Clonorchis sinensis Infection Presenting as Acute Cholangitis and Acute Cholecystitis

Abstract

A 59-year-old woman presented with abdominal pain. Abdominal computerized tomography was suggestive of biliary stones. During endoscopic retrograde cholangiopancreatography, adult worms resembling Clonorchis sinen sis (C. sinensis) were drained. Eggs were detected in stool using the formalin-ether concentration method and C. sinensis-specific antibody was detected in the serum. A diagnosis of C. sinensis infection was made. The symptoms of the patient gradually resolved after treatment with anti-parasite medication. The patient lived in a non-endemic region for C. sinensis infection and had no history of intake of raw or undercooked freshwater fishes. South Korea is one of the endemic countries for C. sinensis infection and people can be infected via indirect routes of transmission such as cooking utensils. Therefore, the possibility of C. sinensis infection should be considered in patients presenting with biliary diseases in South Korea. We describe the clinical findings of this case with a review of literature.

Relationship between Clonorchis sinensis Infection and Cholangiocarcinoma in Korea

“…Although its incidence is high in endemic regions, clonorchiasis has also been increasingly observed in non-endemic regions as well. The cause of this phenomenon can be deduced from some literatures and a case report of adult worm isolation from a patient without any known risk factor [32][33][34]. In a recent survey, women had a higher rate of indirect infection than men both in endemic and non-endemic areas, and also over 4% of patients with C. sinensis infection in this survey had no known risk factor [34].…”