Infection with Fasciola hepatica

Abstract

Fascioliasis, caused by the liver fluke Fasciola hepatica, is an infection that occurs worldwide, although humans are accidental hosts. F. hepatica infection comprises two stages, hepatic and biliary, with different signs and symptoms. Stool examination and ELISA can be used for the initial diagnosis. Radiographic techniques, such as computerised tomography and ultrasonography, as well as magnetic resonance imaging, are used widely for confirmation and follow-up of the disease. Invasive techniques, such as percutaneous cholangiography, endoscopic retrograde cholangiography and liver biopsy, may aid in the diagnosis but are not essential. Triclabendazole is recommended as the first-line agent for the treatment of F. hepatica infection, with bithionol as an alternative.

Hepatobiliary fascioliasis; imaging characteristics with a new finding

“…Humans are accidental hosts. Ingested infective form metacercaria excyst in the intestine, penetrate the bowel wall, enter the peritoneum and then pass through the liver capsule to enter the biliary tree (5). Human fascioliasis has two phases.…”

“…Mild hepatitis, subcapsular hemorrhage, and hepatic necrosis can also be detected. The biliary phase usually presents with intermittent right upper quadrant pain, with or without cholangitis or cholestasis (5)(6)(7).…”

Evaluation of cases with Fasciola hepatica infection: experience in 6 children

“…If the larvae accidentally lose their own way to the liver; they reside in the other organs or systems and cause ectopic fasciolasis [6] . The disease includes 4 clinical periods: (1) Incubation phase, from the ingestion of metacercariae to the first symptoms; (2) Acute phase, migration of the fluke to the bile ducs, with symptoms of fever, abdominal pain, respiratoy symptoms, gastrointestinal disturbances, hepatomegaly, splenomegaly, ascites, anemia, and jaundice; (3) Latent phase, maturation of the parasites and starting of ovoposition with eosinophilia, gastrointestinal complaints and relapses of acute symptoms; (4) Chronic phase with bile duct obstruction, cholecystitis, cholangitis, liver abscess, hemorrhage, lithiasis, and cirrhosis. The chronic stage may be asymptomatic and extended for years if the disease remains untreated [14,18] .…”

“…F. hepatica, a zoonotic helmint, has a cosmopolitan distribution especially in temperate zones, while F. gigantica is found in tropical regions of Africa and Asia [3] . Infection occurs due to ingestion of water or uncooked aquatic plants such as watercress contaminated with metacercariae, which exists in the intestine, perforates the intestinal wall, enters the peritoneum, and passes through the liver capsule to settle in the biliary tree [2,4] . In the biliary tract, the mature fluke releases eggs, which are excreated in feces to complete the life cycle of parasite [4] .…”

“…Fascioliasis is an important chronic parasitic disease caused by two trematode liver fluke species: Fasciola hepatica (F. hepatica) and Fasciola gigantica (F. gigantica) infecting several mammalian species including cattle, goats, sheep, and humans [1,2] . F. hepatica, a zoonotic helmint, has a cosmopolitan distribution especially in temperate zones, while F. gigantica is found in tropical regions of Africa and Asia [3] .…”