capillariasis

What is Capillariasis?

Capillariasis, also known as intestinal capillariasis or capillaria infection, is a parasitic disease caused by the roundworms of the genus Capillaria. This infection can affect both humans and animals.

Causes and Transmission

The disease is typically transmitted to humans through the consumption of raw or undercooked infected fish, particularly small freshwater or brackish-water fish. The parasite multiplies in the human body, leading to various symptoms.

Symptoms

The symptoms of capillariasis can vary depending on the severity of the infection and individual factors. Common symptoms include:

• Diarrhea
• Abdominal pain
• Edema (swelling)
• Weight loss
• Malabsorption

In severe cases, the disease can lead to life-threatening complications if left untreated.

Species Involved

Two species of roundworms are known to cause capillariasis: Capillaria philippinensis and Capillaria hepatica. The former is more commonly associated with intestinal infections, while the latter has a direct life cycle that requires the host to die for proper transmission.

Geographic Distribution

Capillariasis is more prevalent in certain regions, particularly in areas where raw or undercooked fish is consumed as part of the local diet.

References:

• [1] Intestinal capillariasis initially manifests as abdominal/gastrointestinal disease, which can become serious if not treated because of autoinfection.
• [3] Humans acquire the infection by eating small freshwater fish raw. The parasite multiplies, and symptoms of diarrhea, borborygmus, abdominal pain, and edema ...
• [10] Capillariasis is a parasitic infection caused by two species of roundworms: C. hepatica and C. philippinensis.
• [13] Intestinal capillariasis is a parasitic disease caused by Capillaria philippinensis, a nematode that infects the intestines.
• [15] Description of Disease Intestinal capillariasis (capillariasis philippinensis) is a parasitic disease of the small intestines of humans caused by a tiny nematode, Capillaria philippinensis.

Signs and Symptoms of Capillariasis

Capillariasis, a parasitic infection caused by nematodes (roundworms), can manifest in various ways depending on the severity of the infection. Here are some common signs and symptoms:

• Abdominal pain: A frequent symptom of capillariasis, especially in cases where the infection is severe.
• Diarrhea: Diarrhea is a hallmark symptom of intestinal capillariasis, often accompanied by weight loss and malabsorption.
• Weight loss: Malabsorption due to the infection can lead to significant weight loss.
• Borborygmi: Rumbling sounds in the abdomen are another common symptom.
• Hypokalemia: Low potassium levels can occur due to excessive fluid loss and malabsorption.
• Hypoalbuminemia: Low albumin levels can also be present, leading to edema and other complications.
• Edema: Fluid retention can cause swelling in various parts of the body.
• Cachexia: A severe wasting syndrome that can occur due to prolonged infection.

Variations in symptoms

Symptoms can vary depending on the type of capillariasis. For example:

• Intestinal capillariasis: Primarily affects the gastrointestinal system, with symptoms like diarrhea and malabsorption.
• Pulmonary capillariasis: Can cause respiratory distress, coughing, sneezing, wheezing, or exercise intolerance.

Complications

If left untreated, capillariasis can lead to serious complications, including:

• Protein-losing enteropathy: A condition where the intestines lose protein, leading to malnutrition and other problems.
• Cardiomyopathy: Heart muscle damage due to prolonged infection.
• Severe emaciation: Extreme weight loss and wasting.
• Death: In severe cases, capillariasis can be fatal if not properly managed.

These symptoms and complications highlight the importance of prompt medical attention for individuals suspected of having capillariasis.

Diagnostic Tests for Capillariasis

Capillariasis, a parasitic infection caused by the nematode parasite Capillaria philippinensis, can be challenging to diagnose due to its similarity in symptoms with other gastrointestinal infections. However, several diagnostic tests have been developed to confirm the presence of this infection.

1. Stool Examination The most common method for diagnosing capillariasis is through stool examination. This involves collecting a stool sample and examining it under a microscope for the presence of eggs and larvae. According to [3], symptomatic patients often have detectable eggs in their stool, which can be easily confused with those of Trichuris trichiura. However, T. trichiura eggs have prominent bipolar plugs that appear cut off in P. phillipinensis.

2. Biopsy Biopsy of the ileum or liver tissue can also confirm the diagnosis of capillariasis. In [6], the diagnosis was confirmed by biopsy of the ileum, and the pathognomonic radiographic presentation of a ribbon-like appearance in a small bowel series was crucial for diagnosis.

3. Serologic Tests Unfortunately, no serologic tests are available for diagnosing capillariasis. However, laboratory tests may show slight leukocytosis and eosinophilia, which can be indicative of the infection [13].

4. Western Blot Technique A recent study has shown promising results using the Western blot technique to detect antigen recognition patterns in capillariasis patients [15]. This method may provide a more sensitive and specific diagnostic tool for early treatment.

5. Other Diagnostic Methods Other methods, such as ultrasound and MRI examination, can also be used to confirm the diagnosis of capillariasis [7]. Additionally, parasitic detection through either stool examination or small intestinal tissue sample can be performed [8].

In conclusion, while there is no single definitive diagnostic test for capillariasis, a combination of these methods can provide a reliable diagnosis. It is essential to consult with a healthcare provider for accurate diagnosis and treatment.

References: [3] M Ha (2013) - Cited by 3 [6] M Ha (2013) - Cited by 3 [7] L Wang (2019) - Cited by 16 [8] J Limsrivilai (2000) - Cited in [12] [13] Various authors (196, 197) [15] Background Diagnosis of intestinal capillariasis depending on microscopic detection of parasitic stages is of low sensitivity, especially in cases with low worm burden.

Treatment Options for Capillariasis

Capillariasis, an infection caused by a parasite, can be treated with various medications. The primary goal of treatment is to eliminate the parasite from the body and prevent complications.

• Mebendazole: Mebendazole is considered the drug of choice for treating capillariasis. It is effective against both adult and larval stages of the parasite, reducing the risk of relapse [7][8]. The recommended dosage is 200 mg orally twice daily for 10-20 days.
• Albendazole: Albendazole is an alternative treatment option for capillariasis. It has been shown to be effective in treating intestinal capillariasis and is often used as a second-line treatment [5][14]. The recommended dosage is 400 mg orally once daily for 10 days.

Other Considerations

When treating capillariasis, it's essential to consider the safety precautions of medications in different populations. Additionally, extended anthelminthic treatment may be necessary to ensure complete elimination of the parasite from the body [14].

References

• Mebendazole is considered the drug of choice for treating capillariasis [7][8].
• Albendazole is an alternative treatment option for capillariasis [5][14].
• Extended anthelminthic treatment may be necessary to ensure complete elimination of the parasite from the body [14].

Differential Diagnosis of Capillariasis

Capillariasis, a parasitic infection caused by the nematode parasite Capillaria philippinensis, requires careful consideration of differential diagnoses to ensure accurate diagnosis and treatment. The following conditions should be considered in the differential diagnosis of capillariasis:

• Chronic diarrhea: Intestinal capillariasis can present with chronic diarrhea, which may also be caused by other conditions such as inflammatory bowel disease (IBD), celiac disease, or giardiasis.
• Abdominal pain and weight loss: The symptoms of abdominal pain and weight loss in patients with intestinal capillariasis may also be seen in cases of IBD, celiac disease, or pancreatic insufficiency.
• Hepatic capillariasis: This condition can present with fever, hepatomegaly, eosinophilia, and hyperglobulinemia, which are similar to symptoms seen in other liver diseases such as hepatitis or leptospirosis.
• Protein-losing enteropathy: Intestinal capillariasis can cause protein-losing enteropathy, a condition that may also be caused by other conditions such as IBD, celiac disease, or giardiasis.

Key Diagnostic Features

The specific diagnosis of C. philippinensis is established by finding eggs, larvae and/or adult worms in the stool or in intestinal biopsies [10]. Unembryonated eggs are the typical stage found in the feces, while embryonated eggs, larvae, and even adult worms can be found in severe infections [10].

Diagnostic Considerations

The diagnosis of capillariasis may be challenging due to its similarity with other conditions. A combination of macroscopic examination, sieving intestinal contents, or characteristic worm eggs in faeces in patent infections may aid in the diagnosis [9]. Serologic testing is not available for capillariasis, and the definite diagnosis is made by parasite detection or dramatic response to empirical therapy with an anti-parasitic agent (albendazole or ivermectin) [11].

References

• [10] The specific diagnosis of C. philippinensis is established by finding eggs, larvae and/or adult worms in the stool or in intestinal biopsies.
• [9] A combination of macroscopic examination, sieving intestinal contents, or characteristic worm eggs in faeces in patent infections may aid in the diagnosis.
• [11] The definite diagnosis is made by parasite detection or dramatic response to empirical therapy with an anti-parasitic agent (albendazole or ivermectin).