Question

Illness: Anisakiasis

In your case study, provide an introduction to your patient-include name, age, social status. Describe the patient's medical history of the present illness and the chief presenting complaint(clinical presentation). Describe how you would diagnose this illness-what additional symptom would you look for, what diagnostic tests you will do, your expected findings and the subsequent treatment and prognosis. Create a list of at least four other differential diagnoses.

Once you have completed your case study, under your case-study text, describe the classification of the helminth associated with the assigned disease, describe the most common modes of transmission, life cycle, virulence factors, epidemiology, and prevention.

Answer 1

Answer:- A case study on disease Anisakiasis

Name:- Raju Das

Age:- 40 years

Social status:- shop keeper.

Medical history:- The patient suddenly become victim of abodominal pain, vomiting after eating sushi . At first the patient didn't recognize the actual cause and after doctor giving some antibiotics and medicine he recovered but again after three week he ate sushi then again same symptoms occur severely , then he could realise the cause . The doctor after CT scanning found that in the distal body there is thick layer of gastric mucosa and EGD provide evidence of the parasitic attachment with the mucosal lining. The doctor endoscopically removed the parasite and examine and recognised the parasite as Anisakis simplex and give some medicine to take for a period of 3 weeks.

Diagonisis of this illness--- I will diagnise the illness by CT scanning and upper endoscopy and radiography.

Additional symptomps ---- pain in abdomen , vomiting , feeling of nausea, blood and mucous may appear in stool, abdominal distension, mild fever, allergy.

Expected finding:- After CT scan I can found the thick layer of gastric mucosa in distal body , Through EGD I can directly visualise the larva , endoscopy gives result of swelling of gastric mucosa near parasitic attachment.

Treatment :- I will remove the visual parasite either by using biopsy forceps or by endoscopically. I will prescribed the patient to take two times per day albendazole *400 mg for duration 6- 21 days.

Four other differential diagnosis :- I) Narrow Band Imaging

II) Other clinical Laboratory examination such as different cell count amount .

III) Abdominal Ultrasound

IV) Use of serology.

Classification of helminth---

Kingdom----) Animalia

Phylum---) Nematoda

Class-----) secernentea

Order-------) Ascaridida

Family-----) Anisakidae

Genus-----) Anisakis

Species----) A.simplex

Most common mode of transmission ----) consumption of sea food specially undercooked and raw such as sea fish, seal, mackeral, sushi etc.

Life cycle:- life cycle of A.simplex is complex one as it completed through several host. The site of eggs hatching is seawater and produce larvae which are being eaten by crustacean present in sea water , the larva are then passed to fish or squid due to consumption of infected crustaceans , the larva then encyst themself in the gut of fish and squid . The sea mammal at last become host of A.simplex when they eat infected fish or squid and further life cycle is completed in the body of sea mammal itself.

Virulence factor:- third stage larva of A.simplex is the causative factor for anisakiasis disease in human .

Epidemiology:- The disease anisakiasis is caused due to uncooked or raw sea foods mainly sea fish . This disease is caused by helminth Anisakis simplex . Symptoms include abdominal pain, nausea, vomiting, diarrhoea , blood in stool , low grade fever .

Prevention :- the disease can be prevented by ----

I,) proper cooked sea fish or food

II) avoiding raw food