Capillariasis

Capillariasis is a parasitic disease that is caused by the discovered by the Philippine Parasitologist Carmen Velasquez roundworm ( nematode ) Capillaria philippinensis.

Capillariasis was first described in 1963 in the Philippines, subsequent case reports come from Thailand, Japan, Taiwan, Korea, Iran, Egypt, Italy and Spain.

The adult worms live in the mucosa of the small intestine. The females lay eggs that can go with the feces into water. Add the eggs develop into embryos develop. When eggs are eaten by small fish, the larvae hatch, burrow through the intestinal wall and develop in the mesentery of the fish. After a few weeks the development is completed. People become infected when they eat raw or undercooked fish that are infested by C. philippinensis. The eggs of the parasite can also develop in the human small intestine and thus lead to an auto infection. In the human intestine, the adult nematodes meander through the intestinal mucosa and thus give rise to violations of epithelium and submucosa.

Symptoms of infection include chronic diarrhea, abdominal pain, stomach growling, significant weight loss up to cachexia and chronic loss of electrolytes and proteins with the diarrhea. Unlike other worm infestations the Capillariasis often leads to death if not treated in time. Cause of death is usually heart failure due to electrolyte imbalance, or sepsis due to bacterial superinfection.

In the initial phase of the disease the symptoms are non-specific. Diagnosis is made by detection of eggs, larvae or adult worms in the intestinal contents or tissue samples. Often many stool samples and biopsies need to be examined until the diagnosis can be made.

Treatment is with mebendazole or albendazole, 2 times 200 mg per day per os for 20 to 30 days. Fluid and electrolyte losses must be compensated. A high protein diet is recommended. Due to the hazards of the disease must be started with the treatment already in suspected even before the final diagnosis is made.