Clinical, laboratory features and treatment outcomes of patients infected with Fasciola in Northern Vietnam, 2019-2023.

Abstract

Background: Vietnam experiences a significant occurrence of fascioliasis infection, largely due to the common practice of consuming raw vegetables. Diagnosing the fascioliasis infection remains difficult, and patients endure various long-term consequences. The purpose of this study is to describe the clinical and laboratory features, along with the treatment approaches for fascioliasis patients in Vietnam.

Methods: The study included 31 patients diagnosed with fascioliasis in Northern Vietnam between 2019 and 2023. Blood ELISA testing, fresh stool microscopy, ultrasonography, and magnetic resonance imaging were all used to evaluate the patients. The patients received triclabendazole, and the efficacy of treatment was assessed three months later.

Results: All patients infected with Fasciola reported having raw vegetables and exhibited typical clinical symptoms of right hypochondriac pain (61%), epigastric pain (58%), exhaustion, and anorexia (42%). All patients presented with a hepatic lesion, with an average abscess measuring of 5.5 ± 2.8 cm. Increased eosinophil levels were noted in 77% and 68% of the patients, whereas only 13%, 36%, and 19% showed decreased red blood cell counts, elevated white blood cell counts, and increased liver enzyme levels, respectively. Following three months of treatment with triclabendazole, 81% of patients achieved cure, while 19% (6 patients) remained uncured. The patients who did not respond to the initial treatment received an additional dose of triclabendazole (20 mg/kg body weight) and were monitored for another three months; all of these patients were cured.

Conclusions: The functional symptoms associated with fascioliasis include right hypochondriac pain, epigastric pain, fatigue, anorexia, weight loss, and fever. However, observable physical symptoms such as enlarged liver, jaundice, and yellow eyes are uncommon. Patients may exhibit liver lesions and an increase in eosinophils, but they rarely present with elevated liver enzymes or anemia. Treatment using triclabendazole is highly effective; however, an additional dose of triclabendazole is necessary to reach optimal effectiveness.