Fascioliasis

Fascioliasis is an infection caused by flukes of the class trematoda most often characterized by fever, eosinophilia and abdominal pain although as many as one half of the patients may be asymptomatic.

AGE AND SEX OF FASCIOLIASIS

Males are more affected than females. Most of the patients suffering from fascioliasis are adults.

RACE OF FASCIOLIASIS

There appear no apparent racial predilections for fascioliasis infection.

CAUSES OF FASCIOLIASIS

The most common risk factor to catch fascioliasis infection is consumption of
• Contaminated water plants
• Contaminated water
• Consumption of contaminated raw liver from infected sheep, goats or cows.

FASCIOLIASIS SIGNS AND SYMPTOMS

In the physical examination patient reveals no specific signs of infection.
Tenderness of abdomen may be general or may be localized to the right hypochondrium, right upper quadrant, gall bladder, mild epigastrium or left upper quadrant.
Hepatomegaly may occur with tenderness or without tenderness.

Patient often show following symptoms:-
• Fever
• Pallor
• Weight loss

Less often patient present with following symptoms:-
• Urticaria
• Wheezing
• Subcutaneous nodules as large as 6 cm in diameter
Patient with halzoun/marrerra may have severe pharyngitis or laryngeal edema.

INVESTIGATION FOR FASCIOLIASIS

Laboratory tests to be done are as follows:
• CBC count
• Erythrocyte sedimentation rate
• Serology
• Polymerase chain reaction assays
• Immunoglobulin levels
• Liver function tests
• Stool examination for ova and parasites

Imaging studies to be done are as follows:
• Chest radiography
• MRI
• CT scanning
• Cholangiography
• US-guided gallbladder aspiration
• Technetium- 99 scanning

TREATMENT FOR FASCIOLIASIS

Medication to be given for the treatment is praziquantel.
Patients with ascending cholangitis may require surgery.

COMPLICATIONS OF FASCIOLIASIS

• Severe anemia
• Pancreatitis
• Ectopic foci of infection
• Hemoperitoneum
• Subcapsular hematoma
• Hepatic mass
• Cholecystitis
• Ascending cholangitis
• Hemobilia from ulceration of the biliary epithelium
• Gallstones
• Sclerosing cholangitis

PROGNOSIS OF FASCIOLIASIS

Prognosis is excellent with adequate therapy.

DIFFERENTIAL DIAGNOSIS OF FASCIOLIASIS

• Ascariasis
• Amebiasis
• Ancylostoma infection
• Anemia, chronic
• Biliary atresia
• Bancroftian filariasis
• Cholestasis
• Cholelithiasis
• Cutaneous larva migrans
• Cysticercosis
• Dirofilariasis
• Dracunculiasis
• Echinococcosis
• Fever without a focus
• Giardiasis
• Hookworm infection
• Hymenolepiasis
• Hyperosinophilic syndrome
• Intestinal protozoal diseases
• Leptospirosis
• Schistosomiasis
• Taenia infection