Attached
A five-year old boy presented with fever, watery
stools and a febrile convulsion on day one of the illness.
He has had on and off abdominal pain for 5 months.
No urinary symptoms nor blood stained stools noted. He
has had a febrile convulsion at 9 months. Growth and
development were appropriate for the age. The immunisation was uptodate. Examination was unremarkable.
Microscopic examination of faeces showed 10-12 pus cells
and 15-16 red cells per high power field and eggs of
H ym enolepis dim inuta (Figure 1). Stool culture did not
yield any significant pathological organism. Stool virology
could not be performed. Child was treated with praziquantal 10 mg/ kg as a single dose. A microenema was
administered 2 hours later and a 24 hour stool collection
was done to check the excretion of the worms which yielded
numerous worm segments (Figure 2). A repeat stool
examination was done one month later which did not show
evidence of H. dim inuta infestation.
The natural reservoir and definitive host of
H. dim inuta are rodents. Coprophilic arthropods such as
flea and beetle species act as intermediate hosts [1].
Humans act as definitive hosts only when they ingest
cysticercoid larvae infected arthropods with food and
fomites. This is the reason why H. dim inuta infestation is
uncommon in humans [1 ]. Only a limited number of cases
have been reported globally [ 1 ]. H. dim inuta is known to
cause abdominal pain and loose stools in children [3],
H. diminuta infestation has not been reported to cause
seizures before. Praziquantel and niclosamide can be used
for treatment of H. dim inuta infestations.
