyngitis and laryngitis [10].…”

A Case of Unexpected Clinostomum complanatum Infection Initially Presenting as Foreign Body in Pharynx

“…Since its first report in 1995, only 4 cases have been reported until date in Korea. In the previous reports, patients visited the clinic with sore throat symptoms which developed as early as 3 days after consuming freshwater fish and endoscopic examination evidently revealed parasitic infections at various sites such as pharynx, larynx, and nasopharynx [2]. The flatworms were endoscopically or surgically removed under sedation and symptoms were eventually resolved.…”

Human Laryngeal Infection by Clinostomum complanatum

“…The consumption of raw freshwater fish containing metacercariae rarely infects humans where the parasites excyst in the stomach and migrate and !attach to the throat causing pharyngitis or laryngitis. 2 Although most of the human infection cases have been reported in Korea and Japan, 2 , 3 the wide distribution of freshwater fish infection has been reported in North America. 4 Furthermore, along with a few human infection cases after consumption of raw brackish fish, 3 , 5 this case suggests that brackish fish is also not completely safe to eat raw in terms of C. complanatum infection.…”

“…2 Although most of the human infection cases have been reported in Korea and Japan, 2 , 3 the wide distribution of freshwater fish infection has been reported in North America. 4 Furthermore, along with a few human infection cases after consumption of raw brackish fish, 3 , 5 this case suggests that brackish fish is also not completely safe to eat raw in terms of C. complanatum infection. A patient presenting with a globus sensation after consumption of raw fish should be appropriately evaluated including laryngoscopy.…”