Saturday, 12 August 2023

CASE 695: Fasciola sp, UNUSUAL CAUSE of THICKENING of G I TRACT, Dr PHAN THANH HẢI, Dr TRẦN NGÂN CHÂU, Dr LÊ ĐÌNH VĨNH PHÚC, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

  

Two cases of infected Fasciola sp whose larva migrants having in the same time some hepatic lesions and thickening of duodenum (2023) and right colon wall (2017) that are noted at Medic Center. 

CASE ONE:  A male patient 45 year-old, with history of thyroid cancer in 2013, enters a hospital as nausea, abdominal pain without fever after a ceremony buffet one day before.  Ultrasound detects hepatic lesions, and MRI  later reveals lesions in caudate lobe of liver and duodenum D3 wall thickening that is thought a case of infiltration of lymphoma on GI tract and liver.

But lab data notes raised highly the eosinophil proportion (48%) and positive Elisa tests for Fasciola sp and Gnathostoma.
Ultrasound of Medic Center confirmes liver lesions  and  duodenum D3 wall thickening  that maybe concludes due to infected parasites.





After 6 weeks managed by medical parasite drugs for Fasciola sp the male patient remains well; liver lesions reduce its sizes and duodenum wall gets normal on ultrasound and abdominal MSCT , and getting downed the eosinophil proportion.




CASE TWO: 

A female patient with Fascioliasis lesions in her liver and her right colon wall thickening in the same time which were detected by ultrasound and MSCT. 



Endoscopic biopsy of colon result was epithelial inflammation with eosinophil white blood cells.


She was managed successfully as Fasciola visceral larva migrants.
Larva migrants, especially for Fasciola sp, have a classic site in liver and biliary tree in acute phase and chronic phase. 
It exists two cases of larva migrants going outside the liver and biliary tree, to GI tract. If having lesions of it in liver or biliary tree one should not forget to find out larva migrants in another place.

REFERENCES:

https://www.nguyenthienhung.com/2008/10/c-im-siu-m-tn-thng-gan-do-sn-l-gan-ln.html?m=1

Ultrasound and Fascioliasis at MEDIC CENTER, Vietnam (slideshare.net) Oct, 21, 2013











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