[Epidemic human fascioliasis, Cuba 1983. II. Epidemiologic study].
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A 49-years old female patient was admitted to the hospital with abdominal pain and symptoms of a shock. Four months before she had been sick and been an outpatient with slight pain in the upper abdomen and remarkable weight loss. The suspicion of perforated gall bladder was the indication to a laparotomy. A tumor on the right lobe of the liver was found. The histological diagnosis was: eosinophilic portal hepatitis with multiple eosinophilic abscesses in the liver. The parasitologic serology showed a positive test for Fasciola (liver fluke). Praziquantel in high doses was promptly effective and cured the patient. The sheep liver fluke is a common parasite of the biliary tract of herbivores all over the world, but rarely leads to a human disease. The patient had lived many decades in the South Pacific. The differential diagnoses was manifold because of the traveling habits, the clinical symptomatic and the course of the disease. The biology of the sheep liver fluke implies an infection acquired in Europe some weeks before the first symptoms of the disease.
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A 5-year-old intact male llama (Llama glama) with gastric squamous cell carcinoma and generalized metastasis is presented. Weight loss, anorexia and cachexia were the presenting clinical signs. Abnormal laboratory findings included neutrophilia, lymphopenia, increased serum activity of hepatic enzymes, mildly increased serum urea nitrogen concentration and elevated protein concentration and nucleated cell count in the peritoneal fluid. Fasciola hepatica ova were identified by fecal sedimentation examination. The presence of flukes, as well as carcinoma metastasis, probably contributed to the increased serum hepatic enzyme activity. Similarities to gastric squamous cell carcinoma in the equine and bovine species are discussed. This case suggests that neoplasia, although rarely reported in the llama, must be considered in the differential diagnostic list for anorexia and weight loss in the llama.
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A six-year-old girl presented with fever, haematemesis, melaena, fluctuating jaundice, tender hepatomegaly, palpable gall bladder and eosinophilia. At laparotomy a liver fluke was removed from the common bile duct. Despite treatment with praziquantel and metronidazole she succumbed to severe gastrointestinal bleeding.
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Partial purification of a saline extract of adult Fasciola gigantica by chromatography on Sephadex G200 gave four peaks, of which only the first two contained material which gave a precipitation reaction with sera from infected buffaloes. None of these gave false reactions with sera from uninfected animals but even the first and most sensitive fraction only reacted with 57.5 per cent of sera from animals known to be infected with moderate numbers of F gigantica.
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