A Laryngeal Fluke
A 25-year-old woman presented with 1-week history of an itchy throat and cough. She reported having consumed raw carp 3 weeks earlier. The physical examination revealed hyperemia of the oral mucosa. Fiber-optic laryngoscopy showed a living parasite measuring 2 mm by 4 mm on the surface of the left arytenoid laryngeal mucosa, with its head attached to the mucosa by suckers (see video). The organism was removed with the use of a fiber clamp and was identified as an adult liver fluke (Clonorchis sinensis). Testing for anti–C. sinensis IgG antibody was positive. The results of liver-function testing were normal. The patient's symptoms rapidly resolved after removal of the parasite. Liver-fluke infection is a zoonotic disease that is mainly caused by consumption of raw freshwater fish and shrimp throughout Southeast Asia. Liver flukes can cause disorders of the bile duct, gallbladder, liver, and, rarely, pharynx. Morphologic and pathological analyses distinguish adult liver flukes from Gnathostoma spinigerum, Gongylonema pulchrum, and Paragonimus westermani. The patient was treated with praziquantel for 2 days. Recovery was achieved over a 16-month follow-up.
