Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis

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 duoden...

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Main Authors: Lijia Wen, Benhe Wang, Hui Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1515539/full
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author Lijia Wen
Benhe Wang
Hui Zhang
author_facet Lijia Wen
Benhe Wang
Hui Zhang
author_sort Lijia Wen
collection DOAJ
description 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.
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spelling doaj-art-9eaa88c35d314888b61f6ae71f979ccf2025-01-22T07:14:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15155391515539Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosisLijia Wen0Benhe Wang1Hui Zhang2Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, ChinaDepartment of Parasitic Diseases, Jilin Provincial Center for Disease Control and Prevention (Jilin Provincial Academy of Preventive Medicine), Changchun, ChinaDepartment of Laboratory Medicine, The First Hospital of Jilin University, Changchun, ChinaClonorchis 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.https://www.frontiersin.org/articles/10.3389/fmed.2024.1515539/fullClonorchis sinensisEchinostoma hortensetrematodediagnosisendoscopymolecular characterization
spellingShingle Lijia Wen
Benhe Wang
Hui Zhang
Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
Frontiers in Medicine
Clonorchis sinensis
Echinostoma hortense
trematode
diagnosis
endoscopy
molecular characterization
title Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
title_full Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
title_fullStr Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
title_full_unstemmed Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
title_short Clonorchis sinensis and Echinostoma hortense detected by endoscopy and molecular characterization: two case reports and update on diagnosis
title_sort clonorchis sinensis and echinostoma hortense detected by endoscopy and molecular characterization two case reports and update on diagnosis
topic Clonorchis sinensis
Echinostoma hortense
trematode
diagnosis
endoscopy
molecular characterization
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1515539/full
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AT benhewang clonorchissinensisandechinostomahortensedetectedbyendoscopyandmolecularcharacterizationtwocasereportsandupdateondiagnosis
AT huizhang clonorchissinensisandechinostomahortensedetectedbyendoscopyandmolecularcharacterizationtwocasereportsandupdateondiagnosis