Clinical Features
Diphyllobothriasis can last for decades if untreated. Most infections are asymptomatic. Manifestations may include abdominal discomfort, diarrhea, vomiting and weight loss. Vitamin B12 deficiency with subsequent megaloblastic anemia may occur, but has not for several decades in D. latum infections, possibly because of improved nutrition. In one test, nearly half of the ingested vitamin was absorbed by D. latum in otherwise healthy patients, while 80-100% was absorbed by the worm in patients with anemia. It is not known why anemia occurs in some cases but not others. Massive infections may result in intestinal obstruction. Migration of proglottids can cause cholecystitis or cholangitis.
Females cases are disproportionately reported, most likely due to the higher likelihood for them to be involved in meal preparation, rather than any morphological differences.
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