片形吸虫病诊断抗原的研究进展

片形吸虫病(fascioliasis)是由片形吸虫(Fasciola spp.),包括肝片形吸虫和大片形吸虫感染引起的人畜共患寄生虫病。牛羊等经济动物的感染可引起产奶、产肉量降低,劳作能力下降,造成巨大的经济损失:人体片形吸虫病可导致感染者严重的肝、胆病理损伤。片形吸虫病的临床表现和影像学诊断与其它肝胆疾病类似,极易被误诊。目前粪便虫卵病原学检测是最常用的片形吸虫病诊断方法,但存在漏诊、需要专业的镜检人员操作等问题。免疫学诊断技术因具有较高的特异性、敏感性且操作简单易行,近年来已成为片形吸虫病最常用的辅助诊断手段。该文主要综述了片形吸虫病免疫诊断抗原的研究进展。     

云南省片形吸虫和片形吸虫病研究进展

片形吸虫病是一种人兽共患寄生虫病,严重危害人类生命健康、阻碍社会经济发展。片形吸虫主要感染牛、羊等反刍动物,但近年来随着诊断水平的提升,人体片形吸虫感染病例报道有所增多。云南省人体片形吸虫病多年来主要以散在病例发生,并出现过暴发流行,已引起高度关注。本文主要就云南省片形吸虫虫种分布和片形吸虫病研究状况进行综述。     

片形吸虫病研究进展北大核心CSCD

片形吸虫病(fascioliasis)是由片形吸虫(Fasciola spp.)感染引起的人兽共患病,可导致感染者肝、胆病理损伤;牲畜感染引起产奶、产肉量降低,造成经济损失,是影响中国公共卫生和畜牧业经济发展的重要问题。由于其症状与其他肝胆疾病类似,常被误诊。片形吸虫对三氯苯达唑耐药性的出现成为片形吸虫病防治的重大隐患,寻找敏感特异的诊断方法和有效的药物、疫苗成为片形吸虫病防治的重点。本文综述了片形吸虫病流行概况、诊断、药物治疗与耐药性。     

2016年云南3例就诊片形吸虫病例报告

目的了解片形吸虫病例特征,为及时诊治提供参考。方法描述分析片形吸虫病3例患者的流行病学、临床表现、实验室检查、诊治及愈后。结果 3病例均有食生凉拌生菜史,粪便检查发现肝(大)片形吸虫卵。采用三氯苯达唑治疗片形吸虫病疗效显著,预后良好。结论片形吸虫病症状不典型,极易造成误诊,流行区应注意及时诊治。     

三氯苯达唑治疗肝片形吸虫病例报告

报告1例肝片形吸虫患者采用三氯苯达唑、吡喹酮和阿苯达唑的治疗情况,吡喹酮和阿苯达唑对人肝片形吸虫病治疗无效,而三氯苯达唑能有效治疗。     

鄂西自治州肝片形吸虫病流行区传染源调查

肝片形吸虫病是由肝片形吸虫(Fasciolahepatica Linnaeus,1758)寄生所致的一种人兽共患的目然疫源性寄生虫病。1979年朱维忠等报告了湖北省恩施地区4例肝片形吸虫病,嗣后,段帮鼐等1986年又报道了该地区利川市13例。我们于1989年在上述两个发病区进行了中间宿主及终末宿主的调查。一、中间宿主从利川、恩施两市的小溪沟、水塘及稻田中采     

巨大片吸虫脂肪酸结合蛋白的分离、克隆和表达

全世界有三亿以上的牛、水牛感染片吸虫,每年经济损失超过30亿美元。肝片吸虫病引起宿主广泛肝组织损伤及贫血,长期化疗不能预防重复感染,并可能产生抗药性。采用疫苗控制片吸虫病,是一种价廉、高效、可靠,且能长期应用的好方法。 以往学者曾从肝片吸虫成虫提取一种Fh_(sm)Ⅲ_m成份,认为是一种有希望的片吸虫     

三氯苯哒唑成功治愈一例用吡喹酮治疗无效的片形吸虫病

片形吸虫病是一种极为罕见的人兽共患病,常常误诊且治疗措施不力。人因感染片形吸虫而致病,该病主要见于非洲、西欧和拉丁美洲。1992年以前,已有10 0多例报道。自从Yoshida等首次报道用硫双二氯酚(bithionol,BTN)成功治疗人片形吸虫病来,该药不仅被用来治疗片形吸虫病,而且还用于并殖吸虫病(肺吸虫病)、后殖吸虫病、裂头绦虫病等治疗。直到1994年,BTN因其副作用被禁止生产,逐渐被吡喹酮(praziquantel,PZQ )所代替。PZQ虽被广泛用于吸虫病的治疗,但治疗片形吸虫病的有效性尚存争议。患者,女,5 6岁,牧民,入院前有4天发热和右侧腹痛史。…     

温度对肝片形吸虫在小土锅螺体内发育影响的观察

目的探讨温度对肝片形吸虫毛蚴感染小土蜗螺及毛蚴在其体内发育的影响,以期了解片形吸虫的生物学特征,为防控肝片形吸虫病提供科学依据。方法从云南省大理市下关泰兴市场收集病牛肝胆管及胆囊内的肝片形吸虫虫体并剥离出虫卵,孵化出毛蚴,在实验室分批进行人工感染小土蜗螺并观察不同温度下螺内虫体的发育状况。结果平均水温10℃时肝片形吸虫幼虫在小土蜗螺体内只能发育到胞蚴阶段,12℃时只能发育到母雷蚴阶段,18℃时只能发育到子雷蚴早期阶段,22℃时发育到尾蚴阶段。结论温度是影响肝片形吸虫幼虫在小土蜗螺体内发育的重要因素。     

人体大片形吸虫虫卵发育观察

<正>片形吸虫病(fascioliasis)是由片形属的肝片形吸虫(Fasciola hapatica)和大片形吸虫(Fasciola gigantica)等片形吸虫感染引起的一类人兽共患寄生虫病"[1,2]。虫体主要寄生于人体肝脏,急性期主要表现为突发高热、腹痛,常伴有腹胀、呕吐、腹泻或便秘等消化道症状,肝脾大、腹水、贫血等。患者的急性期症状减退或消失后,数月或数年内可无明显不适,或有胃肠道轻度不适。此期病变可逐渐向慢性期过渡。慢性期(又称成虫阻塞期)为成虫长期寄生于肝内胆管,引起胆管炎、胆囊炎和胆管上皮增生等为主要病变基础的一系列临床表现。     

Natural history, clinicoradiologic correlates, and response to triclabendazole in acute massive fascioliasis

Fascioliasis is highly endemic in the Andean region of South America. Newer serological assays have improved our ability to diagnose acute fascioliasis. The diagnosis was established by Fasciola hepatica serology (Fas2-ELISA or Western blot) in 10 patients. Identifiable exposure included ingestion of watercress (N = 8), alfalfa juice (N = 5), and lettuce (N = 1). Computed tomography of the abdomen showed hepatomegaly (N = 9), track-like hypodense lesions with subcapsular location (N = 8), and subcapsular hematoma (N = 2). Radiologic sequelae included cyst calcifications detectable at least 3 years after treatment. Stool examinations were negative for F. hepatica eggs; serology was positive (Arc II [N = 2], Fas2-ELISA [N = 6], Western blot [N = 2]). The syndrome of eosinophilia, fever, and right upper quadrant pain, elevated transaminases without jaundice, hypodense liver lesions on CT, and an appropriate exposure history suggests acute fascioliasis. Fascioliasis is specifically treatable with a single dose of triclabendazole.     

Imported Fasciola hepatica infection in the United States and treatment with triclabendazole.

Infection with Fasciola hepatica, a liver trematode, is not frequently reported in the United States. We describe 2 patients, both originally from Cape Verde, who illustrate the spectrum of clinical presentations of F. hepatica as well as the means of treating infection with this parasite. Patient 1 had extensive disease and underwent multiple diagnostic procedures before the correct diagnosis was reached. Patient 2, who had few symptoms, had fascioliasis diagnosed by a noninvasive evaluation. Both patients were treated with triclabendazole without experiencing significant side effects. Fascioliasis that has been imported to the United States may elude prompt or accurate diagnosis. Obtaining a detailed travel history and recognizing the clinical presentation early in the course of infection may permit timely and noninvasive identification of infection. Triclabendazole is now the recommended drug for treating for fascioliasis because of its efficacy, safety, and ease of use.     

Successful treatment of acute fascioliasis with bithionol

Fascioliasis is the parasitic infestation of the liver and biliary tract related to Fasciola hepatica. Bithionol is proposed as the treatment of choice for human fascioliasis without major side effects. However, the efficacy of bithionol has been evaluated in chronic but not in acute fascioliasis. In this study we report on the success of treatment with bithionol in 10 patients with fascioliasis, 8 having acute fascioliasis. The criteria for the diagnosis of fascioliasis were hypereosinophilia, positive immunoelectrophoresis and indirect hemagglutination. Bithionol was given orally to hospitalized patients at the daily dose of 25 mg/kg body wt for 10 days. Three patients with acute fascioliasis received a second course of bithionol 2 or 3 mo after the first because of the recurrence of diarrhea and fatigue in one patient and persistent hypereosinophilia in two patients. All patients were cured. The follow-up period after the first course of treatment was between 16 and 47 mo. No major side effects were observed. We conclude that bithionol is the drug of choice for both acute and chronic fascioliasis. Moreover, its oral administration may allow treatment of fascioliasis in outpatients who do not have serious symptoms.     

Burden of Fasciola hepatica Infection among children from Paucartambo in Cusco, Peru

There is a high prevalence of fascioliasis in the Peruvian highlands, but most cases remain undiagnosed. The burden of disease caused by chronic subclinical infection is largely unknown. We studied school-age children from a district in Paucartambo Province in Cusco, Peru to evaluate the burden of disease caused by subclinical fascioliasis. Parasite eggs and/or larvae were identified in 46.2% of subjects, including Fasciola hepatica in 10.3% of subjects. Fascioliasis was independently associated with anemia (adjusted odds ratio = 3.01 [1.10-8.23]). Subclinical fascioliasis was common among children and strongly associated with anemia. Anemia should be recognized as an important component of the burden of disease from fascioliasis.     

Human fascioliasis successfully treated with triclabendazole

Fascioliasis, caused by the common liver fluke Fusciolu hepatica , is an endemic infection in sheep and cattle in many parts of Australia. Infections in humans in Australia have been reported infrequently and the most appropriate therapy for human fascioliasis remains to be determined. This case report describes a patient with the infection unsuccessfully treated with multiple high doses of praziquantel, mebendazole or albendazole. The infection was successfully eliminated by the administration of triclabendazole in two single doses of 900 mg (12 mg/kg) two days apart. No side effects were observed after the treatment. Based on our experience and that recently reported in the literature, triclabendazole may be regarded as the drug of choice for the treatment of human fascioliasis. (Aust NZ J Med 1992; 22: 45–47.)     

CASE OF FASCIOLIASIS: EXTRACTION WITH ENDOSCOPIC RETROGRADE CHOLANGIOGRAPHY

Fascioliasis is a worldwide zoonotic infection with fasciola hepatica and fasciola gigantica. The zoonoses are particularly endemic in sheep‐raising countries and are also endemic in Turkey. Clinical features of fascioliasis relate to the stage and intensity of infection. Fasciola hepatica infection comprises two stages: hepatic and biliary, with different signs and symptoms. Cholestatic symptoms may be sudden, but, in some cases, they may be preceded by a long period of fever, eosinophilia and vague gastrointestinal symptoms. We reported a case with fever and upper‐quadrant abdominal pain since 3 months that comes from an area endemic for fasciola hepatica, with suspected imaging about fasciola hepatica in common bile duct on ultrasonography. After that, fasciola hepatica was extracted with endoscopic retrograde cholangiography.     

Fascioliasis: a report of five cases presenting with common bile duct obstruction

Fascioliasis is a zoonotic infection caused by Fasciola hepatica. It is rarely seen with icterus caused by obstruction of the common bile duct. We report five patients with obstructive jaundice due to Fasciola hepatica, who were diagnosed and managed with endoscopic retrograde cholangiopancreatography (ERCP). All cases were admitted to hospital with complaints of icterus and pain in the right upper quadrant of the abdomen; their biochemical values were interpreted as obstructive jaundice. Ultrasound and computer tomography (CT) revealed biliary dilatation in the common bile duct, but did not help to clarify the differential diagnosis. ERCP showed the presence of Fasciola hepatica in the common bile duct. After removing the flukes, the symptoms disappeared and the biochemical values returned to normal. Biliary fascioliasis should be considered in the differential diagnosis of obstructive jaundice. This report confirms the diagnostic and therapeutic role of ERCP in patients with obstructive jaundice caused by biliary fascioliasis.     

Fascioliasis presenting as colon cancer liver metastasis on 18Ffluorodeoxyglucose positron emission tomography/computed tomography: A case report

BACKGROUND Fascioliasis is caused by watercress and similar freshwater plants or drinking water or beverages contaminated with metacercariae. Fascioliasis can radiologically mimic many primary or metastatic liver tumors. Herein, we aimed to present the treatment process of a patient with fascioliasis mimicking colon cancer liver metastasis.CASE SUMMARY A 35-year-old woman who underwent right hemicolectomy due to cecum cancer was referred to our clinic for management of colon cancer liver metastasis. Both computed tomography and 18 F-fluorodeoxyglucose positron emission tomography revealed several tumoral lesions localized in the right lobe of the liver. After a 6-course FOLFOX(folinic acid, fluorouracil, oxaliplatin) and bevacizumab regimen, the hypermetabolic state on both liver and abdominal lymph nodes continued, and chemotherapy was extended to a 12-course regimen. The patient was referred to our institute when the liver lesions were detected to be larger on dynamic liver magnetic resonance imaging 6 weeks after completion of chemotherapy. Right hepatectomy was performed, andhistopathological examination was compatible with fascioliasis. Fasciola hepatica Ig G enzyme-linked immunosorbent assay was positive. The patient was administered two doses of triclabendazole(10 mg/kg/dose) 24 h apart. During the follow-up period, dilatation was detected in the common bile duct, and Fasciola parasites were extracted from the common bile duct by endoscopic retrograde cholangiopancreatography(ERCP). Triclabendazole was administered to the patient after ERCP.CONCLUSION Parasitic diseases, such as those caused by Fasciola hepatica, should be kept in mind in the differential diagnosis of primary or metastatic liver tumors, such as colorectal cancer liver metastasis, in patients living in endemic areas.     

Circulating immune complexes in human fascioliasis. Relationship with Fasciola hepatica egg output

Circulating immune complexes were investigated by the 125I-Clq binding test in serum from patients with fascioliasis. Only 36% of all the patients studied showed significant levels of CIC. Nevertheless, when we considered only the patients eliminating Fasciola hepatica eggs in the stool and/or with the acute phase of the infection, the detection of CIC was very higher (more than 70% of the cases). In addition, a close relationship was observed between F. hepatica egg output and the incidence of CIC. This data suggest strongly the occurrence of specific parasite antigens in the detected CIC. The involvement of CIC in the pathogenesis of the acute hepatic fascioliasis is discussed.     

Preliminary antigenic characterisation of an adult worm vomit preparation of Fasciola hepatica by infected human sera

Fascioliasis is an emerging/re-emerging vector-borne disease with the widest known distribution. Approximately 17 million people are infected around the world, being the Andean region the most affected area. There is an important necessity to develop sensitive and specific diagnostic tools to treat patients early and to avoid complications. In this paper we evaluated the immune response of infected humans against two antigenic preparations: the total soluble extract (FhTSE) and the adult worm vomit (FhAWV) in order to identify antigenic fractions specific for Fasciola hepatica. Both preparations were processed by SDS-PAGE and Western blot with human sera with fascioliasis (F), other parasitosis and healthy individuals. In the immunoblot of FhTSE, sera F recognised 16 bands with MW between eight and 110 kDa, from which those of 8, 9, 10, 38, 45 and 57 kDa were specific. In the preparation FhAWV, sera F recognised nine bands with MW from eight to 85 kDa, from which those of 8, 12, 15 and 24 kDa were specific. Some bands of cross-reaction were evident with sera from patients with other parasitoses, more frequent with the FhTSE. Bands within the MW mentioned, particularly that of eight kDa, have been shown to be specific by others, and deserve additional characterisation for their potential use in immunodiagnosis.