Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

Abstract

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran. 
 Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement.
 Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases.
 Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

Emerging Human Fascioliasis: A Retrospective Study of Epidemiological Findings in Dali, Yunnan Province, China (2012-2021)

“…In endemic areas such as Dali, it is important to be aware of the possibility of fascioliasis in patients presenting with abdominal pain, fever, and elevated eosinophils, as mentioned in previous studies [ 16 , 20 ]. Remarkably, we have presented a comprehensive analysis of the sizes and lengths of Fasciola eggs (144–180×73–96 μm, ×400) found in the stool samples of 6 patients, which fully fit within the range of F. gigantica eggs shed in human stools in areas where F. hepatica is absent [ 21 ].…”

Seroprevalence of Fasciola infection among Iranian patients hospitalized during the initial wave of COVID-19

“…Due to the importance of this helminthic zoonosis infection and the lack of data about its prevalence in Iran, the high rate of its migration, the report of COVID-19 patients, prevalence of definitive hosts in the region, the study of new foci of fascioliasis became the area of the presented study [14,15]. The aim was to investigate fascioliasis among the COVID-19 patients, and the epidemiological factors associated with the infectio, and compare them with a healthy population in Iran.…”

Neospora caninum Infection in Cattle in the Province of Kohgiluyeh and Boyer Ahmad, Southwest of Iran: Seroprevalence and Molecular Assessment

“…The province is located in the southwest of Iran, where due to favorable weather conditions the prevalence of some of parasitic infection is substantial. Previous studies have reported a significant prevalence of helminth and protozoan infections in human as well as among livestock in the area [16][17][18][19][20].…”