Fascioliasis: Clinical presentation and treatment of three cases

Aim: For the diagnosis of Fasciola hepatica disease first step is the direct microscopic examination of feces with clinical finding. In addition to the microscopic diagnosis, radiological examination, serological methods and ELISA method are used for the diagnosis of extra-intestinal helminth infections. If these investigations are not enough for diagnosis, surgical intervention and pathological examination can be required. Materials and Methods: In addition to the clinic symptoms and biochemical and hematological lab tests of three women who admitted to our hospital presenting with positive F. hepatica Indirect Hemagglutination (IHA) in microscopic and radiological examination, findings consistent with F. hepatica were detected in these patients and the difference between the starting time of symptoms and starting time of treatment has been emphasized. Results: There was no animal feeding history but a history of eating fresh vegetables in our case back grounds. Malignancy was suspected after the initial of symptoms in three of our cases and surgery was performed for two cases and the result of biopsy was compatible with abscess. F hepatica eggs were seen in direct microscopic investigation in one case. Cyst hydatic IHA test was detected positive at high titer in two cases. Eosinophilia was found in three cases as well and radiological findings were compatible with Fasciola infection. In our cases where Fasciola IHA test was positive, the duration between beginning of symptoms and diagnosis was approximately one to three months. Conclusions: Our results suggest that to confirm the diagnosis F. hepatica, microbiological, serological and radiological tests should be performed.