Figure 8: Capillaria egg
Figure 9: T. trichiura egg
Parasitological diagnosis is made either by examination of fecal matter
or by intestinal biopsy.
The presence of adults, eggs, or larvae in feces is definitive evidence of infection.
However, as comparison of the above images suggests, it is not uncommon to confuse the eggs of Capillaria with those of T. trichiura.
Unembryonated C. philippinensis eggs are peanut-shaped, 36 to
45 µm in length and 21 µm in width with reduced, flattened
bipolar plugs and a striated shell.
The length and width vary by species, but the characteristic features of the eggs -- namely, peanut shape, inconspicuous polar plugs, and striated texture of outer shell -- allow identification for proper diagnosis.
Adult C. philippinensis worms are thin, filamentous, of uniform diameter, and of length of 6-25 mm in intestines.
In 1992, a group of Italian doctors reported the first documented case of C. philippinensis infection acquired in Indonesia.
A 32-year-old Italian man returned from a one
month-long trip to Indonesia with the following symptoms: heartburn, abdominal
pain, irregular bowel movements, headache, fatigue, weight loss, low-grade
fever, and severe itching. The diagnosis of intestinal capillariasis
was provided by the recovery of C. philippinensis eggs in the stool.
Three weeks of treatment with the antihelmintic agent albendazole resulted
in clinical and parasitologic cure.
Intestinal capillariasis (Capillaria philippinensis) acquired in Indonesia: a case report. Chichino G, Bernuzzi AM, Bruno A, Cevini C, Atzori C, Malfitano A, Scaglia M. Department of Infectious Diseases, University-IRCCS S., Pavia, Italy. Am J Trop Med Hyg 1992 Jul;47(1):10-2.
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