View source for Fasciola hepatica

==Background==
*[[Parasite]]: ''Fasciola hepatica''
*"Liver fluke" or "Sheep liver fluke"
*Eggs in stool of infected mammals (sheep/cattle) → snail → aquatic vegetation → human
*Infected by eating raw watercress or water plants contaminated by immature larvae
*Immature larvae migrate from intestine → abdominal cavity → liver → bile duct (mature adult)

==Clinical Features==
*[[Nausea]], [[vomiting]], [[abdominal pain]]/tenderness, [[hepatomegaly]]
*[[Fever]], [[rash]], [[shortness of breath]]
*Marked peripheral [[eosinophilia]]
*Liver hematoma
*Chronic: Inflammation and obstruction of liver, gallbladder, pancreas
**[[Biliary colic]], [[cholangitis]], [[cholelithiasis]], obstructive [[jaundice]]
*Ectopic fascioliasis: Erythematous itchy nodules
*Pharyngeal fascioliasis: pharyngitis with edema, congestion, suffocation

==Differential Diagnosis==
*[[Amebiasis]], [[larva migrans]], [[cysticercosis]], [[ascariasis]], [[hepatitis]], [[parasitic infection]]
*Biliary atresia, [[cholecystitis]], [[cholelithiasis]], cholestasis

{{Helminth Types}}

==Evaluation==
*CBC: Leukocytosis, anemia, eosinophilia
*Elevated ESR and LFT
*Stool ova and parasites, culture
*Microscopy
*Endoscopy or surgery, biopsy
*Serology (ELISA), PCR
*CT abdomen, US, ERCP, cholangiography, MRI

==Management==
*[[Triclabendazole]] (10mg/kg PO x 1-2 days)
*Alternative: Bithionol and nitazoxnide
*ID and GI consult
*Possible surgery consult

==See Also==
*[[Parasitic diseases]]

==References==
<references/>
*http://www.cdc.gov/parasites/fasciola/gen_info/index.html
*Leder K, et al. Liver flukes: Fascioliasis. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014.
*Tolan RW, et al. (2013, Apr 12). Fascioliasis. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/997890-overview

[[Category:ID]]
[[Category:Tropical Medicine]]