Fascioliasis (Fasciola hepatica infection)

Notes
  • Commonly known as coomon liver fluke.
  • It is the sheep and cattle liver fluke that affects human after ingesting the parasite metacercariae from sheep or cattle dung encysted on plants.
  • Statistics: Size of the fluke – 30mm x 13; global burden - 2.4 millions; population at risk globally – 180 million; prevalence in Taita Taveta Kenya - cattle (25.9%), goats (23.4%) and sheep (33.3%).
  1. Transmission
  • The Life-cycle;

_Human feeds on food contaminated with the fluke.

_Immature flukes migrate through the intestinal wall to peritoneal cavity, liver and eventually the biliary tract.

_The fluke mature in the biliary tract.

Symptoms
  • Mainly asymptomatic
  • Abdominal pain
  • Fever
  • Malaise
  • Weight loss
  • Urticaria
  • Cholelithiasis
  • Cholangitis
  • Obstructive jaundice
  • Pancreatitis
Diagnosis
  • Physical examination
  • Microscopy for yellow-brown eggs in stool /biliary materials
  • CT scan
  • Cholangiography
  • Immunoassay
  • MRI
  • Endoscopic retrograde cholangiopancreatography (ERCP)
Management
  • Surgery
  • Tabs Triclabendazole 10mg/kg/dose OD x 2/7. (drug of choice but not currently available in the Easr African market)
  • Tabs Nitazoxanide: adults 500 mg BD x 7/7. 1-3yrs: 100 mg BD x 7/7. 4-11yrs: 200 mg BD x 7/7
  • Praziquantel is not effective in clearing this fluke.
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