A Fascioliasis Case: a not Rare Cause of Hypereosinophilia in Developing Countries, Present in Developed too.
Bottom Line: But computed tomography scan revealed irregular nodular lesions in periportal area of the liver.F. hepatica indirect hemagglutination test in serum was positive at a titer of 1/1280.Clinical and laboratory signs were completely resolved after treatment.
Affiliation: Department of Infectious Diseases.
Fascioliasis is a worlwide parasitic zoonosis, endemic in south-east mediterranean area, but uncommon in other areas. Clinical signs are usually non-specific. A 32 year old male patient was admitted to our hospital with complaints of abdominal pain, diarrhea, fatigue, nausea, lost of appetite, itching, cough, night sweats and weight loss. Complete blood count revealed hypereosinophilia. The abdominal ultrasound scan was normal. But computed tomography scan revealed irregular nodular lesions in periportal area of the liver. Based on these clinical and radiological signs and continuous hypereosinophilia, the patient was serologically investigated for Fasciola hepatica infection. F. hepatica indirect hemagglutination test in serum was positive at a titer of 1/1280. Single dose Triclabendasole 10mg/kg was administered and repeated two weeks later. Clinical and laboratory signs were completely resolved after treatment. Serological tests for fascioliasis should be included in all patients with hypereosinophilia and abnormal liver CT.
No MeSH data available.
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Mentions: His laboratory tests were as follows: leukocytes 7800/mm3, eosinophils 3900/mm3 (%49), platelets 293000/mm3, hemoglobin 13,8 g/dL, hematocrit %42.6, C-Reactive Protein (CRP) 35 mg/dl. Peripheric blood smear revealed eosinophilia as high as 46% of white blood cells. Routine biochemical tests, urine analysis, and serum IgE were in normal range. Hepatitis B virus surface antigen (HBsAg), anti-hepatitis C virus antibodies (Anti-HCV), anti-human immunodeficiency virus antibodies (Anti-HIV), venereal disease research laboratory (VDRL), Epstein-Barr virus virus capsid antigen (EBV-VCA) IgM, cytomegalovirus (CMV) IgM, anti-rubella IgM, Rose-Bengal, Wright agglutination, and Grubel-Widal tests were negative. The chest radiogram was also normal. Nonpruritic skin lesions on his back were diagnosed as dermographic urticaria after consulting with a dermatologist (Figure 1). Desloratadin and hydroxyzine were administered. The skin lesions were not resolved with these drugs. The patient was hospitalized to investigate the possible infectious causes of hypereosinophilia.
No MeSH data available.