Fasciola hepatica

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  • 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

Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)


  • 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


  • Triclabendazole (10mg/kg PO x 1-2 days)
  • Alternative: Bithionol and nitazoxnide
  • ID and GI consult
  • Possible surgery consult

See Also