Selcuk AKSOZ, Hakan Sezgin SAYINER, Sadik AKGUN, Seda GUVENC

Fascioliasis: Clinical presentation and treatment of three cases

Aim: For the diagnosis of Fasciola hepatica disease first step is the direct microscopic examination of feces with clinical finding. Inaddition to the microscopic diagnosis, radiological examination, serological methods and ELISA method are used for the diagnosisof extra-intestinal helminth infections. If these investigations are not enough for diagnosis, surgical intervention and pathologicalexamination can be required.Materials and Methods: In addition to the clinic symptoms and biochemical and hematological lab tests of three women whoadmitted to our hospital presenting with positive F. hepatica Indirect Hemagglutination (IHA) in microscopic and radiologicalexamination, findings consistent with F. hepatica were detected in these patients and the difference between the starting time ofsymptoms and starting time of treatment has been emphasized.Results: There was no animal feeding history but a history of eating fresh vegetables in our case back grounds. Malignancy wassuspected after the initial of symptoms in three of our cases and surgery was performed for two cases and the result of biopsy wascompatible with abscess. F hepatica eggs were seen in direct microscopic investigation in one case. Cyst hydatic IHA test wasdetected positive at high titer in two cases. Eosinophilia was found in three cases as well and radiological findings were compatiblewith Fasciola infection. In our cases where Fasciola IHA test was positive, the duration between beginning of symptoms anddiagnosis was approximately one to three months.Conclusions: Our results suggest that to confirm the diagnosis F. hepatica, microbiological, serological and radiological testsshould be performed.

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