During two years (2002-2004) a study was conducted in the Northern parts of Vietnam, 35 fascioliasis patients have been determined in 15 provinces. The clinical symptoms found in these patients were pain in the right quadrian of chest 94.3%, fever 60.0%, weight loss 57.1%, indigestion 54.3%, digestive disorder 42.9%, upper abdominal pain 42.9%, allergery 17.1%, out-penetration of adult worm from knee-joints 2.9%. The sub-clinical symptoms detemined by ultrasound images were liver abscesses with mixed echo (100%), eosinophillia in 34 patients (97.1%), Fasciola eggs in stool (25.7%), ELISA (+) with Fasciola gigantica antigen (100%) and almost by title of 1/12,800. Within those patients had been followed, some biochemical index of liver and kidney (GOT, GPT, Creatinin, Ure) were unchanged.
Fascioliasis ; Epidemiology ; Diagnosis

Adolescent ; Fascioliasis ; diagnosis ; drug therapy ; etiology ; Humans ; Male

Fascioliasis is a zoonotic disease caused by Fasciola hepatica, a liver fluke, for which human acts as an accidental host. Fascioliasis, while common in some tropical countries, is rare in Korea. Endoscopie retrograde cholangiopancreatography(ERCP) has been described in only a very few cases as a useful technique for the diagnosis of fascioliasis. We report a case of fascioliasis diagnosed by ERCP, after endoscopic sphinchterotomy adult worms were removed by Dormia basket.
Adult ; Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Fasciola hepatica ; Fascioliasis* ; Humans ; Korea ; Pancreas* ; Sphincterotomy, Endoscopic ; Zoonoses

Fasciola hepatica infection may result in biliary obstruction with or without cholangitis in the chronic biliary phase. Because clinical symptoms and signs of F. hepatica are similar to other biliary diseases that cause bile duct obstruction, such as stones or bile duct malignancies, that are, in fact, more common, this condition may not be suspected and diagnosis may be overlooked and delayed. Patients undergoing endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the evaluation of bile duct obstruction may be incidentally detected with the worm, and diagnosis can be confirmed by extraction of the leaf-like trematode from the bile duct. Intraductal ultrasonography (IDUS) can provide high-resolution cross-sectional images of the bile duct, and is useful in evaluating indeterminate biliary diseases. We present a case of biliary fascioliasis that was diagnosed using IDUS and managed endoscopically in a patient with acute cholangitis.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Cholestasis ; Diagnosis ; Endosonography ; Fasciola hepatica ; Fascioliasis* ; Humans ; Ranunculaceae ; Ultrasonography*

Aged ; Animals ; Clonorchis sinensis ; parasitology ; Emigrants and Immigrants ; Fasciola hepatica ; Fascioliasis ; diagnosis ; parasitology ; pathology ; Humans ; Male

Hepatic eosinophilic abscess is a very rare disease which has been reported in fascioliasis, and some gastrointestinal malignancy. We experienced 5 cases with hepatic eosinophilic abscesses which were caused by unknown etiology, confirmed by liver biopsy, from 1990 to 1994. The chracteristics of the cases including clinical menifestations, serologic findings, ultrasonography and abdominal computerizes tomogram(CT) were summerized. They had no characteristic findings except eosinophilia in clinical menifestations and they showed various ultrasonographic and CT findings which are different from the radiologic findings of liver abscesses by bacterial or amebic infection. We think that hepatic eosinophilic abscess must be included in differential diagnosis of all hepatic tumors.
Abscess* ; Biopsy ; Diagnosis, Differential ; Eosinophilia ; Eosinophils* ; Fascioliasis ; Liver ; Liver Abscess ; Rare Diseases ; Ultrasonography

We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F. hepatica. Histologically, numerous eggs of F. hepatica were noted with acute and chronic granulomatous inflammations in the subserosa and pericolic adipose tissues. Conclusively, a rare case of ectopic fascioliasis has been confirmed in this study by the adult worm recovery of F. hepatica in the mesocolon.
Animals ; Fasciola hepatica/genetics/*isolation & purification ; Fascioliasis/diagnosis/*parasitology ; Female ; Humans ; Mesocolon/*parasitology ; Middle Aged

In order to obtain the most specific and sensitive antigen from crude antigens of Fasciola hepatica for the immunodiagnosis of bovine fascioliasis by the enzyme linked immunosorbent assay(ELISA), phosphate buffered saline extract of F. hepatica was prepared. The crude extract was fractionated into 7 antigens using Sephadex G-100 column chromatography. Seven fractionated antigens were applied to ELISA, precipitation test and intradermal test, respectively. Results obtained are as follows: The specificity (95 per cent confidence interval in negative sera of bovine fascioliasis ; Mean+2 x SD of absorbance ) of the first (MW>150,000) and the second antigens (MW 120,000) were 93.7 per cent, but those of others including crude antigen showed 100 per cen.t. The sensitivity (positive sera of bovine fascioliasis having higher values with compared to the criterion) of the first, the sixth (MW 16,000) and the seventh antigen (MW<5,000) were 91.6 per cent, 87.5 per cent and 0 per cent, respectively, but those of others showed all 100 per cent. The absorbance by ELISA using the fifth antigen (MW 26,000) was 8.43-folds higher in the positive sera than that in the negative sera. This could be used as one of the most specific antigens for the immunodiagnosis of bovine fascioliasis. In Ouchterlony test, precipitin lines were not found in the sera naturally infected with F. hepatica, but some were found in the sera of rabbits immunized with the crude antigens. The numbers of precipitin lines in the sera of rabbits were different in the different fractionated antigens. They were 6 in the crude, 2 in the second and the third antigens, 1 in the forth, the fifth and the sixth antigens and absent in the seventh antigen, respectively. The wheal size for the bovine infected with F. hepatica was 2.46+-0.15 cm in the intradermal test antigen (saline extract of F. hepatica) supplied by the Veterinary Research Institute, Rural Development Administration, Korea. The wheal size of the first, the second and the third antigens were larger than that of intradermal test antigen, whereas those of the forth, the fifth, the sixth and the seventh antigens showed smaller than that of the intradermal test antigen. The results suggest that the fifth antigen may be specific antigen for the immunodiagnosis of bovine fascioliasis.
parasitology-helminth-trematoda ; immunology ; enzyme-linke immunosorbent assay ; diagnosis ; fascioliasis ; Fasciola hepatica

Human fascioliasis is a zoonosis caused by Fasciola hepatica, and this is a trematode that infests cattle and sheep. Humans are accidental hosts in the life cycle of this parasite. People are infected by ingestion of the water or the raw aquatic vegetables that are contaminated with the metacercaria. This fluke's worldwide distribution occurs in areas where sheep, cattle and goats are raised, and there is a life-cycle niche for this fluke in lymnaeid snails. However, it is a rare disease in Korea. We experienced four human fascioliasis which were difficult to differentiate from hepatic malignancy in three patients, and this was misdiagnosed as common hepatic duct tumor in one patient. The patients manifested only vague abdominal symptoms. Intrahepatic fascioliasis showed multiple ill-defined hypoattenuating lesions and filling defects of the lesion lumens on radiologic study. A striking eosinophilia from the patients' blood was identified and a positive finding of a serum enzyme linked immunosorbent assay for the Fasciola hepatica was also noted in three of four patients. The therapeutic trial with triclabendazole and praziquantel was not successful.
Adult ; Bile Duct Neoplasms/*diagnosis ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis ; Diagnostic Errors ; English Abstract ; Fascioliasis/*diagnosis ; Female ; Humans ; Liver Diseases, Parasitic/*diagnosis ; Middle Aged

Fascioliasis is a zoonotic helminthiasis caused by Fasciola hepatica, the sheep liver fluke. Humans are accidental hosts in the life cycle of the parasite. They are infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. The diagnosis of fascioliasis is based on clinical symptoms, absolute eosinophilia, serologic test (ELISA), radiologic finding, and presence of eggs in the feces or duodenal fluid. Recently, some radiologists have been reporting specific findings of fascioliasis by MRI. We report a case of liver abscess associated with fascioliasis diagnosed by MRI.
Diagnosis ; Eating ; Eggs ; Eosinophilia ; Fasciola hepatica ; Fascioliasis* ; Feces ; Helminthiasis ; Humans ; Life Cycle Stages ; Liver Abscess* ; Liver* ; Magnetic Resonance Imaging* ; Ovum ; Parasites ; Serologic Tests ; Sheep ; Vegetables ; Water