title: The variable presentations and broadening geographic distribution of hepatic fascioliasis.
abstract: We report 2 unrelated cases of hepatic fascioliasis in travelers returning to the United States from Africa and the Middle East. The first case presented with acute infection. Prominent clinical features included abdominal pain, elevated liver transaminases, serpiginous hepatic lesions, pericapsular hematoma, and marked peripheral eosinophilia. The second case was diagnosed in the chronic stage of infection and presented with right upper quadrant abdominal pain, cystic hepatic lesions, and an adult fluke in the common bile duct. We review the life cycle of Fasciola species, the corresponding clinical features during the stages of human infection, diagnostic methods, and the evolving understanding of the epidemiology of human fascioliasis, particularly emphasizing fascioliasis in African countries.
authors.affiliation: Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado 80045, USA. sarah.rowan@ucdenver.edu
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Rowan
authors.forename: Marilyn E
authors.initials: ME
authors.lastname: Levi
authors.forename: Jean M
authors.initials: JM
authors.lastname: Youngwerth
authors.forename: Brian
authors.initials: B
authors.lastname: Brauer
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Everson
authors.forename: Steven C
authors.initials: SC
authors.lastname: Johnson
mesh_terms: D000349:Africa; D000368:Aged; D000818:Animals; D005210:Fasciola hepatica / Q000254:growth & development / Q000302:isolation & purification*; D005211:Fascioliasis / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008018:Life Cycle Stages; D008297:Male; D008875:Middle Aged; D019371:Topography, Medical; D014195:Travel; D014481:United States