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A yellow clown goby exhibiting the classic sunken belly of hexamita
Hexamita is a genus of protozoa that lives in both fresh and saltwater. While it generally doesn't bother most fish, when a stressor lowers the function of a fish's immune system, things can take a turn. Species in the hexamita genus are known to infect mammals and avians as well, however, they are specialized in which class of animals they infect, so transmission from fish to you is very unlikely. They typically live in the intestines of infected animals, spreading through feces. There are cases where hexamita can infect the outside of a fish, which can contribute to Head and Lateral Line Erosion/Hole in the Head. This parasite is related to giardia, as they are both double celled organisms, called diplomonads.
Symptoms
Symptoms
Most cases of hexamita are asymptomatic, as healthy fish will be able to fight off the attackers. It is only when a fish becomes stressed or the amount of hexamita organisms out paces the immune functioning of the fish. Typical symptoms are white and stringy feces, Sunken Belly, weight loss, and a decreased appetite. In some cases, typically in cichlids and tangs, hexamita will contribute to head and lateral line damage that looks like the eroding of scales and skin. Because of the nature of the slime coat of the fish, hexamita rarely interacts with the fish's outer layers, except in cases of malnutrition and dirty water or other stressors.
Treatment
Treatment
If the fish isn't too far gone, treatment is possible. Due to the internal nature of the disease, medication needs to reach the inside of fish. More on that here. The best treatment option is to use praziquantel in tandem with metronidazole. If only using one, the drug of choice is metronidazole. Treat with medicated food for at least a week, though 2 weeks is ideal to completely rid the fish of parasites. Metronidazole is very safe, so it's fine to medicate longer than might be necessary as a precaution.
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