A 49 year old man presents with progressive fatigue and numbness in his feet. He frequently eats raw freshwater fish that he catches while camping. Laboratory studies show hemoglobin 9.4 g per dL, mean corpuscular volume 112 fL, and low vitamin B12 level. Which of the following is the most likely causal organism?
- A)Diphyllobothrium latumGABARITO
- B)Giardia lamblia
- C)Echinococcus granulosus
- D)Trichinella spiralis
- E)Strongyloides stercoralis
Explicação
Diphyllobothrium latum is correct. The fish tapeworm competes for vitamin B12 and can produce megaloblastic anemia and neurologic symptoms after ingestion of raw freshwater fish. The dietary history is the defining clue. Ver explicação completa e trilha adaptativa →