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      • Record: found
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      Human fascioliasis by Fasciola hepatica: the first case report in Nepal

      case-report

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          Abstract

          Background

          Fascioliasis is a zoonotic disease caused by Fasciola species. Patient may be asymptomatic or presents with jaundice and biliary colic or right hypochondriac pain due to bile duct obstruction with gastrointestinal symptoms.

          Case presentation

          We report a case of human fascioliasis in a 45 years old female presented to Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal on August, 2015 with fever, right hypochondriac pain, jaundice and occasional vomiting with anorexia for 4 months whose alkaline phosphatase was elevated and peripheral blood smear revealed eosinophilia. The patient also gives the history of consumption of water-cress. Endoscopic Retrograde Cholagiopancretography (ERCP) showed the presence of a flat worm resembling Fasciola hepatica and stool routine examination revealed ova of F. hepatica. The patient was treated with nitazoxanide by which she got improved. Repeat stool examination 2 weeks after treatment revealed no ova of F. hepatica.

          Conclusions

          Patient with fascioliasis can be simply diagnosed with stool routine microscopy and treated with nitazoxanide. So patient with right hypochondriac pain, sign and symptoms of obstructive jaundice, eosinophilia and history of water-cress consumption should be suspected for fascioliasis and investigated and treated accordingly.

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          Most cited references8

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          Epidemiology of human fascioliasis: a review and proposed new classification.

          S Mas-Coma, J. Guillermo Esteban, M D Bargues (1998)
          The epidemiological picture of human fascioliasis has changed in recent years. The number of reports of humans infected with Fasciola hepatica has increased significantly since 1980 and several geographical areas have been described as endemic for the disease in humans, with prevalence and intensity ranging from low to very high. High prevalence of fascioliasis in humans does not necessarily occur in areas where fascioliasis is a major veterinary problem. Human fascioliasis can no longer be considered merely as a secondary zoonotic disease but must be considered to be an important human parasitic disease. Accordingly, we present in this article a proposed new classification for the epidemiology of human fascioliasis. The following situations are distinguished: imported cases; autochthonous, isolated, nonconstant cases; hypo-, meso-, hyper-, and holoendemics; epidemics in areas where fascioliasis is endemic in animals but not humans; and epidemics in human endemic areas.
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            A PCR-RFLP assay for the distinction between Fasciola hepatica and Fasciola gigantica.

            A Marcilla, M D Bargues, S Mas-Coma (2002)
            Fascioliasis is of well-known veterinary importance and an increasing human health problem, with reported cases in the five continents. The causative agents, Fasciola hepatica and Fasciola gigantica, present geographical distributions, which overlap in many regions of Africa and Asia, and in which the differentiation of both species is usually difficult because of the many variations in their morphological characteristics. Moreover, in humans, liver fluke classification cannot be achieved by clinical, pathological, coprological or immunological methods. The differential diagnosis between F. hepatica and F. gigantica infection is very important because of their different transmission and epidemiological characteristics. A simple and rapid PCR-restriction fragment length polymorphism (RFLP) assay, using the common restriction enzymes Ava II and Dra II, is described to distinguish between both fasciolid species. It is based on a 618-bp-long sequence of the 28S rRNA gene recently obtained from liver fluke populations of South America, Europe and Africa. This sequence showed a few nucleotide differences between both fasciolids and no intraspecific variations within each species. This assay provides unambiguous results and may be useful for both individual subject diagnosis and epidemiological surveys of humans and animals in endemic regions of sympatry.
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              Vaccines against the zoonotic trematodes Schistosoma japonicum, Fasciola hepatica and Fasciola gigantica.

              David McManus, Heather J. Dalton (2005)
              Schistosoma japonicum, Fasciola hepatica and F. gigantica are digenetic trematodes and, therefore, possess similar life cycles. While schistosomiasis japonica has for a long time been recognised as a major disease of both humans and animals, infection with fasciolids has only been considered of relevance to animals. However, a number of recent reports indicate that fasciolosis is becoming a serious public health problem, especially in South America, Egypt and Iran (sporadic cases are also on the increase throughout Europe). Vaccines targeted at animals could play an important role in controlling these three diseases in animals and, by blocking transmission of infection, have a concurrent beneficial effect on disease in humans. Approaches towards identifying and producing vaccines against these parasites are similar and are discussed in this review.
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                Author and article information

                Contributors
                Ranjit Sah: ranjitsah57@gmail.com , ranjitsah@iom.edu.np
                Shusila Khadka: shushila.mbbs9@gmail.com
                Mohan Khadka: khamohan620@gmail.com
                Dipesh Gurubacharya: dipeshgurubacharya@gmail.com
                Jeevan Bahadur Sherchand: jeevanbsherchand@gmail.com
                Keshab Parajuli: drkparajuli@iom.edu.np
                Niranjan Prasad Shah: niranjshah@yahoo.com
                Hari Prasad Kattel: kattelhari@hotmail.com
                Bharat Mani Pokharel: bmp268@hotmail.com
                Basista Rijal: basistarijal@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Res Notes
                Journal ID (iso-abbrev): BMC Res Notes
                Title: BMC Research Notes
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1756-0500
                Publication date (Electronic): 5 September 2017
                Publication date PMC-release: 5 September 2017
                Publication date Collection: 2017
                Volume: 10
                Electronic Location Identifier: 439
                Affiliations
                [1 ]ISNI 0000 0004 0635 3456, GRID grid.412809.6, Department of Microbiology, Institute of Medicine, , Tribhuvan University and Teaching Hospital (TUTH), ; Kathmandu, Nepal
                [2 ]ISNI 0000 0004 0635 3456, GRID grid.412809.6, Department of Medicine (Gastroenterology), Institute of Medicine, , Tribhuvan University and Teaching Hospital (TUTH), ; Kathmandu, Nepal
                Article
                Publisher ID: 2761
                DOI: 10.1186/s13104-017-2761-z
                PMC ID: 5583974
                PubMed ID: 28870243
                SO-VID: a8c76524-9e92-4472-8950-6ce125a0c515
                Copyright © © The Author(s) 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 25 June 2017
                Date accepted : 29 August 2017
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Medicine
                Keywords: fasciola hepatica,fascioliasis,right hypochondriac pain,tuth (tribhuvan university teaching hospital),nepal
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: fasciola hepatica, fascioliasis, right hypochondriac pain, tuth (tribhuvan university teaching hospital), nepal

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