Crystallization ; Eosinophils ; enzymology ; Fascioliasis ; pathology ; Granuloma ; pathology ; Humans ; Liver ; pathology ; ultrastructure ; Lung ; pathology ; ultrastructure ; Lung Diseases, Parasitic ; pathology ; Lysophospholipase ; metabolism ; Paragonimiasis ; pathology

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

Adolescent ; Animals ; Humans ; Liver Diseases, Parasitic ; Male ; Pentastomida

Fascioliasis is a foodborne zoonotic parasitic disease. We report 4 cases occurring in the same family, in whom diagnosis of acute fascioliasis was established after series of tests. One case was hospitalized with fever, eosinophilia, and hepatic lesions. MRI showed hypodense changes in both liver lobes. The remaining 3 cases presented with the symptom of stomachache only. Stool analysis was positive for Fasciola eggs in 2 adult patients. The immunological test and molecular identification of eggs were confirmed at the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China. The results of serological detection were positive in all the 4 patients. DNA sequencing of PCR products of the eggs demonstrated 100% homology with ITS and cox1 of Fasciola hepatica. The conditions of the patients were not improved by broad-spectrum anti-parasitic drugs until administration of triclabendazole.
Adult ; Asian Continental Ancestry Group ; Centers for Disease Control and Prevention (U.S.) ; China* ; Diagnosis ; Eggs ; Eosinophilia ; Fasciola ; Fasciola hepatica ; Fascioliasis* ; Fever ; Humans* ; Immunologic Tests ; Liver ; Magnetic Resonance Imaging ; Ovum ; Parasitic Diseases ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Catheter Ablation ; Humans ; Liver Diseases, Parasitic ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Paragonimiasis ; diagnosis ; pathology ; surgery

No abstract available.
Adult ; Animals ; *Capillaria ; Diagnostic Errors ; Dirofilariasis/*diagnosis ; Enoplida Infections/*diagnosis ; Humans ; Korea ; Liver/*parasitology ; Liver Diseases, Parasitic/*diagnosis ; Male

Most of human dirofilariasis are pulmonary or subcutaneous infections, but there have been a few reports of human dirofilariasis in unusual sites, such as large vessels, mesentery, peritoneal cavity, and spermatic cord. We present the first case of human hepatic dirofilariasis, which was surgically diagnosed. A 39-yr-old man without any evidence of systemic symptom was found incidentally to have a hepatic nodule during routine physical check-up. The histologic findings of the resected lesion showed a granulomatous lesion with central necrosis containing up to 35 transverse sections of a nematode, ranging 30-80 micrometer in diameter. Thin (1.5-5 micrometer) cuticle with transverse striations surrounded polymyarian and muscle bundles occupied a sixth of both sides of outer body cavity. Central portion of the body cavity was occupied with an intestine-like tubular structure and a larger reproductive tube. These microscopic findings were consistent with degenerated Dirofilaria immitis. Antibody test by enzyme-linked immunosorbent assay for patient serum reacted positively against adult D. immitis antigen.
Adult ; Animals ; Dirofilaria immitis/anatomy & histology/isolation & purification ; Dirofilariasis/*diagnosis/parasitology ; Humans ; Liver Diseases, Parasitic/*diagnosis/parasitology ; Male

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

Although Vietnam has a high risk of fishborne zoonotic trematode (FZT) infections for humans, little information exists on the epidemiology of these infections in the country's fish. Because of the importance of cultured catfish and snakehead production in An Giang province, a major production area in the Mekong Delta of Vietnam, a survey for FZTs was carried out in randomly selected fish farms between June 2005 and March 2006. For comparison, wild fish from the same area were also surveyed. A total of 852 cultured fish from 4 districts were collected and examined by pepsin digestion to determine their FZT infection status. In Tra catfish, the prevalence of all types of metacercariae was 2.6%, of which the prevalence of Haplorchis pumilio was 0.7%. The overall prevalence of metacercariae in wild fish was 30.6%, of which 10.3% harbored zoonotic species: H. pumilio (2.8%) and Procerovum sp. (5.6%). The prevalence of Opisthorchis metacercariae, which were diagnosed as O. viverrini, was 1.9%. No metacercariae were found in cultured snakehead fish, although wild-caught snakehead fish had a FZT prevalence of 10.3%: 5.1% were O. viverrini; 2.6% H. pumilio; and 2.6% were Procerovum sp. These are the first reports of H. pumilio, Procerovum sp., and O. viverrini metacercariae in Vietnamese fish. These results indicate that consumption of improperly prepared fish represents a significant risk of acquiring FZTs in this south Vietnam region.
Animals ; Aquaculture ; Fish Diseases/*epidemiology/parasitology ; Fishes ; Intestinal Diseases, Parasitic/epidemiology/parasitology/*veterinary ; Liver Diseases, Parasitic/epidemiology/parasitology/*veterinary ; Prevalence ; Trematoda/growth & development/*isolation & purification ; Trematode Infections/epidemiology/parasitology/*veterinary ; Vietnam/epidemiology ; Zoonoses/*epidemiology/parasitology