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PubMed1994

Intraocular fascioliasis: a case report.

We report the case of a 28-year-old male who had been ill with headache and motor weakness for a month and developed sudden pain and blindness of the right eye. During ophthalmoscopy, a worm was recognized penetrating the iris, occupying the anterior chamber for a brief period, returning back behind the iris, and leaving corneal edema with hyphyema. Enucleation was performed to prevent the worm's escape from the eye. The enucleated eye revealed areas of a focal degeneration of sclera and intraocular hemorrhage. Microscopic findings of an abrupt tissue defect and few inflammatory reactions in the uvea suggested very recent migration of a moving worm. The flatworm detected in the anterior chamber was identified to be a juvenile Fasciola sp. This case is presumed to be the first case of intraocular fascioliasis reported in the literature.

Adult↗
PubMed1997

Fasciola hepatica cysteine proteinases: immunodominant antigens in human fascioliasis.

Fasciola hepatica adult worm cysteine proteinases were active-site, affinity radio-labeled with benzyloxicarbonyl-L-tyrosine-L-alanine diazomethylketone (Z-Tyr125I-Ala-CHN2). Sera from patients with fascioliasis and from rabbits experimentally infected with F. hepatica immunoprecipitated the radiolabeled parasite cysteine proteinases in immunoelectrophoresis assays. Two purified antigens were identified as part of the complex mosaic of antigens immunoprecipitated by the sera of infected patients. These antigens (Fas1 and Fas2) have been shown to be an important part of the Fharc2 precipitin band used for serologic diagnosis in humans and cattle. They showed cysteine proteinase activity with different proteolytic specificities and partial identity in double immunodiffusion assays. The results obtained in this work show that the Fas1 and Fas2 antigens are sensitive and specific antigens for diagnosis of this serious helminthic disease in humans and other susceptible hosts.

Animals↗
PubMedDate not supplied

Liver fascioliasis, a "mysterious" disease. Report of a case.

A case of human fascioliasis diagnosed during the invasive phase is presented. The disease was suspected clinically and the findings of immunological, laparoscopical and histological examinations confirmed the correct diagnosis.

Fasciola hepatica↗
PubMed1976

Incidence of fascioliasis in cattle slaughtered in Buachi (Nigeria).

A survey was carried out in Bauchi abattoir during the period March 1973 to February 1974 in order to estimate the incidence of bovine fascioliasis. A total of 14,270 cattle originating from various markets in North-eastern Nigeria were examined. The incidence rate varied considerably, the highest being recorded in cattle from markets adjacent to large floodplains. The overall incidence rate was 31-7 per cent. The monthly incidence was highest during the periods immediately before and after the onset of the rains and was more a reflection of the marketing policy of the cattle owners than of the epizootiology of the disease. The annual loss in revenue caused by liver condemnations alone was estimated as 19,375 Naira.

Abattoirs↗
PubMed2001

[Stomach ache and fever after consumption of watercress in Turkey: fascioliasis].

A 52-year-old woman presented several months after returning from a visit to Turkey with stomach-ache and fever. Laboratory results showed leucocytosis with marked eosinophilia. Furthermore, serum liver enzyme activities were slightly elevated. A CT scan of the abdomen showed several spots which, on a later scan, had migrated. Serologic tests confirmed the clinical diagnosis of fascioliasis. The patient was successfully treated with triclabendazole. Infection presumably occurred after eating watercress which the patient had bought on a market in Turkey.

Abdominal Pain↗
PubMed2002

Dot ELISA for measuring anti-Fasciola IgG isotypes among patients with fascioliasis.

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Forty-five patients were proved to have Fasciola infection by passing eggs in their stool samples. Pallor was the major presenting symptom (95.5%) followed by abdominal pain (93.3%) and fever (15.5%). Hepatomegaly was recorded in 86.6% of patients compared to 33.3% with splenomegaly. Abdominal, ultrasonography revealed hepatomegaly in 38 cases (84.4%) and common bile duct dilatation in 35 patients (77.7%). Moreover, 4 cases showed Olympic game rings which are diagnostic. All of patients had positive IgG4 levels, 40 cases were found positives for specific total IgG and 42 cases for IgG1, whereas, only 30 cases had positive IgG2 levels (66.6%). Dot-ELISA showed that IgG2 and IgG4 giving the highest specificity (>99%), followed by IgG1 (90%) and the least specific test was obtained with detection of IgG (85%). From the present work, it was concluded that detection of anti-Fasciola isotypes especially IgG4 is very specific for accurate diagnosis of fascioliasis.

Adolescent↗
PubMed1999

Oxygen free radical and nitric oxide production in single or combined human schistosomiasis and fascioliasis.

The levels of superoxide (O(-)2) and nitric oxide (NO) production by monocytes have been measured in 15 patients with S. mansoni, 15 patients with Fasciola and six patients with combined infection as well as in control group (15). The levels of both radicals were significantly higher in all patient groups than in the control group, indicating that these radicals may have a role in the immunity against such infections. Patients with chronic fascioliasis showed lower level of O(-)2 and NO than those with schistosomiasis. This may be due to the lodging of the mature Fasciola spp. away from the immune system and subsequently decreased amount of antigens reaching the circulation. In combined infection, the levels of these products were at the highest value, due to increased antigenic stimulation and cross reactivity between the two parasites which may have lead to augmented immune response.

Adolescent↗
PubMedDate not supplied

Biliary fascioliasis: case report and review of the literature.

Hepatobiliary parasitic diseases are rare in Lebanon. We recently encountered biliary fascioliasis in a Lebanese native. The clinical and laboratory findings were nonspecific. The biliary parasite (Fasciola hepatica) was identified by sonography and confirmed at ERCP that has retrieved the parasite from the common bile duct.

Adult↗
PubMed1961

The control of snail hosts of bilharziasis and fascioliasis in Southern Rhodesia.

The authors review the experimental work that has been done since the Second World War on the use of chemical molluscicides in Southern Rhodesia and describe the development of a co-operative snail control campaign involving local landowners and various Government departments. In 1959 and 1960 efforts were concentrated on four large-scale experiments to test the methods of application of copper sulfate, sodium pentachlorophenate and Bayer 73 under a variety of climatic and physiographic conditions.From this work the authors conclude that it would appear possible and practicable to control vector snails in natural water courses and reservoirs in savannah areas of Central Africa to a degree at which it is thought that transmission of bilharziasis from man to man and of fascioliasis from animal to animal does not take place.

Animals↗
PubMedDate not supplied

Hepatic fascioliasis and biliary surgery.

This series represents seven cases of hepatic fascioliasis (HF), two diagnosed as the sequelae of the disease and five showing the parasite itself at the time of the primary surgical intervention. The mean history of the symptoms was 42.6 mths. All of the patients were initially misdiagnosed as having cholecysto- and/or coledocho-lithiasis or hepatitis. Definite diagnosis was established intraoperatively in each instant. At surgery cholecystectomy, choledochotomy with extirpation of the flukes from the biliary tree and T-tube biliary drainage was performed without any complications in five patients. The remaining two patients were suffering from recurrent cholangitic episodes and were regarded as sequelae and therefore treated with hepatic peri-arterial neurectomy with favourable results. Six patients received medical treatment involving emetine hydrochloride. Two patients failed to return for follow-up while others were seen to be well 6, 12, 24 mths and 13 and 24 yrs postoperatively, implying promising long-term results both in the active and chronic stages of HF.

Adult↗
PubMed2003

The effect of metronidazole in treating human fascioliasis.

BACKGROUND: The aim of this study was to determine the effect of metronidazole in patients who did not cure after treatment with triclabendazole, in Guilan (Northern Province of Iran). MATERIAL/METHODS: Patients, who passed fasciola egg in stool and had positive serum anti fasciola antibody (ELISA), at least three months after treatment with triclabendazole, were enrolled and received 1.5 g/day metronidazole orally for three weeks. Two months and 12 months after end of therapy, stool examination in 3 consecutive days and serum anti fasciola antibody were performed. Frequency of patients with negative serology for fasciola and/or absence of fasciola egg in stool were determined. Chi-square test was used and P value <0.05 was considered significant. RESULTS: Forty-six patients, 26 females and 20 males, were enrolled with mean (+/-SD) age of 34.6(+/-9.8) years. Three patients excluded because of drug side effect and poor compliance. Two months after end of therapy, stool exam became negative in 35 patients and in 31 patients became negative both in serology and stool examination. (Difference in response to treat between age groups and genders was not significant). All patients with abdominal pain became pain free after therapy. Most frequent side effects were metallic taste in 14 (30.4%), headache in 8 (17.4%) and nausea in 6 (13%). 12 months after end of therapy, 28 out of 35 patients were examined again and all were negative both in serology and egg in stool examination. CONCLUSIONS: Metronidazole, 1.5 g/day for 3 weeks, seems to be an effective, available, well-tolerated alternative for treatment of human fascioliasis.

Adult↗
PubMed2003

Immunodiagnosis of human fascioliasis using an antigen of Fasciola gigantica adult worm with the molecular mass of 27 kDa by a dot-ELISA.

Immunodominant antigens of an approximate molecular mass of 27 kDa (FG 27) were obtained from an excretory-secretory product of adult Fasciola gigantica by a simple continuous-elution method. A dot-ELISA using the FG 27 antigen was developed for the detection of specific antibodies from patients infected with F. gigantica. Control sera were obtained from patients with other parasitic infections and healthy volunteers. The accuracy, sensitivity, specificity, and positive and negative predictive values were 98.2%, 100%, 97.4%, 76.9% and 100%, respectively. This dot-ELISA is a specific, sensitive and easy to perform method for the rapid diagnosis of fascioliasis, particularly when more complex laboratory tests are unavailable.

Animals↗
PubMedDate not supplied

[Fascioliasis: diagnosis, epidemiology and treatment].

Fascioliasis is a trematode, disease of liver and bile ducts of sheep, cattle, and other ruminants throughout the world that is caused by the fluke, Fasciola hepatica. Human infection has been reported in Mexico, Cuba, Puerto Rico, Chile, Peru, Uruguay, Brazil, Argentina, the US, Europe, eastern Africa, Japan and Australia. The parasite's miracidium invades one of the various Lymnaea water snail hosts. Infection results from ingestion of encysted metacercariae attached to raw watercress (Nasturtium officinale). Symptoms recorded from human cases included irregular fever, epigastric pain and abdominal tenderness, obstructive jaundice and leucocytosis with eosinophilea up to 60%. Specific diagnosis is based on recovery of the eggs in the patient's stool or from biliary tract drainage. Treatment is with emetine hydrochloride given intramusculary. Bithionol is given orally at a dosage of 30-50 mg/kg but on alternate days from 10 to 15 doses. Praziquantel is probably effective. Preventive measures include education of the public on mode of transmission of life cycle of the parasite, and dipping fresh watercress into boiling water for a few sec, or drying suspected watercress.

Administration, Oral↗
PubMed2004

Detection of anti-Fasciola isotypes among patients with fascioliasis before and after treatment with Mirazid.

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom (87.7%) followed by pallor (83.3%) and fever (16.7%). Anaemia and hepatomegaly were recorded in 77.7% of patients compared to 27.7% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 77.7% of patients. Moreover, 5 cases showed diagnostic. Olympic game rings All patients had positive IgG4 levels, 55 cases were positive for specific total IgG and IgG1, whereas, only 24 cases had positive IgG2 levels (26.6%). All negative control group showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity (95%), followed by IgG2 (85%) and the least specific test was obtained with detection of IgG (70%) and IgG1 (65%). One month after treatment, 91.1% of patients (82/90) were completely cured and even after another two months follow-up. In completely cured patients none of anti-Fasciola isotypes was significantly changed. So, detection of anti-Fasciola isotypes especially IgG4 is very specific for the accurate diagnosis of human fascioliasis.

Adolescent↗
PubMed2005

Fascioliasis: an exceptional cause of acute pancreatitis.

CONTEXT: Fasciola hepatica is known to cause bile duct inflammation and biliary obstruction but is rarely reported as responsible for producing acute pancreatitis. CASE REPORT: We report on a patient complaining of acute pancreatitis. Endoscopic retrograde cholangio-pancreatography showed distinct features and sphincterotomy allowed extraction of multiple parasites. CONCLUSIONS: Pancreatitis may occur in some patients with fascioliasis, but the condition may be overlooked in chronic cases. Endoscopic retrograde cholangio-pancreatography rule out other possible causes of irregularity and thickening of the common bile duct wall. Parasite removal during endoscopic retrograde cholangio-pancreatography is one therapeutic option. Hepatic involvement must be ruled out and complete pharmacological treatment is advised in this patient.

Acute Disease↗
PubMed2005

Human fascioliasis in some areas in Cairo and Giza Governorates, Egypt.

This study comprised 462 clinically suspected cases of fascioliasis. Stool examination revealed positive 11 cases for Fasciola eggs (2.38%). Serum samples were obtained for serodiagnosis from 133 suspected cases from Cairo governorate (G) and 149 from Giza G. Using IHAT, positive results were reported in 12.03% of suspected cases in Cairo G and 11.41% in Giza G. For ELISA 15.03% and 18.12% respectively were positive. Out of 462 clinically suspected cases, 58 patients were liable to be infected with Fasciola depending on the presence of Fasciola eggs in stool and/or a positive serological result with either IHAT (56.9%) or ELISA (81.03%) or both (48.28%). Serological examination of sera of cases shedding eggs revealed that one case was positive for ELISA, 4 cases were positive for IHAT and ELISA, whereas 5 cases were serologically negative. Serum from one case with Fasciola eggs in stool could not be obtained for serological diagnosis. Clinical picture of infected cases indicated that 82.76% were suffering from abdominal pain, 43.1% palor and digestive disturbances, and 25.86% fever. On physical examination, 46.55% revealed hepatomegaly. Eosino-philia was observed in 70.69% of the patients. Statistically, no significant difference (P. > 0.05) was observed among patients in both governorates regarding age, sex, clinical manifestations, detection of eggs in stool, hepatomegaly, and serological tests. However, eosinophilia was significantly higher (P < 0.05) in cases from Giza G.

Adolescent↗