Acute fascioliasis—clinical and epidemiological features of four patients in Chile

Abstract

Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infections with the foodborne trematode Fasciola hepatica is challenging. We report four serologically confirmed cases that illustrate our experience with this parasitic infection in Chile. All patients were adults presenting with upper abdominal pain. Other symptoms included fever, nausea/vomiting, and cutaneous manifestations. In all cases, marked eosinophilia was present. All patients lived in an urban environment, and three reported the consumption of raw watercress. Computed tomography (CT) scans showed hypodense hepatic lesions, whereas ultrasonography findings were unremarkable. One patient suffered portal vein thrombosis, which might be a rare complication of acute fascioliasis. All patients were successfully treated with triclabendazole. Our case series demonstrates that patients with acute fascioliasis typically present with a combination of upper abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT imaging. Diagnosis should be confirmed by serological investigation. A history of recent consumption of raw watercress is an important finding, but in some patients the source of infection remains obscure.

Immunodetection of Fasciola gigantica Circulating Antigen in Sera of Infected Individuals for Laboratory Diagnosis of Human Fascioliasis

“…Egypt, especially the Nile Delta, is a hot spot for Fasciola infection, which has appeared to be endemic, with estimated prevalence varying between 2 and 17% (4-6). Furthermore, fascioliasis has been recognized as an emerging infection in international travelers and migrants, causing significant problems in diagnosis and therapy (7). Owing to the disease's high-level endemicity in some developing countries and its emergence in nature, the WHO classified it as a neglected parasitic infection and decided to launch a worldwide initiative against this infectious disease (2).…”

Gastos hospitalarios en pacientes con fascioliasis en fase aguda, hidatidosis de tratamiento quirúrgico y neurocisticercosis en un hospital general en Chile

“…Los detalles clínicos y epidemiológicos de estos pacientes han sido publicados previamente [7][8][9] . Se contó con información suficiente para 16 de estos casos, representando 21 ingresos: cuatro pacientes con FA (cuatro ingresos), siete pacientes con H (11 ingresos) y cinco pacientes con NCC (seis ingresos).…”

“…Los gastos en los casos de FA fueron explicados principalmente por la estadía hospitalaria. De acuerdo a nuestra experiencia, este componente depende de la experiencia del grupo médico tratante, puesto que en áreas de baja endemia esta enfermedad simula una condición maligna y el diagnóstico se retrasa 7 . No fue posible efectuar una comparación de los gastos asociados a FA ya que, de acuerdo a nuestro conocimiento, no existen publicaciones sobre esta condición que hayan evaluado este aspecto económico.…”

Fascioliasis and Eosinophilia in the Highlands of Cuzco, Peru and Their Association with Water and Socioeconomic Factors

“…We suspect that many of the children with eosinophilia may have had acute or chronic Fasciola infection. 24,25 Testing of one stool specimen probably limited our ability to detect low-intensity infections. Furthermore, Marcos and others 13 described a strong association between eosinophil counts and Fasciola infection in highly endemic areas.…”