Liver flukes diagnosed by ERCP in a local immigrant community

Area of Science:

• Hepatology
• Infectious Diseases
• Parasitology

Background:

• Liver flukes (Clonorchis sinensis) are common in Asia but considered rare in the United States.
• This series details three cases of C. sinensis diagnosed at a single institution.

Purpose of the Study:

• To report on the diagnosis of Clonorchis sinensis in patients presenting with biliary symptoms in the US.
• To raise awareness of this pathogen in clinical practice.

Main Methods:

• Three patients with biliary abnormalities underwent Endoscopic Retrograde Cholangiopancreatography (ERCP).
• Direct visualization and histopathologic confirmation of liver flukes were performed.
• Epidemiologic data, including recent immigration from China, were collected.

Main Results:

• All three patients were diagnosed with Clonorchis sinensis infection.
• Two patients had initially negative stool studies for ova and parasites.
• Histopathology and patient travel history confirmed the diagnosis.

Conclusions:

• Clonorchiasis should be considered in the differential diagnosis for patients with nonspecific biliary symptoms and risk factors.
• This highlights an 'uncommonly common' pathogen in specific patient populations.