DDSEP® 8 Quick Quiz

November 2016 Quiz 2

Publish date: November 7, 2016

A 40-year-old man presents to the clinic with 2 months of diarrhea and significant fatigue. He has no significant past medical history and works as a chef in a local sushi bar. He has nonbloody watery stools with nocturnal symptoms. The diarrhea is associated with abdominal cramps. His physical examination is unrevealing. His hemoglobin is 9.8 g/dL, with a mean corpuscular volume of 110 fL. Peripheral eosinophilia is noted. A stool sample is sent to the lab and is pending.

Which of the following medications is most likely to help?

Paromomycin.

Praziquantel.

Pyrantel pamoate.

Mebendazole.

Albendazole.

Q2: Answer: B

This is likely a tapeworm infection with Diphyllobothrium latum, and most tapeworm infections are treated with praziquantel. D. latum infection can be acquired by ingesting certain forms of freshwater fish, and those who consume raw fish, including sushi, are at increased risk. Patients infected with D. latum may develop a megaloblastic anemia secondary to vitamin B12 deficiency given that D. latum competitively interferes with normal host absorption. All the other agents listed would not be used for treatment of tapeworm infection.

Reference

1. Scholz T., et al. Update on the human broad tapeworm (genus Diphyllobothrium), including clinical relevance. Clin Microbiol Rev. 2009;22:146-60.

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