Acute shock caused by Clonorchis sinensis infection: a case report

Area of Science:

• Parasitology
• Infectious Diseases
• Gastroenterology

Background:

• Clonorchiasis, caused by Clonorchis sinensis (C. sinensis), is a food-borne zoonotic disease often presenting with mild or asymptomatic infections.
• Delayed diagnosis of clonorchiasis can lead to chronic conditions and severe complications like cholangiocarcinoma.
• Acute shock as a direct consequence of C. sinensis infection has not been previously reported.

Purpose of the Study:

• To report the first fatal case of acute shock attributed to Clonorchis sinensis infection.
• To raise awareness regarding the potential severe complications of clonorchiasis.
• To emphasize the utility of specific diagnostic methods for C. sinensis.

Main Methods:

• A patient presenting with symptoms of acute shock and severe abdominal pain after consuming raw freshwater fish was investigated.
• Diagnostic imaging (CT scan) revealed cholecystitis and cholelithiasis, leading to cholecystectomy.
• Identification of C. sinensis was confirmed through morphological analysis and PCR of liver flukes found during surgery.
• Treatment with praziquantel led to the patient's recovery and restoration of liver function.

Main Results:

• A fatal case of acute shock was successfully linked to Clonorchis sinensis infection.
• The presence of C. sinensis was confirmed via morphological analysis and PCR.
• The patient recovered following anthelmintic treatment with praziquantel.

Conclusions:

• Clonorchis sinensis infection can precipitate acute shock, a rare but severe clinical presentation.
• This case underscores the importance of recognizing the potential for severe complications in clonorchiasis.
• Polymerase chain reaction (PCR) offers a valuable tool for accurate diagnosis, potentially preventing misdiagnosis and unnecessary surgical interventions.