Clin Endosc.  2013 Nov;46(6):675-678.

Intestinal Capillariasis Diagnosed by Endoscopic Biopsy

• Ha M
• Jun DH
• Kim JH
• Kim YJ
• Kwon KA
• Park DK
• Ku YS

Abstract

Many new parasitic infections have emerged in Korea, with >35 new species appearing since the 1980s. Among them, Capillaria species are unique for contributing to morbidity in many countries as well as in Korea. Since the first reported case of a 41-year-old male patient diagnosed with intestinal capillariasis in 1991, a total of six cases have been reported thus far. In this case report, we present another imported case of intestinal capillariasis in Korea, in which a 42-year-old male patient presented with intractable diarrhea and weight loss. The diagnosis was confirmed by biopsy of the ileum. The pathognomonic radiographic presentation of a ribbon-like appearance in a small bowel series was crucial in raising an early suspicion of capillariasis and in deciding to perform diagnostic biopsy.

Keyword

Capillaria; Capillaria philippinensis; Intestine, small; Colonoscopy; Albendazole

MeSH Terms

Adult
Albendazole
Biopsy*
Capillaria
Colonoscopy
Diagnosis
Diarrhea
Humans
Ileum
Intestine, Small
Korea
Male
Weight Loss
Albendazole

Figure

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  Fig. 1 Abdominal radiograph. Small bowel series performed with barium illustrates marked luminal narrowing and effacement of folds producing a ribbon-like appearance of the ileum. However, even the involved ileum does not show demonstrable luminal narrowing or passage disturbance, and the folds are well preserved in the jejunum.

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  Fig. 2 (A, B) Endoscopic images of the distal ileum. Scattered erosive mucosal lesions with loss of villi and several shallow erosions with whitish exudates were observed.

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  Fig. 3 Photomicrograph of the biopsy specimen from the distal ileum (H&E stain, ×200). Biopsy specimens of the ileum show atrophic changes of the intestinal villi, infiltration of plasma cells and eosinophils, and several sections of worms invading the mucosa (arrows).

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