Fasciola hepatica can have an initial presentation similar to the presentation of malignancy. Here, we report a case of a hepatic mass caused by fasciola hepatica. [ncbi.nlm.nih.gov]

• Inflammation

  Histological analysis revealed chronic inflammation and granuloma with giant cells surrounding Fasciola hepatica eggs. Fas2 antigen was detected in the tissue by immunohistochemistry. [ncbi.nlm.nih.gov]

  Fasciola hepatica is a syncytial cytoplasmic layer bounded externally by a plasma… (More) IARC monographs on the evaluation of carcinogenic… 1994 Hiroshi Ohshima, Helmut Bartsch Mutation research 1994 Infection by bacteria, parasites or viruses and tissue inflammation [semanticscholar.org]

• Anemia

  Fascioliasis was independently associated with anemia (adjusted odds ratio = 3.01 [1.10-8.23]). Subclinical fascioliasis was common among children and strongly associated with anemia. [ncbi.nlm.nih.gov]

  Three exacerbations of symptoms were associated with severe microcytic hypochromic anemia, possibly due to blood loss into the biliary tract. [amjmed.com]

  At this stage, the excretory-secretory products synthesized by the fluke are responsible for anemia, diarrhea, eosinophilia and non-specific symptoms and signs. [elsevier.es]

  Laboratory Evaluation Eosinophilia, leukocytosis, and elevated inflammatory markers are common in acute infections ( Table 1 ); anemia and/or elevated serum hepatic transaminases, bilirubin, or alkaline phosphatase are only occasionally transiently present [doi.org]

  In children, severe anemia is a common result of infection and is the greatest source of disability from infection in this age group. [stanford.edu]

• Hunting

  On the hunt for helminths: innate immune cells in the recognition and response to helminth parasites. Cell Microbiol. 2008; 10 (9): 1757-64[ DOI ][ PubMed ] 10. Xia J, Jiang SC, Peng HJ. [hepatmon.com]

  Vet Rec. 1975; 97: 492 PubMed Google Scholar Hunt AT The Tidenham epidemic: 40 cases of liver fluke infestation. [amjmed.com]

  View Article PubMed Google Scholar Hunt M, Kikuchi T, Sanders M, Newbold C, Berriman M, Otto TD. REAPR: a universal tool for genome assembly evaluation. Genome Biol. 2013;14:R47. [doi.org]

• Anorexia

  We report a case of human fascioliasis in a 45 years old female presented to Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal on August, 2015 with fever, right hypochondriac pain, jaundice and occasional vomiting with anorexia for 4 months [ncbi.nlm.nih.gov]

  There were no other symptoms like anorexia, weight loss, nausea, vomiting, cough, diarrhea, jaundice, urticaria, pruritus and arthralgia. On physical examination, mild RUQ tenderness and normal liver span were noticed. [elsevier.es]

  During the acute phase, migrating parenchymal larvae generally cause fever, eosinophilia, right upper quadrant pain and especially significant anorexia. [uab.edu]

• Pallor

  Mass migration of juveniles may produce extensive traumatic tissue damage, coagulative necrosis, haemorrhage, urticaria, eosinophilia, leukocytosis, pallor, anaemia, and can be fatal. [parasite.org.au]

  Physical examination: T 37.7C; HR 90; RR 22; Sat O2 94 % Pallor +++. Multiple enlarged lymph nodes ranging from 0.5 to 2 cm in diameter in cervical, retroauricular, submandibular, axillary, inguinal and umbilical regions. [uab.edu]

• Loss of Appetite

  Three months before admission, the patient developed loss of appetite and nausea, followed by 3 to 4 daily episodes of watery diarrhea and diffuse abdominal pain. [uab.edu]

• Jaundice

  A 47-year-old woman from Eastern Turkey presented with fever, right upper quadrant abdominal pain, and jaundice. [ncbi.nlm.nih.gov]

  On physical examination, she appeared to be jaundiced with mild epigastric pain. [scielo.isciii.es]

• Liver Mass

  Hypereosinophilia and liver mass in an immigrant. Am J Trop Med Hyg. 2002 Jun. 66(6):774-6. [Medline]. [Full Text]. Pearson RD. Nitazoxanide As Treatment of Intestinal Parasites in Children. Curr Infect Dis Rep. 2004 Feb. 6(1):25-26. [Medline]. [emedicine.com]

• Flushing

  An early flush-like rash often occurs (not present here) and wanes after a few days to be replaced by the morbilliform rash as occurred here. A late petechial rash may also occur. [uab.edu]

• Suggestibility

  Although the radiological findings strongly suggested that there was fasciolosis in three cases, F. hepatica eggs were detected in two patients only. These data suggest that human fasciolosis is not as rare as previously reported in Turkey. [ncbi.nlm.nih.gov]

  [Submitted] PDF - English 1MB Summary Recent studies suggest that liver fluke (Fasciola hepatica) infections in cattle have increased in Denmark in recent years. [orgprints.org]

  Application: To support the diagnosis of Fasciola hepatica infection, when suggested by findings at surgery or in conjunction with ova passed in stool. See Ova cysts parasites faeces. [rcpa.edu.au]

  Anallysis of the rate of activation data suggests that the activation process behaves like a first-order reaction. [molpharm.aspetjournals.org]

[…] will often show elevated cholestatic liver enzyme levels, and in endemic areas, this laboratory finding raises suspicion of the diagnosis. 5 In nonendemic areas, elevated cholestatic liver enzyme levels associated with abdominal pain usually leads to workup [cmaj.ca]

• Liver Biopsy

  Abstract We have evaluated the possible mechanisms of liver fibrosis caused by Fasciola hepatica in an animal model and in culture using immortalized human stellate cells. Liver biopsies of F. hepatica-infected rats were performed at wk 8 and 16. [ncbi.nlm.nih.gov]

  biopsy: after excistation in the small intestine, metacercariae penetrate the intestinal wall and the Glisson capsule, cross the liver parenchima to the bile ducts. [web.archive.org]

  Microscopy of the gallbladder revealed a nonspecific chronic cholecystitis; a liver biopsy disclosed florid changes of large duct biliary obstruction, granulomas, patchy periductular fibrosis and an ovum morphologically similar to an ovum of Fasciola [amjmed.com]

  A liver biopsy typically reveals necrosis, acute and chronic inflammatory changes, debris, and occasionally fragments of migrating larvae. [doi.org]

Coproparasitological observations carried out at 12, 18, 60 and 120 days post-treatment were negative. No clinical symptoms were registered up to 2 months after treatment. [ncbi.nlm.nih.gov]

Faecal samples may be taken to help confirm if such treatments are necessary. [nadis.org.uk]

Closantel treatment failure was confirmed on two of the farms. As the animals were housed 12–16 weeks before treatment and thereafter during the entire study, failure due to the presence of juvenile flukes was excluded. [slu.se]

Prognosis The disease rarely kills in humans. The prognosis is excellent with adequate treatment. Prevention Water-grown vegetables should be washed with 6% vinegar or potassium permanganate for 5-10 minutes, which kills the encysted metacercariae. [patient.co.uk]

Opisthorchis viverrini is notable, because it is classified as a group 1 carcinogen by the International Agency for Research on Cancer (IARC) 3 and is a significant risk factor for cholangiocarcinoma (CCA), a deadly cancer of the biliary tree, with a very poor prognosis [doi.org]

In the differential diagnosis of biliary obstruction with unknown etiology, biliary fascioliasis should be considered in endemic and nonendemic regions. [ncbi.nlm.nih.gov]

Funding: Sequencing of the genomes of Fasciola/Neorickettsia was supported by the ‘Sequencing the etiological agents of the Food-Borne Trematodiases’ project (NIH-NHGRI award number U54HG003079). [doi.org]

A complete understanding of molecular epidemiology is expected to help greatly in designing global actions and local interventions for control of fascioliasis. [ncbi.nlm.nih.gov]

Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 63 (‎15)‎, 109 - 111. https://apps.who.int/iris/handle/10665/226666 Journal Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 63 (‎15)‎: 109 - 111 Language English [apps.who.int]

Epidemiology of human fascioliasis: a review and proposed new classification. Bull World Health Organ. 1999; 77 (4): 340-6 6. Rondelaud D, Hourdin P, Vignoles P, Dreyfuss G. [intjinfection.com]

From the Centers for Disease Control and Prevention Laboratory Identification of Parasites of Public Health Concern website. 20 Table 1 Classification of Fascioliasis by Clinical Manifestations and Laboratory Findings Phase Time Frame Pathophysiology [doi.org]

Incidence of human infection has increased over the past 20 years. [2, 3, 4] Pathophysiology Sheep, cattle and goats are the definitive hosts. Other alternate herbivore hosts are horses, pigs, buffaloes, donkeys and pigs. [emedicine.com]

Despite those interactions, the persistence of the parasite in the host for many years provides evidence of its ability to prevent or downmodulate the inflammatory response in the infection site. [eurekaselect.com]

PREVENTION and CONTROL Infection by Fasciola hepatica can be prevented by not consuming raw plants containing metacercariae. [msu.edu]

Fasciola infection is both treatable and preventable. Above Images: Left: Fasciola hepatica egg in an unstained wet mount (400x magnification). F. hepatica eggs are broadly ellipsoidal, operculated, and measure 130–150 μm by 60–90 µm. [cdc.gov]

This study demonstrates that components of the tegumental surface of F. hepatica can be defined using proteomic approaches, but also indicates the need to prevent vomiting if tegument secretions are to be characterised. [ncbi.nlm.nih.gov]