Chronic diarrhea in returing travelers: intestinal parasitic infection with the fluke Metagonimus yokogawai.

An unusual intestinal infection with the parasite Metagonimus yokogawai was acquired by an American traveling in the Orient. Diarrhea began abroad, and recurred at intervals until she was seen 1 1/2 years later. Stool examinations resulted in the recovery of small operculated ova characteristic of intestinal or biliary fluke infection. Treatment with hexylresorcinol failed to eradicate the infection, but subsequent use of tetrachloroethylene was successful and facilitated recovery of adult parasites, leading to the specific diagnosis of metagonimiasis. Metagonimiasis and related intestinal fluke infections should be considered as a possible cause of persistent diarrhea in travelers returning from endemic areas abroad.