Capillaria philippinensis 菲律賓毛線蟲 A very small whipworm which is normally parasitic in fish-eating birds Distribution of Capillariasis Philippine islands 菲律賓群島 - Northern Luzon 呂宋島西北部海岸 - North eastern Mindanao 民答那峨 Thailand 泰國 Japan 日本
Morphology of C. philippinensis 形態與鞭蟲相似但較小 食道由桿狀細胞 stichocytes 組成 雄蟲 大小約 2.1~3.7 x 0.02~0.04 mm 尾端有兩對乳突 (尾翼)及 一交尾剌 大小約 2.6 ~4.9 x 0.04~0.06 mm 陰道口微突 子宮位於蟲體中央， 內含蟲卵及（或）幼蟲 雌蟲 vulva ovary vagina stichosome esophagus uterus Female C. philipinensis
Transmission 傳播途徑 Ingestion of infective eggs in raw,undercooked, Infective stage 感染期: larvae 幼蟲 Intermediate host 中間宿主: fish 淡水或海水魚類 Natural definitive host (終宿主) : fish- eating birds Ingestion of infective eggs in raw,undercooked, or pickles fish 吃入含有感染期幼蟲而末經煮熟的魚類 Autoinfection 自體感染
Life Cycle 生活週期 體內 體外 蟲卵在水中 發育成 胚卵 被淡水或海水魚類吞食 在腸道中發育成感染性幼蟲 人類食入被含有 之魚類 幼蟲在小腸內 發育為成蟲 雌雌交配 產卵 蟲卵在 腸內孵化 發育為幼蟲 自體感染 蟲卵 隨糞便 排出體外 5~10 days 3 wks 厚殼卵 薄殼胚卵 體內 體外
Clinical Features 臨床徵候 Adults and larvae can be found in the crypts of small intestine especially jejunum, upper ileum and less often, in the duodenum Adult C. philippinensis in the mucosa of small intestine The anterior ends sometimes penetrate into the lamina propria Villi tends to be flattened and atrophic Early and mild infections Abdomminal pain 腹痛, intestinal gurgling 腸鳴 and chronic watery diarrhoea 慢性水瀉
Clinical Features 臨床徵候 Heavy infections Severe malabsorption of fats and sugar Protein losing enteropathy (15X than normal) Reduced level of carotene, plasma K, Na and Ca salts 電解質流失 Decreased excretion of xylose Decreased level of IgM and IgG Anorexia 食慾不振, nausea 噁心, vomiting 嘔吐 Watery diarrhoea (5~10 times/day) cachexia 惡體質, muscle wasting 肌肉萎縮, oedema 水腫 Cardic failure 心臟衰竭, hypotension 低血壓 DEATH in 2~8 wks (mortality rate 6.7~20%)
Laboratory Diagnosis Finding eggs, adult worms or larvae in feaces 菲律賓毛線蟲卵 長寬約 36~45 x 19~21 mm 形狀較接近長方形 Plug (卵塞) 較不突出 卵殼外層有橫紋 土黃色，無閃亮光澤 鞭蟲卵 長寬約 50 x 25 mm 酒桶形 卵塞突出 無橫紋 褐黃色，有閃亮光澤
Prevention and Control