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A human case of invasive fascioliasis associated with liver abscess
Jin-Bong Kim,1Dong-Joon Kim,1Sun Huh,*2 and Seung-Yull Cho3
1Department of Internal of Medicine, College of Medicine, Hallym University, Chunchon 200-702, Korea.
2Department of Parasitology, College of Medicine, Hallym University, Chunchon 200-702, Korea.
3Department of Parasitology, Catholic University College of Medicine, Seoul 137-701, Korea.
Received November 08, 1995; Accepted November 29, 1995.
Abstract
A 56 year-old Korean housewife/farmer/goat keeper suffered from right upper quadrant pain and fever with chills. In the abdominal sonogram and computerized tomography, multiple, 2-3 cm, irregular shaped cavities were observed in the right lobe of liver. A liver biopsy revealed extensive central necrosis with Characot-Leyden crystals surrounded by palisading histiocytes, eosinophil-rich inflammatory infiltration. Worm was not observed. However, the serologic test for Fasciola-specific IgG antibody by micro-ELISA was positive. Prior antibody levels did not differ and eosinophilia persisted 6 and 16 months after praziquantel treatment although the cavitary lesions in the liver disappeared 6 months after the treatment. Reported herein is a human case of invasive fascioliasis diagnosed clinically by a combination of radiological, histopathological and serological studies.
Figures
Fig. 1 Abdominal CT scan showing multiple, variable sized, hypodense masses (arrow) with peripheral rim enhancement in the posterior segment of right lobe of the liver.
Fig. 2 Endoscopic retrograde cholangiography showing multiple contrast collection (arrow) in the right lobe.
Fig. 3 Liver needle biopsy revealing central necrotic debris with Charcot-Leyden crystals surrounded by palisading histiocytes, eosinophil rich inflammatory cell infiltration. H & E × 100.
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