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Case Reports
. 2023 Dec 18:42:e2023077.
doi: 10.1590/1984-0462/2024/42/2023077. eCollection 2023.

First known case of human bertiellosis in a child in Paraná, Brazil

Nathália Mitsue Kishi  1 , Amanda Parteka de Godoy  1 , Bárbara Luiza Viana Afonso  1 , Cristina Alvarez Mattar  1 , Gabriela Riter Martins de Matos  1 , Lucas Müller Prado  1 , Maria Augusta Kormann  1 , Raphael Ferreira Barbosa  1 , Rodolfo Corrêa de Barros  1 , Andrea Maciel de Oliveira Rossoni  1
Affiliations
Case Reports

First known case of human bertiellosis in a child in Paraná, Brazil

Nathália Mitsue Kishi et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: To describe the first known case of human Bertiellosis in Paraná (Brazil).

Case description: A 6-year-old male residing in the Brazilian state of Paraná was suffering from intermittent nonspecific abdominal pain and abdominal distension, associated with expulsion of live tapeworms in his feces for 7 months. He had a history of interaction with monkeys on an island. His first feces analysis was inconclusive, with an initial hypothesis of an atypical Taenia. However, after additional research, the parasitologist identified pregnant proglottids of Bertiella sp. The patient was initially treated with an unknown dosage of albendazole and nitazoxanide, as it was believed he had been infected with Taenia sp. Since the symptoms persisted, praziquantel 10 mg/kg was prescribed without further proglottids elimination.

Comments: Human Bertiellosis is a rare zoonosis, with less than one hundred cases reported. However, it is a cause of chronic abdominal pain and should be kept as a differential diagnosis, especially in cases reporting recurrent tapeworm expulsion in feces and refractory treatment with albendazole.

Objetivo:: Descrever o primeiro caso conhecido de bertielose humana no Paraná, Brasil.

Descrição do caso:: Criança de seis anos do sexo masculino, residente no Paraná, Brasil, apresentava dor abdominal inespecífica intermitente e distensão abdominal, associadas à expulsão de helmintos vivos em suas fezes havia sete meses. Tinha um histórico de interação com macacos em uma ilha. Sua primeira análise de fezes foi inconclusiva, com hipótese inicial de uma Taenia atípica. No entanto, após pesquisas adicionais, o parasitologista identificou proglótides gravídicas de Bertiella sp. O paciente foi inicialmente tratado com uma dosagem desconhecida de albendazol e nitazoxanida, pois se acreditava que havia sido infectado por Taenia sp. Diante da persistência dos sintomas, foi prescrito praziquantel 10 mg/kg, sem mais eliminação de proglótides.

Comentários:: A bertielose humana é uma zoonose rara, com menos de cem casos relatados. No entanto, é uma causa de dor abdominal crônica e deve ser mantida como diagnóstico diferencial, principalmente nos casos que relatam expulsão recorrente de helmintos nas fezes e que são refratários ao tratamento com albendazol.

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Conflict of interest statement

Conflict of interests

The authors declare is no conflict of interests.

Figures

Figure 1
Figure 1. A. Macroscopic view of proglottids of Bertiella sp. obtained from the stools of the patient. B-C. Eggs found in the pregnant proglottids with typical pyriform apparatus (arrows). Scale bars: A=1 cm, B-C=20 μm.
See this image and copyright information in PMC

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