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May 3, 1985

Hold the Sushi

Author Affiliations

Hospital of the University of Pennsylvania Philadelphia

JAMA. 1985;253(17):2495-2496. doi:10.1001/jama.1985.03350410041015

To the Editor.—  The following case of Diphyllobothrium infestation is presented for its epidemiologic interest.

Report of a Case.—  A 37-year-old woman, previously healthy, complained of three weeks of mild diarrhea, mucus in the stool without blood, and weight loss of 5 lb (2.3 kg). She reported occasionally passing long, flat, segmented structures, which she thought might be worms. The patient worked as a tapestry designer, and her work often took her to New York City, where she frequented Japanese restaurants and sushi bars. The physical examination findings were entirely normal, with no evidence of pallor, glossitis, or neurologic dysfunction. A complete blood cell count and findings from a battery of chemistry studies were normal. A sample of stool showed typical operculated eggs and proglottids of the fish tapeworm Diphyllobothrium. The patient's symptoms resolved with a single dose of niclosamide, and follow-up stool analysis three months later revealed no ova

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