Challenges in Diagnosis and Treatment of Fasciola Infection

A 57-year-old female patient presented with fever, nausea, vomiting, loss of appetite, and weight loss within the last two months. Ceftriaxone and metronidazole therapy was start-ed upon discovery of a liver abscess but provided no benefit. Following the of abscess bi-opsy, the patient developed fever, itching, anemia, acute renal failure, hyperbilirubinemia, and eosinophilia that required intensive care unit (ICU) admission. The Fasciola hepatica antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Triclabendazole was started, after which the symptoms and magnetic resonance imaging (MRI) findings regressed. Even without eosinophilia, F. hepatica should be considered in cases with a liver abscess that does not respond to antibiotics.

Automated summary

This is a case of a 57-year-old female patient with symptoms of fever, nausea, vomiting, loss of appetite, and weight loss. Antibiotic therapy for liver abscess was ineffective. After liver abscess biopsy, the patient developed fever, itching, anemia, acute renal failure, hyperbilirubinemia, and eosinophilia. The patient was admitted to the intensive care unit and Fasciola hepatica antibodies were detected. Treatment with Triclabendazole led to improvement in symptoms and MRI findings.