[A man in his thirties with icterus and itching]

Area of Science:

• Hepatology
• Infectious Diseases
• Gastroenterology

Background:

• Opisthorchiasis/Clonorchiasis, a common cause of jaundice in Southeast Asia affecting 35 million people, is rarely seen in Europe.
• This case highlights a patient from Southeast Asia presenting with jaundice in Norway, a region with low endemicity.

Observation:

• A male patient from Southeast Asia presented with jaundice and itching, exhibiting cholestasis.
• Diagnostic imaging (ultrasound, MRCP, CT) ruled out mechanical obstruction or tumors.
• Endoscopic retrograde cholangiopancreatography (ERCP) revealed hookworms in the duodenum and parasite eggs in stool, consistent with Opisthorchiasis/Clonorchiasis.

Findings:

• The patient's jaundice was attributed to bile duct obstruction caused by liver flukes (Opisthorchiasis/Clonorchiasis).
• Microscopic examination of stool confirmed the presence of Opisthorchis/Clonorchis eggs and hookworm eggs.
• Liver biopsy and serological tests did not indicate infectious or autoimmune liver disease.

Implications:

• This case underscores the potential for parasitic liver fluke infections to cause jaundice in non-endemic regions like Europe, particularly with increasing migration.
• Early diagnosis and prompt treatment with Praziquantel are crucial for managing Opisthorchiasis/Clonorchiasis.
• Increased awareness and diagnostic vigilance are necessary for healthcare providers in Europe to recognize and treat these uncommon presentations.