The clinical characteristics of fascioliasis in pediatric patients

Fascioliasis is a trematode flatworm infection caused by Fasciola hepatica and F. gigantica. Fasciola hepatica is mesoendemic in Turkey. Six cases of pediatric fascioliasis are presented here. All patients had histories of consumption of various raw vegetables. Four of our patients were at the hepatic phase, and two were at the biliary phase. Except for one patient, all patients had eosinophilia. In three patients, total IgE levels were markedly increased. In these patients, there was an eosinophilic leukomoid reaction accompanied by a high total IgE level. Except for one of our patients, all patients had positive indirect hemagglutination tests. This patient was diagnosed as having fascioliasis with a compatible clinical picture. Except one, all of our patients were completely treated with a single-treatment regimen of triclabendazole; one patient needed re-administration. Only in patient 1, liver enzymes increased after triclabendazole administration because he had taken the medication for longer than prescribed by mistake. The elevation of liver enzymes was not observed in the other patients who received the correct dose. All patients recovered completely with triclabendazole treatment. The patients' dietary habits, eosinophilia, and markedly elevated IgE levels may be significant predictors for physicians to suspect fascioliasis.