Fasciola hepatica in a German Traveler Returning From Thailand
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Fasciola hepatica in a German Traveler Returning From Thailand. / Schmiedel, Stefan; Salzer, Helmut.
In: J TRAVEL MED, Vol. 22, No. 4, 08.2015, p. 285–286.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Fasciola hepatica in a German Traveler Returning From Thailand
AU - Schmiedel, Stefan
AU - Salzer, Helmut
PY - 2015/8
Y1 - 2015/8
N2 - A 46-year-old man presented with nonspecific clinical signs including abdominal pain, diarrhea, fatigue, and nausea after returning from a trip to the northeast of Thailand 5 months ago. Laboratory diagnostics revealed a hypereosinophilia of 45% and slightly elevated cholestatic liver enzymes with an alkaline phosphatase of 163 U/L (40–129 U/L) and a gamma-glutamyl transferase of 109 U/L (−65 U/L); besides serological confirmation, repeated stool samples showed the eggs of Fasciola hepatica (miracidia of F. hepatica measuring 136 × 74 µm). The abdominal T1-weighted axial magnetic resonance imaging (MRI) showed multiple tubular, hypointense parenchymal lesions in liver segments II, IVa, and VII representing pyogenic microabscesses consistent with F. hepatica; mild dilatations of the intrahepatic bile duct with a mild reactive/inflammatory reaction were identified, but with no significant cholestasis (Figures 1 and 2). The patient was started on oral therapy with triclabendazol (10 mg/kg) single dose. Infections with the trematode F. hepatica are an extremely rare phenomenon among travelers, despite the high disease burden among local populations in endemic areas; therefore, F. hepatica infections should be kept in mind when dealing with patients with a relevant travel history suffering from nonspecific signs and hypereosinophilia.
AB - A 46-year-old man presented with nonspecific clinical signs including abdominal pain, diarrhea, fatigue, and nausea after returning from a trip to the northeast of Thailand 5 months ago. Laboratory diagnostics revealed a hypereosinophilia of 45% and slightly elevated cholestatic liver enzymes with an alkaline phosphatase of 163 U/L (40–129 U/L) and a gamma-glutamyl transferase of 109 U/L (−65 U/L); besides serological confirmation, repeated stool samples showed the eggs of Fasciola hepatica (miracidia of F. hepatica measuring 136 × 74 µm). The abdominal T1-weighted axial magnetic resonance imaging (MRI) showed multiple tubular, hypointense parenchymal lesions in liver segments II, IVa, and VII representing pyogenic microabscesses consistent with F. hepatica; mild dilatations of the intrahepatic bile duct with a mild reactive/inflammatory reaction were identified, but with no significant cholestasis (Figures 1 and 2). The patient was started on oral therapy with triclabendazol (10 mg/kg) single dose. Infections with the trematode F. hepatica are an extremely rare phenomenon among travelers, despite the high disease burden among local populations in endemic areas; therefore, F. hepatica infections should be kept in mind when dealing with patients with a relevant travel history suffering from nonspecific signs and hypereosinophilia.
M3 - SCORING: Journal article
VL - 22
SP - 285
EP - 286
JO - J TRAVEL MED
JF - J TRAVEL MED
SN - 1195-1982
IS - 4
ER -