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PubMedDate not supplied

Pediatric fascioliasis: report of three cases.

Fascioliasis is an uncommon hepatobiliary disease in children. Ultrasonographic, computed tomography (CT) and magnetic resonance imaging (MRI) findings of the disease have been thoroughly described in the last decade. These radiological findings play an important role in the differential diagnosis of the disease since it may clinically mimic several hepatobiliary and systemic diseases. We report three children with fascioliasis, emphasizing the radiological findings in both the hepatic and biliary phases of the disease. If radiological findings are not appropriately interpreted, the diagnosis may be overlooked or delayed. In all three cases the serological confirmation was performed by ELISA method. Patients were treated with oral triclabendazole and soon recovered.

Adolescent↗
PubMedDate not supplied

[Hepatic subcapsular hematoma caused by fascioliasis].

UNLABELLED: The case of a 22 year old woman from Huaraz is presented herein. She suffered from pain at right hypocondrium, associated to nausea and vomits, which intensified three days prior to admission. Upon examining her, a faded gallbladder murmur was found on the base of the right hemithorax. There is pain in the abdomen when touched at the epigastrium and right hypocondrium. The liver is perceived 3 cm beneath the costal edge: White blood count with severe eosinophilia. Mild cholestasis is observed. Abdominal scan: Heterogeneous hepatic mass, with a 13 cm diameter in the right lobe. CAT scan: Subcapsular 14x8 cm mass. Scintiscan: Liver with a low absorption area showing absence of perfusion to the vascular pool. She undergoes an exploratory laparotomy and an 800 cc subcapsular hematoma is found in segment 6, 7 and 8, which is drained. Evolution evidences the persistence of eosinophilia and positive Arc-2 is obtained for Fasciola. She was administered Triclabendazol and is currently asymptomatic. CONCLUSION: The invasive stage of human fascioliasis may cause hepatic hematoma as a rare complication. The triad of persisting eosinophilia, painful hepatomegalia and prolonged fever leads to insist in the search of fascioliasis in endemic areas.

Adult↗
PubMed1992

[Human fascioliasis. Tomodensitometric aspects. Apropos of 2 cases].

The authors report two cases of hepatic fascioliasis in which the CT scans of the liver revealed multiple hepatic low density lesions, better seen after intravenous bolus injection of contrast material. This CT signs may help in the diagnosis, follow up and to access the efficacy of hepatobiliary fascioliasis treatment.

Acute Disease↗
PubMed1992

[Fascioliasis in populations of rural areas with high prevalence of animal infection].

Between January 1986 and December 1990 the prevalence of F. hepatica infection was studied in 5861 rural inhabitants of the provinces of Curico, Talca and Linares, VII Region, an hyperendemic zone of animal fascioliasis. Every one was screened by intradermal (IDR), complement fixation (CF), double diffusion (DD) counterelectrophoresis (CIEF), immunoelectrophoresis (IEP) and enzyme-linked immunoabsorbent assay (ELISA) tests. 366/1881 (9.3%) had positive IDR; 61 (1.04%) positive CF; 14 (0.24%) positive DD and 105/3838 (2.73%) positive ELISA and thus considered under suspicion to be infected. F. hepatica eggs were searched in stool in 241 of these persons. 37 cases were thus confirmed. Another 4 individuals with positive immunobiological tests and absence of the parasite eggs in stools were confirmed by duodenal intubation. 21 of the confirmed cases (51.2%) had less than 15 years of age. Women were more frequently infected than men (73.2% vs 26.8%). The 41 cases represent 0.7% of the surveyed population predicting 2000 cases among the total rural population of these provinces (300,000 persons). These results indicate that human fascioliasis is an important problem in the zone, perhaps much higher if family contacts of the index cases and symptomatic persons are included.

Adolescent↗
PubMed2003

Efficacy of Mirazid (Commiphora molmol) against fascioliasis in Egyptian sheep.

The efficacy of Mirazid (Commiphora molmol or Myrrh) was evaluated in sheep naturally infected with fascioliasis. Total doses of one or two capsules (300 mg each) were given for one, two or three successive days on an empty stomach an hour before breakfast. A total dose of 600 mg gave a cure rate of 83.3%, while a total dose of 900 to 1200 mg gave a complete cure rate (100%), with no clinical side effect. The cure rate was achieved by stool examination and/or macroscopically on slaughtering the sheep. Mirazid proved to be safe and very effective in sheep fascioliasis in Gharbia Governorate.

Animals↗
PubMed2004

Study of some immune aspects in patients with fascioliasis before and after Chommiphora molmol (Mirazid) treatment.

This study was planned to evaluate the in vitro production of IL-1 beta and IL-4 by peripheral blood mononuclear cells (PBMCs) and total IgE in patients with fascioliasis before and 3 months after treatment with purified extract of myrrh from Commiphora molmol tree (Mirazid), to determine the role of these variables in immunopathogenesis of the disease in relation to this new drug. The study was carried out in Departments of Tropical Medicine, Al-Azhar University Hospitals in the period from March 2002 to November 2003. A total of 35 patients with chronic fascioliasis with age range from 9-45 years in addition to 10 healthy subjects with matched age and sex serving as controls were studied. Serum IgE and in vitro IL-1 and IL-4 were estimated by enzyme immuno-assay (ELISA) before and 3 months after therapy. Results revealed significant increase in IL-1 beta in patients before treatment than control (p<0.001) but it decreased significantly after therapy (p<0.001) to reach the control level (p=0.16). In contrast, IL-4 was significantly lower than control before therapy (p=0.04) and increased significantly after treatment (p<0.001) to reach normal levels as control (p=0.59). Total IgE was significantly elevated in patients before treatment (p<0.001) and it did decrease significantly with treatment (p<0.001), although it remained significantly higher than the control level. In conclusion, Mirazid is an effective fasciolicidal drug. IL-1 may be involved in disease immunopathogenesis and the depressed IL-4 may be a phenomenon of parasite immune suppression. Complete decline of total IgE is not an early criterion of cure.

Adolescent↗
PubMed2005

Serodiagnosis of human fascioliasis by a cystatin capture enzyme-linked immunosorbent assay with recombinant Fasciola gigantica cathepsin L antigen.

Cathepsin L1, a cysteine protease secreted by the gastrodermis of juvenile and adult Fasciola gigantica, was expressed in Escherichia coli as a calmodulin binding peptide fusion protein with a molecular mass of approximately 35 kD. The recombinant cathepsin L1 (rCTL1) was tested for its antigenic potential in a cystatin capture enzyme-linked immunosorbent assay (ELISA) to diagnose human fascioliasis. The ELISA plates were sensitized with chicken egg cystatin and incubated with bacterial lysates containing the recombinant protein before the standard ELISA procedures were performed. Analysis of the sera of 13 patients infected with F. gigantica (group 1), 204 patients with other parasitic infections (group 2), 32 cholangiocarcinoma patients (group 3), and 42 healthy controls (group 4) showed that the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this ELISA using rCTL1 were 100%, 98.92%, 98.97%, 81.25%, and 100%, respectively. These results indicate that this assay has high sensitivity and specificity in the diagnosis of human fascioliasis. In addition, we have produced sufficient amounts of antigen for use in diagnosis.

Animals↗
PubMed2005

Cholestasis in human fascioliasis in Dakahlia Governorate, Egypt.

This study was conducted to assess cholestasis in human fascioliasis. Twenty five patients, passing Fasciola eggs, were compared to twenty age- and sex-matched healthy controls. All were subjected to thorough clinical examination, stool analysis, complete blood picture, liver function tests (AST, ALT, SAP, GGT and total serum bilirubin). Autoimmune and viral hepatitis (HCV & HBV) were excluded. All cases were subjected to radiological examinations (chest x-ray and abdominal ultrasonography). The study revealed significant elevation of liver enzymes in the patients compared to the controls (p < 0.001). Calcular and non-calcular cholecystitis were common findings among patients (32% and 24% respectively). Ascites (4%) and dilated intra-hepatic biliary radicals (32%) were encountered; pleural effusion was detected by chest x-ray in 20% of cases. So, fascioliasis should be considered in the diagnosis of cholestasis in Fasciola endemic areas.

Age Factors↗
PubMed1991

Problem of fascioliasis in animal husbandry in Thailand.

One of the most important parasitic diseases in adult cattle and buffalo in Thailand is fascioliasis, caused mainly by Fasciola gigantica. The economic loss from fascioliasis in cattle and buffalo throughout Thailand has been assessed at not less than 100 million Baht. Recent investigations have been shown that the average prevalence of F. gigantica in cattle and buffalo in Thailand was 11.8%. However, the prevalence varies considerably between villages, ranging from 0 to 85%. The prevalence is high in areas surrounding dams or large ponds in which Lymnaea auricularia rubiginosa, the intermediate host of F. gigantica is found. An epidemiological study revealed that the disease has a seasonal pattern from which the following conclusion for control of the disease can be drawn. Strategic liver fluke treatment of all cattle and buffalo which are older than 8 months should be carried out once a year in September. In addition, animals in poor condition should be treated in April to prevent severe losses, especially in high prevalence areas or where strategic treatment was missed. Problems of liver fluke control include the lack of knowledge about the parasite on the part of the farmers and the lack of availability of drug supplies at the village level, both of which are important to allow strategic treatment of animals. To approach these problems, the government had developed "Farmer Self-Help Worm Control Program" in seven provinces in Northeast Thailand which is operated by village farmers trained as program "keymen". This program is very effective and will be extended throughout Thailand in the next Seventh Social and Economic Development Plan.

Animals↗
PubMed1991

Liver fluke disease (fascioliasis): epidemiology, economic impact and public health significance.

Liver fluke disease (fascioliasis) is an important parasitic disease found worldwide affecting sheep, goats, cattle and buffalo, as well as other domestic ruminants. The common causative agents are Fasciola hepatica and F. gigantica which require various species of Lymnaea, fresh water snails, as their intermediate hosts. The epidemiology of the disease and its prevalence in Malaysia is mentioned briefly. The disease causes considerable impact on the economy of the livestock industry. The economic losses consist of costs of anthelmintics, drenches, labor, liver condemnation at meat inspection; and losses in production due to mortality, reduction in meat, milk and wool production; and reduction in growth rate, fertility and draught power. The disease also has public health significance, causing human fascioliasis and "halzoun".

Animals↗
PubMed1991

Human fascioliasis in Egypt: effect of infection and efficacy of bithionol treatment.

The present study was conducted on 14 patients with established fascioliasis. The effect of infection on the haematological and biochemical parameters was determined and the liver and gall bladder were studied by ultrasonography. Bithionol was given in the dose of 30 mg kg-1 body weight every other day for 5 doses. The therapeutic efficacy was assessed by egg and eosinophilic counts and quantitative estimation of antibody titres by indirect haemagglutination test. Results revealed that fascioliasis caused normocytic hypochromic anaemia and eosinophilia. Serum bilirubin, ALT and AST were within normal range. Ultrasonography showed a normal echogenic pattern of the liver and gall bladder. One case showed thickness of the gall bladder wall which was tender under the transiducer. Fasciola eggs disappeared completely after the 5th dose giving a cure rate of 100%. Antibody titres reached a normal level at the end of the 3rd month post treatment. Bithionol proved to be a potent fasciolicidal drug with minimal side-effects.

Adolescent↗
PubMed1989

Dot-enzyme-linked immunosorbent assay (dot-ELISA) for the rapid diagnosis of human fascioliasis.

A dot-enzyme-linked immunosorbent assay (dot-ELISA) was developed as a fast and field applicable antibody detection tool for the diagnosis of human fascioliasis. The assay is performed using partially purified antigens from a species of Fasciola at 180 ng protein/dot (2 microliters) and serum samples at 1:20 dilution (1 microliter). Dot-ELISA results completely agreed with those of micro-ELISA. Antigen-coated nitrocellulose sheets stored for 3 mo at -20 C showed results identical to fresh sheets. Sera from patients with fascioliasis (n = 30) and other parasitic or viral infections (n = 120) were compared with sera from healthy controls (n = 14). Ninety samples can be tested within 90 min. The sensitivity, specificity, and speed of the assay may justify its use in laboratory and field studies.

Antigens, Helminth↗
PubMed1989

Sensitivity of crude and purified Fasciola antigens in immunological diagnosis of human fascioliasis.

A study has been done to find the effect of purification of crude antigens, extracted from adult Fasciola gigantica and Fasciola hepatica worms on the sensitivity of some serological techniques in diagnosis of fascioliasis. Using C.I.E.P. test, the partially purified antigens of both Fasciola species were less sensitive than their corresponding crude ones. Using I.H.A., the difference between results of crude and partially purified antigens for the two species were statistically insignificant, both (P greater than 0.05). So in applying this test, there is no need for the partially purification of antigen. On using E.L.I.S.A. the partially purified antigens showed higher sensitivities for detection of fascioliasis than their corresponding crude ones. Partially purified F. gigantica and F. hepatica antigens gave nearly the same results whether using C.I.E.P., I.H.A. or E.L.I.S.A. However, E.L.I.S.A. was the most sensitive technique followed by I.H.A. then C.I.E.P.

Animals↗
PubMed1988

Bithionol (Bitin) treatment in established fascioliasis in Egyptians.

The present study is an evaluation of bithionol treatment in established fascioliasis. Eight patients were enrolled in the study. All were passing eggs of Fasciola spp. and seven had concomitant Schistosoma mansoni infection. The clinical and haematological findings conformed with the known picture of fascioliasis. Bitin tablets (200 mg) were administered in the dose of 30 mg kg-1 body wt every other day for five doses. Eggs were counted during and for 4 months after the end of therapy. Fasciola ova disappeared after the second or third dose giving a cure rate of 100%. Ova of S. mansoni did not show any change in number. As regards the liver function tests; bilirubin, SGOT and SGPT values were within the normal range and were not affected by treatment. A raised SAP level was observed before therapy which was significantly higher after bithionol. Creatinine phosphokinase and lactate dehydrogenase enzymes and kidney function tests showed almost normal values and were not altered by therapy. It was concluded that Bitin was a potent fasciolicidal drug in the dose used. No side effects were observed.

Adolescent↗
PubMed1986

Computed tomography findings of hepatic lesions in human fascioliasis: report of two cases.

Two patients with hepatic fascioliasis are presented. Computed tomography demonstrated multiple low density areas located in the center and periphery of the liver. In one patient a spontaneous decrease in the size of the low-density areas occurred but the abdominal symptoms were persistent before bithionol treatment. After the treatment both patients became asymptomatic. The computed tomography scan can be a useful tool for the diagnosis and follow-up of the patients with hepatic fascioliasis.

Fasciola hepatica↗
PubMed1985

[Rafanoxide therapy in a child with fascioliasis].

A seven-year-old girl with fascioliasis was treated with rafanoxide which is used for therapy of fascioliasis in sheep and cattle. This is the first report in the literature concerning the usage of rafanoxide in children according to our knowledge. Rafanoxide was given in a single dose of 7.5 mg per kg body weight orally.

Administration, Oral↗
PubMed1981

Circulating immune complexes in human fascioliasis. Relationship with Fasciola hepatica egg output.

Circulating immune complexes were investigated by the 125I-Clq binding test in serum from patients with fascioliasis. Only 36% of all the patients studied showed significant levels of CIC. Nevertheless, when we considered only the patients eliminating Fasciola hepatica eggs in the stool and/or with the acute phase of the infection, the detection of CIC was very higher (more than 70% of the cases). In addition, a close relationship was observed between F. hepatica egg output and the incidence of CIC. This data suggest strongly the occurrence of specific parasite antigens in the detected CIC. The involvement of CIC in the pathogenesis of the acute hepatic fascioliasis is discussed.

Animals↗