Decrease in human fascioliasis in Gipuzkoa (Spain)

Helminthosis and eosinophilia in Spain (1990-2015)

The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations.

Sonographic findings of hepatic lesions in human fascioliasis

PURPOSE

The aim of this retrospective study was to analyze the sonographic features of hepatic lesions in patients with fascioliasis to help determine the utility of sonography in diagnosing this disorder in patients from areas in which Fasciola hepatica infestation is endemic.

METHODS

Seven patients with acute-phase (hepatic) fascioliasis had been identified among a previously reported series of 37 patients with fascioliasis who had been evaluated sonographically at Donostia Hospital in San Sebastián (Guipúzcoa), Spain. The 4 men and 3 women ranged in age from 29 to 69 years (mean, 49 years). A history of ingestion of watercress had been confirmed in 6 of the patients.

RESULTS

Sonographically, the hepatic lesions appeared as focal areas of increased echogenicity in the right lobe (2 cases), multiple nodular or irregular lesions of variable echogenicity, ranging from 5 to 25 mm in diameter, in both lobes (4 cases), and a single 6-cm complex mass in the right hepatic lobe (1 case). Therapy with dehydroemetine, praziquantel, or bithionol resulted in complete remission, although 2 patients required an additional treatment cycle. One patient also underwent surgery.

CONCLUSIONS

Sonography can be useful in the detection and follow-up of hepatic lesions in human fascioliasis and can facilitate the diagnosis of this condition, particularly in areas where it is endemic.