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Human fascioliasis presenting as liver abscess: clinical characteristics and management

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Abstract

Background

Human fascioliasis, caused by the liver flukes F. hepatica, and F. gigantica, is a neglected tropical disease that causes health problems in many regions of the world. This disease can be classified as either acute or chronic based depending on the clinical manifestations and laboratory findings.

Methods

We retrospectively reviewed the demographic data, clinical features, radiologic manifestations, and the response to specific treatment of patients diagnosed with hepatic fascioliasis as well as fasciola liver abscess in Thailand.

Results

A total of 175 patients were included in the study, 126 patients were females (72%), while the mean age was 47.8 years (16–84 years). The most common symptoms were abdominal pain (74.9%), weight loss (29.1%) and fever (28%). Peripheral eosinophilia was observed in 92% of patients. The typical radiologic findings discovered conglomerated hypodensity which are rim-enhancing lesions located in the subcapsular and peripheral region of the liver. Most of patients were improved after a single dose of triclabendazole treatment. Adding antibiotic had no statistical impact on treatment outcome (p = 0.78).

Conclusions

Human fascioliasis presents with a wide clinical spectrum; therefore, a high index of suspicion is required to establish a correct diagnosis. Clinicians need to be aware of hepatic fascioliasis when patients in such endemic areas present as hypereosinophilia and typical liver imaging. Prompt specific treatments will contribute towards a satisfactory outcome in patients.

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Abbreviations

NTDs:

Neglected tropical diseases

WHO:

World Health Organization

CT:

Computed tomographic

MRI:

Magnetic resonance imaging

ES:

Excretory secretory

DIC :

Disseminated intravascular coagulation

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Acknowledgements

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Funding

Not applicable. No funding was obtained for this study.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Apinya Leerapun, Siripa Puasripun, Phuripong Kijdamrongthum & Satawat Thongsawat

Authors
  1. Apinya Leerapun
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  2. Siripa Puasripun
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  3. Phuripong Kijdamrongthum
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  4. Satawat Thongsawat
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Contributions

AL: study concept and design; data analysis and interpretation; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; administrative, technical, or material support; study supervision. SP: data acquisition; data analysis and interpretation; drafting of the manuscript; statistical analysis. PK: data acquisition; critical revision of the manuscript for important intellectual content. ST: critical revision of the manuscript for important intellectual content; administrative, technical, or material support; study supervision.

Corresponding author

Correspondence to Apinya Leerapun.

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Competing interests

Apinya Leerapun, Siripa Puasripun, Phuripong Kijdamrongthum and Satawat Thongsawat declare that they have no competing interests.

Ethics approval and consent to participate

The Research Ethics Committee of the Faculty of Medicine, Chiang Mai University approved the protocol for this retrospective study and waived the need to obtain consent for the collection, analysis, and publication of the retrospectively obtained and anonymised data.

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Leerapun, A., Puasripun, S., Kijdamrongthum, P. et al. Human fascioliasis presenting as liver abscess: clinical characteristics and management. Hepatol Int 15, 804–811 (2021). https://doi.org/10.1007/s12072-021-10180-z

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  • DOI: https://doi.org/10.1007/s12072-021-10180-z

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