[Hepatic fascioliasis. Uncommon cause of prolonged febrile syndrome with hypereosinophilia and hypodense images on computed tomography of the liver].
A 40 year old man was admitted with prolonged fever, hypereosinophilia, increased serum levels of cholestasis enzymes and low density masses in the hepatic computed tomography (CT). A liver needle biopsy was performed under CT control. Neoplastic, pyogenic or amoebic etiology were excluded. Stool parasitologic examination was also negative. A diagnosis of hepatic fasciolasis was based on the finding of operculate eggs in duodenal juice obtained by duodenal aspiration. The patient was successfully treated with triclabendazole (10/mg/kg/single dose). The purpose of this communication is to emphasize 1) that prolonged fever with hypereosinophilia and focal lesions in hepatic CT suggest the presence of fasciola hepatica which must be investigated particularly in duodenal juice; 2) the CT aspects of this disease; 3) that triclabendazole, a benzimidazolic compound, is a new therapeutic possibility acting on immature and adult forms of the parasite in the liver.
Melero
M
M
Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Rigou
R C
RC
Lloveras
J
J
Gennaro
O
O
D000328:Adult; D000871:Anthelmintics / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D004802:Eosinophilia / Q000209:etiology*; D005211:Fascioliasis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005334:Fever / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D014057:Tomography, X-Ray Computed; D000077682:Triclabendazole
D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole
Fasciolasis hepática. Causa infrecuente de síndrome febril prolongado con hipereosinofilia e imágenes hipodensas en la tomografía computada de hígado.