A case of human infecton of Fasciola sp

• Published in: Kanzo Vol. 18; no. 8; pp. 571 - 578
• Main Authors: TAMURA, Masahiro, MATSUI, Tsutomu, TSUJII, Tadasu, YAMANAKA, Fumio, INOKI, Shozo, ARAKI, Tsuneji, HASHIMOTO, Toshio
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Hepatology 1977
• ISSN: 0451-4203; 1881-3593; 1881-3593
• DOI: 10.2957/kanzo.18.571

Besides this report, 22 cases of human infection with Fasciola hepatica have been reported in Japan. The present case is a 66 years old famer who has lived in Nara Prefecture since his birth. His complaints were irregular fever and discomfort sensation on the right hypochondrium. A clinical examination revealed high eosinophilia, increase in γ-globulin, IgG, IgM and IgE, and slight elevation of GOT, GPT, Al-P and LAP. A skin test with Fasciola hepatica antigen was positive. A precipitation bands were observed between the patient's serum and Fasciola hepatica antigen using the Ouchterlony double immunodiffusion method and immunoelectrophoretic method. Liver scintigraphy with 99mTc revealed a massive defect occupying the whole left lobe. Displacement of the left hepatic artery and the disappearance of its peripheral branches were observed on selective celiac angiogram. Laparoscopic examination showed a white and yellow coated nodular surface and a brownish green tumor on the inferolateral part of the left hepatic lobe. Microscopy of the liver specimen therefrom showed the presence of eosinophilic granuloma. Repeated examinations by the AMS III method revealed the presence of Fasciola eggs in feces, the size being 140μ and 62μ wide. The tumor in the left hepatic lobe disappeared by the daily dose of 50 mg/Kg bithionol on every other day for 40 days, and the clinical findings were improved during and after treatment.