Hepatic Capillariasis in Maine Presenting as a Hepatic Mass

Abstract

We report the first case of hepatic capillariasis in Maine. The patient was a 54-year-old male carpenter who presented with a subacute history of severe abdominal pain, fevers, and weight loss. Initial diagnostic studies suggested a hepatic mass associated with para-aortic lymphadenopathy. The patient underwent open laparotomy for resection of the mass. He was found to have an eosinophilic granuloma in the liver; further evaluation revealed degenerating Capillaria hepatica. The exact route of infection in this case is unknown but is most likely due to accidental ingestion of soil contaminated with mature capillaria eggs. This patient had a low parasite burden and did not exhibit significant peripheral eosinophilia. After treatment with thiabendazole, he recovered uneventfully.

Prevalence of Calodium hepaticum (Syn. Capillaria hepatica) in house mice (Mus musculus) in the Azores archipelago

“…Children or adults, with the habit of eating soil (geophagia and pica) as well as children with soil-to-hand-to-mouth contact, are especially at risk (Juncker-Voss et al, 2000). In man, this zoonosis is probably underestimated and mistaken for other granulomatous hepatitis or hepatic cancer mass (Klenzak et al, 2005). In areas infested with rats, especially within closed environments such as zoological parks, where the prevalence of the parasite in Rattus norvegicus can reach 100%, transmission to cohabiting mammals increases (FarhangAzad, 1977;Landolfi et al, 2003;Redrobe and PattersonKane, 2005).…”

Rattus norvegicus como indicador de la circulación de Capillaria hepatica y Taenia taeniaeformis en la Plaza Minorista de Medellín, Colombia

“…La dispersión de huevos de C. hepatica en el ambiente en el que residen, puede conducir a la contaminación del suelo y aumentar la posibilidad de la ingestión de estados infecciosos, tanto por parte de los habitantes humanos como de los animales de compañía (caninos y felinos callejeros). En este contexto y para los casos de parasitismo hepático, en esta población humana debe tenerse en cuenta la capilariasis como diagnóstico diferencial, pues la de esta causa puede confundirse con otras hepatitis granulomatosas o cáncer hepático (10).…”

“…La presencia de poblaciones densas de roedores y las deficientes condiciones de saneamiento ambiental, son factores que predisponen a la infección humana con algunos helmintos (C. hepatica) (10). La infestación con roedores principalmente en ambientes cerrados y la alta prevalencia de estos helmintos en R. norvegicus, son factores que incrementan el riesgo de transmisión a otros mamíferos que cohabitan en áreas específicas (11,12).…”

Capillaria hepatica, A Case Report and Review of the Literature

“…Hypergammaglobulinemia, high serum levels of alanine amino-transferase (ALT), aspartate amino-transferase (AST), and lactic dehydrogenase (LDH) are commonly observed (4,6,9). Hepatic mass may be an unusual manifestation of the infection (2).…”

“…Humans are rarely infected as the second host (1)(2)(3)(4)(5). The ova are present in the liver of primary host; soil gets contaminated by faces of the infected animal and it takes four to five weeks for the eggs to embryonate.…”