Skip to main content

CASE REPORT article

Front. Med.
Sec. Gastroenterology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1515539
This article is part of the Research Topic Control of Parasitic Zoonoses View all articles

Clonorchis sinensis and Echinostoma hortense Detected by Endoscopy and Molecular Characterization: Two Case Reports and Update on Diagnosis

Provisionally accepted
Lijia Wen Lijia Wen 1,2Benhe Wang Benhe Wang 3,4*Hui Zhang Hui Zhang 5*
  • 1 Jilin University, Changchun, China
  • 2 Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, Changchun, Hebei Province, China
  • 3 Jilin Provincial Center for Disease Control and Prevention (JPCDC), Changchun, Jilin Province, China
  • 4 Jilin Provincial Academy of Preventive Medicine, Changchun, China
  • 5 Department of Laboratory Medicine, First Affiliated Hospital of Jilin University, Jilin University, Changchun, Hebei Province, China

The final, formatted version of the article will be published soon.

    Clonorchis sinensis (C. sinensis) and Echinostoma hortense (E. hortense) infections represent significant food-borne zoonotic parasitic diseases. C. sinensis stands as the primary parasite underlying cholangitis, cholelithiasis, and even cholangiocarcinoma, whereas E. hortense parasitizes the duodenum. Unfortunately, the non-specific clinical presentations of these two trematodes frequently mislead clinicians, resulting in overlooks or misdiagnoses, and consequently, inadequate treatment. We diagnosed digestive system trematodes through endoscopic observation and molecular methods. Herein, we present a case where C. sinensis was definitively diagnosed through direct observation under duodenoscopy. For the first time, we captured the entire migratory process of the parasite from the common bile duct into the intestinal lumen. In another case, multiple active trematodes were detected on the duodenal wall under duodenoscopy, subsequently extracted using endoscopic forceps. Based on the morphology of the worms and their eggs, an initial diagnosis of Echinostoma was made. To confirm the species, we designed primers targeting the ribosomal ITS (internal transcribed spacer) and mitochondrial COX-1(cyclooxygenase-1) genes, followed by PCR amplification and sequencing. The results conclusively matched the sequence of E. hortense, verifying our final diagnosis. Our proposed approach, integrating endoscopy with molecular characteristics, offers novel strategies for diagnosing trematode infections. This methodology represents a significant advancement in the field, enhancing the accuracy and timeliness of treatment interventions.

    Keywords: Clonorchis sinensis, Echinostoma hortense, trematode, diagnosis, Endoscopy, molecular characterization, ITS, COX-1

    Received: 23 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Wen, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Benhe Wang, Jilin Provincial Center for Disease Control and Prevention (JPCDC), Changchun, 130062, Jilin Province, China
    Hui Zhang, Department of Laboratory Medicine, First Affiliated Hospital of Jilin University, Jilin University, Changchun, 130021, Hebei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.