J Korean Med Sci.  2009 Oct;24(5):963-966. 10.3346/jkms.2009.24.5.963.

A Case of Gastritis Associated with Gastric Capillariasis

• Kim J
• Joo HS
• Jung S
• Kim HS
• Lee MY
• Jeong JJ
• Kim HS

• KMID: 1782024
• DOI: http://doi.org/10.3346/jkms.2009.24.5.963

Abstract

This report is about the case of gastritis associated with capillariasis. The patient was a 52-yr-old Korean woman who occasionally ate raw fish and chicken. She complained of mild abdominal pain and nausea, but not diarrhea. An endoscopic examination revealed an exudative flat erosive change on the gastric mucosa of the antrum. She was microscopically diagnosed as chronic gastritis with numerous eosinophil infiltrations. The sectioned worms and eggs in mucosa were morphologically regarded as belonging to the genus Capillaria. This is the first case of gastric capillariasis reported in the Republic of Korea.

Keyword

Capillaria; Stomach; Biopsy; Endoscopy

MeSH Terms

Albendazole/therapeutic use
Animals
Antiprotozoal Agents/therapeutic use
*Capillaria
Endoscopy, Gastrointestinal
Enoplida Infections/*diagnosis/drug therapy
Female
Gastric Mucosa/parasitology/*pathology
Gastritis/*diagnosis
Humans
Middle Aged

Figure

• 

  Fig. 1 Endoscopic finding of the stomach showing an exudative flat erosive change on antral mucosa.

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  Fig. 2 Three sectioned worms in the superficial portion of the gastric mucosa. Adult female worms with eggs in the uterus had invaded the epithelial layer of the glands and adjacent tissues of the lamina propria causing inflammatory cell infiltration (H&E stain, ×100).

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  Fig. 3 Cross and tangential sections of eggs observed in the uterus. In egg cross-sections, egg shell striations were arranged radially. In tangential-sectioned eggs, striations formed a network resembling a net with irregular meshes (inset: ×400) (H&E stain, ×200).

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  Fig. 4 Longitudinal sections showing stichosome in the worm anterior (H&E stain, ×100).

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  Fig. 5 Extra-uterine eggs embedded in the gastric mucosa. Inconspicuous flattened bipolar mucoid plugs and egg shell striations were clearly observed in longitudinal-sectioned eggs (H&E stain, ×400).

Reference

1. Cross JH. Intestinal capillariasis. Clin Microbiol Rev. 1992. 5:120–129.

2. Beaver PC, Jung RC, Cupp EW. Clinical Parasitology. 1984. Philadelphia: Lea & Febiger;231–252.

3. Hong ST, Cross JH. Arizono N, Chai JY, Nawa Y, Takahashi Y, editors. Capillaria philippinensis infection in Asia. Asian Parasitology. 2005. vol. 1 Food-borne helminthiasis in Asia. Chiba: Federation of Asian Parasitologists;225–229.

4. Lee SH, Hong ST, Chai JY, Kim WH, Kim YT, Song IS, Kim SW, Choi BI, Cross JH. A case of intestinal capillariasis in the Republic of Korea. Am J Trop Med Hyg. 1993. 48:542–546.

5. Hong ST, Kim YT, Choe G, Min YI, Cho SH, Kim JK, Kook J, Chai JY, Lee SH. Two cases of intestinal capillariasis in Korea. Korean J Parasitol. 1994. 32:43–48.

6. Okulewicz A, Zalesny G. Biodiversity of Capillariinae. Wiad Parazytol. 2005. 51:9–14.

7. Fresh JW, Cross JH, Reyes V, Whalen GE, Uylangco CV, Dizon JJ. Necropsy findings in intestinal capillariasis. Am J Trop Med Hyg. 1972. 21:169–173.

8. Chitwood MB, Valesquez C, Salazar NG. Capillaria philippinensis sp. n. (Nematoda: Trichinellida), from the intestine of man in the Philippines. J Parasitol. 1968. 54:368–371.

9. Hong ST, Lim HS, Kim DH, Kim SJ. A case of gastroenteritis associated with gastric trichuriasis. J Korean Med Sci. 2003. 18:429–432.

10. Cross JH, Basaca-Sevilla V. Experimental transmission of Capillaria philippinensis to birds. Trans R Soc Trop Med Hyg. 1983. 77:511–514.