A Rare Case of Intestinal Taeniasis Presenting With Hematochezia and Iron Deficiency Anemia.

CASE REPORT

A 37-year-old male immigrant from Thailand presented to the emergency department with chest pain, fatigue, and hematochezia. Severe iron deficiency anemia was noted (Hgb 6 gm/dL, iron 11 μg/dL, ferritin 2 ng/mL, total iron bonding capacity (TIBC) 425 mcg/dL). Esophagogastroduodenoscopy with duodenal biopsies was unrevealing. Colonoscopy was remarkable for multiple, flat, ribbon-like structures (Figures 1 and 2). Specimens were collected for microscopic analysis and confirmed the structures to be Taenia proglottids (Figure 3). The patient had reported daily consumption of raw beef and pork before immigrating to the United States 10 years before his presentation. A single dose of praziquantel was provided with resolution of his symptoms and anemia at follow-up.

Figure 1.

Multiple Taenia proglottids visualized on colonoscopy.

Figure 2.

Multiple Taenia proglottids visualized on colonoscopy.

Figure 3.

Microscopic analysis of biopsied proglottids using hematoxylin and eosin with identification of numerous eggs. Scale bar 200 μm.

Visualization of proglottids during colonoscopy is extremely rare. A case report described Taenia proglottids identified during colon cancer screening in an asymptomatic patient.[1] Thailand is noted to have a high prevalence of taeniasis because of the fact that consumption of raw meats is a common practice in traditional cuisine.[2] The gold standard for diagnosis of Taenia is identification of proglottids or eggs on stool microscopy. In cases of iron deficiency anemia (IDA) with hematochezia, clinicians should consider appropriate stool testing for Taenia infection in patients presenting from countries where this infection is endemic.

DISCLOSURES

Author contributions: All authors contributed equally to the manuscript including data acquisition, interpretation, as well as manuscript drafting, revision, and approval of the final manuscript. K. Yuquimpo is the author guarantor.

Financial disclosure: None to report.

Previous presentation: This case was presented at the 2021 ACG National Conference; October 22-27; Las Vegas.

Informed consent was obtained for this case report.