RESUMEN
Human hepatic fasciolosis has been reported in 81 countries, some of which are endemic areas. In Europe, case reports from humans were published in Portugal, Spain, France, and Italy. Regarding Romania, we do not have any data on the prevalence of this parasitosis, with the exception of two cases of twins that were born in Romania and diagnosed in the last 37 years in Italy after joining their mother that lived there. We report the case of a patient diagnosed in Romania with chronic fasciolosis, presented as a hepatic pseudotumor that was diagnosed during the histopathological examination of the hepatic lesion. The patient received oral treatment with triclabendazole, two doses of 10 milligrams (mg) per kilogram (kg) of body weight, given 12 h apart, with no side effects during or after the treatment. The evolution of the patient was favorable. In conclusion, even in areas free of human fasciolosis, the presence of an anemic syndrome especially in children, abdominal pain in the upper quadrants, associated or not with other digestive manifestations, even more so associated with eosinophilia in the acute phase, should be carefully evaluated for ruling out a parasitosis such as fasciolosis even in countries where this diagnosis seems unlikely.
RESUMEN
Se realizó un estudio clínico epidemiológico para determinar la ocurrencia de fasciolosis hepática humana y parasitosis intestinales en el caserío Mesa Arriba, municipio Carache. estado Trujillo, Venezuela, zona descrita como endémica para fasciolosis bovina, donde dos casos aislados, se han reportado en humanos. Se estudiaron 98 personas previo consentimiento informado, a quienes se les realizó una encuesta epidemiológica, examen físico, hematología, aminotransferasas, estudio coproparasitológico y serológico: ELISA con antígeno de excreción-secreción de adultos de Fasciola hepatica (AFhES) y Western blot(WB). Con base en los datos obtenidos, se conoció que el 88,8% de los participantes había consumido berro silvestre (Rorippa nasturtium aquaticum) y 59,2% tuvo contacto con ganado vacuno. En el estudio coproparasitológico se encontró que el 47,9% presentó algún tipo de parásito intestinal, 20,4% correspondió a helmintos, 15,3% a protozoarios y 12,2% a infecciones mixtas. No se encontraron huevos de Fasciola hepatica. El 18,4% de las personas mostró eosinofilia. Se obtuvo un suero positivo por el método de ELISA, con bandas inespecíficas al WB-AFhES. Se administró tratamiento específico para parásitos intestinales. No se demostró fasciolosis humana en este trabajo, a pesar de encontrar factores favorables a la infección, pero el mismo representó una aproximación a su estudio epidemiológico en el estado Trujillo.
A clinical-epidemiological study to determine the occurrence of human hepatic fasciolosis and intestinal parasitosis was done at the Mesa Arriba Village, Carache Municipality, Trujillo State, Venezuela, area which has been described as endemic for bovine fasciolosis and where two isolated cases have been reported in humans. The study included 98 persons who, after previously signing an informed consent form, answered an epidemiological survey and were physically examined and submitted to the following laboratory tests: complete hematology, aminotransferase, and coproparasitology and serology; ELISA using Fasciola hepatica adult excretion-secretion antigen (AFhES) and Western Blot (WB). Based on the results obtained, it was found that 88.8% of participants had consumed wild watercress (Rorippa nasturtium aquaticum) and 59.2% had contact with bovine cattle. The coproparasitological study showed that 47.9% had some type of intestinal parasite: 20.4% corresponded to helmints, 15.3% to protozoa, and 12.2% mixed infections. There were no Fasciola hepatica eggs; 18.4% of the individuals showed eosinophilia. The ELISA test gave one positive serum with non-specific WB-AFhES bands. Specific anti-intestinal parasite treatment was indicated. Human fasciolosis was not demonstrated in this study, in spite of finding favorable factors for this infection, but is represents and approximation to its epidemiological study at Trujillo State.