Update on hepatobiliary flukes: fascioliasis, opisthorchiasis and clonorchiasis

Marcos, Luis A.; Terashima, Angélica; Gotuzzo, Eduardo

doi:10.1097/qco.0b013e32830f9818

Cited by 173 publications

(121 citation statements)

References 49 publications

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“…This outcome may be due to the fact that diagnosis occurred in the hepatic phase, where an immature worm feeds on liver tissue with no egg production as all cases had eosinophilia and HFL, which are observed in early infection. 6 It also can be an indicator that Fasciola is not yet an endemic disease for humans in Upper Egypt as the immune systems react strongly to the parasites giving rise to severe symptoms. While in endemic areas, immune system tends to be exposed to parasite antigens through whole life leading to moderate immune reaction.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic cases can be discovered accidently. 1,6 Unusual clinical manifestations are common as Fasciola can be found to be ectopic in the spine, pancreas, kidney, and spleen. 7,8 Diagnosis depends mainly on finding eggs in stool analysis, but other serological and imaging techniques are also of great value.…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography (CT) can detect microabscesses caused by worms tunneling liver tissues, which is important in follow-up. 6,9 The drug of choice is triclabendazole at a single dose of 10 mg/kg body weight for for 2 days. 10 The clinical presentation of human fascioliasis infection is unusual, ranging from asymptomatic cases to cholangitis, hepatitis, and hepatic focal lesions (HFLs).…”

Section: Introductionmentioning

confidence: 99%

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Human Fascioliasis: A Re-emerging Disease in Upper Egypt

Mekky¹,

Tolba²,

Abdelmalek³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. In recent years, the number of humans infected with Fasciola has risen rapidly. Diagnosis is based mainly on detection of eggs in stool analysis. The rate of infection in Egypt is unknown. In this retrospective study, we describe 23 cases of hepatic fascioliasis, and only 2 of these cases showed eggs in stools. The symptoms of infection, such as pyrexia of unknown origin, epigastric pain, and abdominal distension, were suggestive. Imaging techniques, including abdominal ultrasonography and computed tomography, were very helpful in detecting hepatic changes. An indirect hemagglutination assay proved to be of value for diagnosis. Treatment using a 2-day triclabendazole regimen cured the infection and signs of hepatic involvement disappeared. Combining both imaging techniques and laboratory tests is essential for diagnosis of fascioliasis in the early stage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Human Fascioliasis: A Re-emerging Disease in Upper Egypt

Mekky¹,

Tolba²,

Abdelmalek³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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“…allow discrimination by serology-for example, by the Fas2-ELISA [53]. Further diagnosis could be achieved by coproscopy, i.e., demonstrating eggs of the parasite in stool samples [52,54]. For the differential diagnosis of cysticercosis, a highly specific western blot based on Taenia solium-derived glycoproteins and an ELISA based on recombinant antigens are available [55,56], although in EITB cross reactivity with sera from AE patients with non-diagnostic higher molecular weight components have been reported [57].…”

Section: Discussionmentioning

confidence: 99%

Serological diagnosis of echinococcosis: the diagnostic potential of native antigens

et al. 2011

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PURPOSE: Human alveolar (AE) and cystic echinococcosis (CE) caused by the metacestode stages of Echinococcus multilocularis and E. granulosus, respectively, lack pathognomonic clinical signs. Diagnosis therefore relies on the results of imaging and serological studies. The primary goal of this study was to evaluate the efficacy of several easy-to-produce crude or partially purified E. granulosus and E. multilocularis metacestode-derived antigens as tools for the serological diagnosis and differential diagnosis of patients suspicious for AE or CE. METHODS: The sera of 51 treatment-naïve AE and 32 CE patients, 98 Swiss blood donors and 38 patients who were initially suspicious for echinococcosis but suffering from various other liver diseases (e.g., liver neoplasia, etc.) were analysed. RESULTS: According to the results of enzyme-linked immunosorbent assays (ELISA), metacestode-derived antigens of E. granulosus had sensitivities varying from 81 to 97% and >99.9% for the diagnosis of CE and AE, respectively. Antigens derived from E. multilocularis metacestodes had sensitivities ranging from 84 to 91% and >99.9% for the diagnosis of CE and AE, respectively. Specificities ranged from 92 to >99.9%. Post-test probabilities for the differential diagnosis of AE from liver neoplasias, CE from cystic liver lesions, and screening for AE in Switzerland were around 95, 86 and 2.2%, respectively. Cross-reactions with antibodies in sera of patients with other parasitic affections (fasciolosis, schistosomosis, amebosis, cysticercosis, and filarioses) did occur at variable frequencies, but could be eliminated through the use of confirmatory testing. CONCLUSIONS: Different metacestode-derived antigens of E. granulosus and E. multilocularis are valuable, widely accessible, and cost-efficient tools for the serological diagnosis of echinococcosis. However, confirmatory testing is necessary, due to the lack of species specificity and the occurrence of cross-reactions to other helminthic diseases. Abstract Purpose Human alveolar (AE) and cystic echinococcosis (CE) caused by the metacestode stages of Echinococcus multilocularis and E. granulosus, respectively, lack pathognomonic clinical signs. Diagnosis therefore relies on the results of imaging and serological studies. The primary goal of this study was to evaluate the efficacy of several easy-to-produce crude or partially purified E. granulosus and E. multilocularis metacestode-derived antigens as tools for the serological diagnosis and differential diagnosis of patients suspicious for AE or CE. Methods The sera of 51 treatment-naïve AE and 32 CE patients, 98 Swiss blood donors and 38 patients who were initially suspicious for echinococcosis but suffering from various other liver diseases (e.g., liver neoplasia, etc.) were analysed. Results According to the results of enzyme-linked immunosorbent assays (ELISA), metacestode-derived antigens of E. granulosus had sensitivities varying from 81 to 97% and [99.9% for the diagnosis of CE and AE, respectively. Antigens derived from...

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“…About 10 million people world-0304-4017/$ -see front matter © 2010 Elsevier B.V. All rights reserved. doi: 10.1016/j.vetpar.2010.11.042 wide suffer from opisthorchiasis (WHO, 1995;Schuster, 2010) and their number is increasing in some areas (Keiser and Utzinger, 2005;Marcos et al, 2008). In particular, O. felineus affects 1.6 million people (Yossepowitch et al, 2004), causing abdominal pain, fever, diffuse myalgia, diarrhoea, cholangitis, pancreatitis and possibly, in long lasting chronic infections, cholangiocarcinoma (Sripa, 2003).…”

Section: Introductionmentioning

confidence: 99%

Investigation on Opisthorchis felineus occurrence and life cycle in Italy

Liberato

Scaramozzino

Brozzi

et al. 2011

Veterinary Parasitology

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a b s t r a c tOpisthorchiasis is a fish borne parasitic infection caused by helminths of the genus Opisthorchis (Digenea, Opisthorchiidae), affecting humans and other fish-eating mammals. Despite Opisthorchis felineus was first described in Italy in 1884, no cases of human opisthorchiasis were reported in this country until 2004; from then on, 4 outbreaks due to this species have been recorded in Central Italy. Following the more relevant of these outbreaks, involving 34 people in August 2007, snails, fishes and fecal samples collected from the Bolsena and Bracciano lakes (Central Italy) were analyzed in order to define the cycle of O. felineus in the area and investigate its prevalence in the different hosts. Pools of 20-40 snails each (4983 specimens altogether) of the genus Bithynia were analyzed by PCR for parasite DNA detection. Eight hundred and ninety-four fish belonging to 12 species were collected from the two lakes and tested for metacercariae both by muscle compression and digestion techniques. Eighty-seven fecal samples of 5 putative definitive host species were collected very close to the two lakes and tested for parasite eggs detection by formalin-ethyl acetate concentration technique. Identification at the species level of metacercariae and eggs, respectively, from fish and stool was confirmed by PCR analysis and sequencing. O. felineus DNA was detected in 0.08% (overall minimum infection rate) of snails of the genus Bithynia from the two lakes. The tench, Tinca tinca, was the only fish found infested in both lakes (prevalence 88.5%). O. felineus eggs were found only in cat feces (prevalence 46.4%). The tench represents the only threat for the human consumption in the study area while Coregonus sp., the most economically important species for the local fishery and frequently consumed raw marinated, resulted to be not infected. The high prevalence recorded both in fish and in definitive host suggests a widespread and massive presence of the parasite in the area. Further studies are needed to better investigate the possible role of some cyprinids species as intermediate hosts, in order to check their safety for human consumption.

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Update on hepatobiliary flukes: fascioliasis, opisthorchiasis and clonorchiasis

Abstract: There is a better understanding of risk factors, clinical manifestations and complications, novel diagnosis tests and effective treatment, which together should help reduce the morbidity and mortality of these infections.

Cited by 173 publications

References 49 publications

Human Fascioliasis: A Re-emerging Disease in Upper Egypt

Human Fascioliasis: A Re-emerging Disease in Upper Egypt

Serological diagnosis of echinococcosis: the diagnostic potential of native antigens

Investigation on Opisthorchis felineus occurrence and life cycle in Italy

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