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23825

Hepatic Fascioliasis, Unexpected Diagnosis and Atypical Presentation

Article

Last updated: 03 Jan 2025

OverviewSimilar Items

Subjects

-

Tags

Endemic medicine
Hepatology
Infectious diseases

Abstract

A 35 years old female living in a village belongs to Zagazig, a city in the Nile delta, Egypt, presented to another health institute with upper abdominal pain, anorexia for one month. Her blood results were as follow; normal complete blood count (CBC), increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) more than twice the upper limit of normal, alkaline phosphatase (ALP): 185 U/L, gamma-glutamyl transpeptidase (GGT): 115 U/L and bilirubin: 1.5 mg/dl. Abdominal ultrasonography showed hypo-echoic focal lesions with ill-defined borders which were confirmed by abdominal CT. Her physician gave a probable diagnosis of HCC (based on high incidence of HCC in our community) and referred to our hospital. On admission the patient complained of upper abdominal pain. On examination there was no fever, no jaundice, and no organomegaly. Repeated laboratory tests showed normal CBC, ALT; 55 U/L, AST; 43U/L, ALP; 143 U/L, GGT; 96  U/L,  bilirubin;  2 mg/dl  and Alfa fetoprotein (AFP); 6 ng/ml. Abdominal CT imaging confirmed the presence of multiple branching hypo-dense focal lesions in segments 7 and 8 of the liver but no cirrhosis (Fig. 1). Serology for viral hepatitis (B,C) was negative. However, repeated stool analysis revealed Fasciola eggs. Nitazoxanide was given for one month. Her symptoms resolved and liver biochemistry improved. However, CT abdomen showed regression of the lesions but didn't disappear completely, so, Triclabendazole 10mg/kg was given once. Two months later, there was resolution of the focal lesions completely.

DOI

10.21608/aeji.2018.23825

Keywords

hepatic, Fascioliasis

Authors

First Name

Tarik

Last Name

Zaher

MiddleName

-

Affiliation

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Email

tareqzaher@zu.edu.eg

City

-

Orcid

-

First Name

Elsayed

Last Name

Saad

MiddleName

-

Affiliation

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Email

dr.sayedsaad79@gmail.com

City

-

Orcid

0000-0001-9492-9707

First Name

Ahmad

Last Name

Elsamak

MiddleName

-

Affiliation

Radiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Email

-

City

-

Orcid

-

Volume

8

Article Issue

4

Related Issue

4189

Issue Date

2018-12-01

Receive Date

2019-01-07

Publish Date

2018-12-01

Page Start

218

Page End

220

Print ISSN

2090-7613

Online ISSN

2090-7184

Article File

AEJI_Volume 8_Issue 4_Pages 218-220.pdf

PDF . 257.0kB

Link

https://aeji.journals.ekb.eg/article_23825.html

Detail API

https://aeji.journals.ekb.eg/service?article_code=23825

Order

9

Type

Case report

Type Code

622

Publication Type

Journal

Publication Title

Afro-Egyptian Journal of Infectious and Endemic Diseases

Publication Link

https://aeji.journals.ekb.eg/

MainTitle

Hepatic Fascioliasis, Unexpected Diagnosis and Atypical Presentation

Details

Type

Article

Created At

22 Jan 2023