Korean J Gastroenterol.  2021 Jan;77(1):39-44. 10.4166/kjg.2020.152.

Fasciola Hepatica Induced Hepatic Abscess Treated with Triclabendazole

• Park HJ
• Choi GS
• Jung M
• Lee SU

• KMID: 2510775
• DOI: http://doi.org/10.4166/kjg.2020.152

Abstract

Fascioliasis is a zoonotic disease caused by Fasciola Hepatica that infects mainly cattle, sheep, and goats. Humans can be infected by water or aquatic plants contaminated with metacercariae. The authors encountered two cases of F. hepatica infection. One patient reported abdominal discomfort with marked eosinophilia. The other patient had chest discomfort with marked eosinophilia. The abdominal CT images revealed hypodense lesions in the liver. The ultrasonography-guided liver biopsy findings in both patients were indicative of parasitic infections. Serological tests confirmed the definite diagnoses. Both patients were treated with a single dose of triclabendazole, which is the treatment of choice for fascioliasis. These findings suggest that a diagnosis of fascioliasis, particularly in the acute phase, should be considered in patients with abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT.

Keyword

Fasciola Hepatica; Fascioliasis; Liver abscess; Triclabendazole

Figure

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  Fig. 1 Axial computed tomography scan images of the case one patient. (A) Multiple clustered hypodense lesions (black arrows) were observed (on the admission day). (B) Few hypodense lesions (black arrows) were observed (Four months from discharge).

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  Fig. 2 Microscopic findings of the case one patient. Portal inflammation by eosinophils, lymphocytes, plasma cells, and macrophages extends to the hepatic lobules (H&E, ×200).

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  Fig. 3 Axial computed tomography scan images of the case two patient. (A) On the admission day, several ill-defined linear low densities (black arrows) were noted. (B) No active hepatic lesions were noted 2 months after discharge.

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  Fig. 4 Microscopic findings of the case two patient. (A) Inflammation of eosinophils, lymphocytes, plasma cells, and macrophages was noted at the border of the necrotic area (H&E, ×200). (B) Multiple Charcot-Leyden crystals (arrowheads) were noted in the center and periphery of the necrotic area (H&E, ×400).

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