The Clinical Picture Caused by Fasciola gigantica: Analysis of 3250 Patients Along the 1995-2019 Countrywide Spread in Vietnam.

Abstract

Background: Fasciola gigantica is the causal agent of human fascioliasis, which is emerging in southern Asia and increasingly reported in Africa. Unfortunately, knowledge of the clinical picture by F gigantica is insufficient, because of the sporadic individual case reports, or few case series of short number of patients from areas where the 2 genetically pure fasciolid species geographically overlap and specific causality was not verified.

Methods: The clinical picture is assessed from patients examined in well-equipped hospitals of big cities in Vietnam. Records of 3250 Fasciola-infected patients were registered in individual cards and a database for their complete analysis was constructed. Case profile was based on typical symptoms, blood eosinophilia, serological test, imaging techniques, Kato-Katz test, and ex juvantibus confirmation. Anamnesis furnished information about place of residence, professional activities, and infection source.

Results: Symptoms, signs, and manifestations, including neurological, meningeal, neuropsychic, and ocular disorders, are analyzed according to frequency, sex, and age groups. Early patient diagnosis and treatment facilitated by radio broadcasting underlie differences between serological positivity, coprological positivity, and liver lesions and explain the absence of severe long-term complications and posttreatment sequelae.

Conclusions: This is the first sufficiently wide study of the clinical picture caused by F gigantica. The assessment has been made in a population without previous contact with fascioliasis and shows that F gigantica (and F gigantica-like hybrids) do not cause clinical pictures different from those caused by Fasciola hepatica. This clinical picture will be useful for physicians and health officers in endemic areas of Asia and Africa.