Parasites, Hosts and Diseases

"Jee-Won Chai"

Case Reports

Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient: Min Jae Kim, Woo Ho Kim, Hyun-Chae Jung, Jee-Won Chai, Jong-Yil Chai; Korean J Parasitol 2013;51(2):207-212.
Published online April 25, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.2.207

Abstract
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Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea.

Citations

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A surgically confirmed case of breast sparganosis showing characteristic mammography and ultrasonography findings: Jae-Hwan Park, Jee-Won Chai, Nariya Cho, Nam-Sun Paek, Sang-Mee Guk, Eun-Hee Shin, Jong-Yil Chai; Korean J Parasitol 2006;44(2):151-156.
Published online June 20, 2006; DOI: https://doi.org/10.3347/kjp.2006.44.2.151

Abstract
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A case of breast sparganosis was confirmed by surgical excision of a worm (fragmented into 5 pieces) in a 59-year-old Korean woman suffering from a palpable mass in the left breast. Mammography and ultrasonography characteristically revealed the presence of several well-defined, isodense and hypoechoic tubular masses, in the upper quadrant of the left breast, each mass consisting of a continuous cord- or worm-like structure. During surgery, a long segment of an actively moving sparganum of Spirometra sp. and 4 small fragments of the same worm, giving a total length of 20.3 cm, were extracted from the upper outer quadrant of the left breast and the axillary region. The infection source remains unclear, because the patient denied ingesting any snake or frog meat or drinking untreated water.

Citations

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Breast and Scrotal Sparganosis
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