Bertiella studeri Infection, China

To the Editor: Bertiella is a genus of tapeworm in the family Anoplocephalidae, many species of which exist as parasites of nonhuman primates. Two species of the genus, Bertiella studeri and B. mucronata, can infect humans (1). More than 50 cases of human infection have been recorded, and the geographic distribution of cases shows that the tapeworm exists in countries in Asia, Africa, and the Americas. We report a B. studeri infection in a person; to our knowledge , this case of bertiellosis is the first in China. The patient was a 3.5-year-old Chinese boy from Suzhou City, Anhui Province. The boy had a 6-month history of frequent abdominal pain. His parents had noticed living " parasites " in his feces for 3 months; a segment of the worm was expelled every 2 or 3 days. According to the symptoms, doctors at the local hospital diagnosed his condition as Taenia solium infection and prescribed praziquantel, but no drug was available in the hospital or local drugstores. Consequently, the parents brought the child to Bengbu Medical College for further diagnosis and treatment. The patient appeared healthy; routine medical examination showed normal heart, lung, liver, and spleen, and he had no fever. Though the patient had intermittent epigastric pain, the abdomen was soft and tender. A total of 133 proglottids were collected from the feces. Their average length was 0.1 cm, and the total length of all proglottids was 13 cm; each segment was 0.68–1.10 cm in width. Eggs (N = 53) were examined microscopically; they were roundish or oval, an average of 45.31 µm diameter (range 37.93–50.00 µm), and clearly showed typical pyriform apparatus, with visible hooklets (Figure). Other laboratory examinations showed hemoglobin level of 110 g/L, erythrocytes 3.9 × 10 12 cells/L, and leukocytes 8.0 × 10 9 cells/L. Although 2 species can para-sitize humans, the geographic distribution and egg size of these species differ (2). B. mucronata has smaller eggs and is found only in the New World. On the basis of the size of the proglottids (3), larger eggs with pyri-form apparatus and hooklets, and geographic distribution, the infecting ces-tode was identified as B. studeri. The origin of infection was not confirmed; the only clue was that the boy's parents had once raised tame monkeys in a zoo. When the boy was 2 years old, he often played in the wildland, which is part of the zoo near …