Fascioliasis: A challenging differential diagnosis for radiologists

Abstract

We report a case of a 39 year old male who presented with nausea and right upper quadrant pain. Marked eosinophilia and a hypoechoic liver lesion on ultrasound were identified. The differential diagnosis included neoplasms, infectious diseases and hepatic abscess. Indirect hemagglutination test using purified adult Fasciola hepatica f1Ag confirmed serologic diagnosis of fascioliasis. Radiologists should keep in mind the importance of correlating imaging, clinical and laboratory findings in order to reach the correct diagnosis.

Liver fluke in a young Nepalese girl: A rare diagnostic puzzle

“…2,5 Although rare, extrahepatic involvement of fascioliasis has also been described, affecting organs like the skin, eyes, heart (pericarditis or cardiac conduction abnormalities), and lungs (pleural effusion). 6 In the background of these symptoms, the most striking laboratory finding in both stages is peripheral eosinophilia. 7 Owing to a long period of latency and a biphasic mode of presentation, early identification of fascioliasis continues to pose a diagnostic challenge.…”

“…Occasionally, moving parasites in the gallbladder or the dilated bile ducts can be demonstrated on a USG. In the absence of mobile parasites, only non‐specific changes like focal hypo/hyperechoic lesions, ductal ectasia, wall thickening, or diffuse involvement of the liver can be seen on USG 6 . Computed tomography (CT) scan and MRI features might vary depending on the stage of the disease process at presentation.…”

“…In the absence of mobile parasites, only non‐specific changes like focal hypo/hyperechoic lesions, ductal ectasia, wall thickening, or diffuse involvement of the liver can be seen on USG. 6 Computed tomography (CT) scan and MRI features might vary depending on the stage of the disease process at presentation. On CT, focal capsular thickening and enhancement secondary to the penetration of parasites through the liver capsule in the hepatic phase are noted, while residual parenchymal calcification might be seen in the biliary phase.…”

Parasites of the liver – epidemiology, diagnosis and clinical management in the European context

“…Imaging techniques often lack distinct pathological findings and might reveal hepatomegaly or focal liver lesions. 101 Serum antibody tests can be applied from 2 weeks after infection with sufficient sensitivity. In chronic infections, a possibly motile parasite might be detected sonographically in the gallbladder or main bile ducts.…”

“…In chronic infections, a possibly motile parasite might be detected sonographically in the gallbladder or main bile ducts. 101,102 After a prepatent period of 10 to 16 weeks, eggs can be detected in bile or stool with varying sensitivity.…”