Human Fasciola hepatica Infection in Türkiye is More Then We Knew: A Systematic Review

Fasciola hepatica is a trematode that is easily visible to the naked eye. It infects sheep and cattle, but can sometimes be an accidental host in humans. This review was carried out to review the published studies on human Fasciola hepatica in Türkiye and to systematically examine the data obtained from the studies. Literature search was conducted using keywords such as "Fasciola hepatica, Fascioliasis, Türkiye (Turkey)" from "Pubmed, Google Scholar, Google" databases. In addition, poster presentations presented at congresses of national infectious disease societies on the subject were also included in the study. Eighty-four studies published in Türkiye between 1993-2022 and 183 cases examined in these studies were included in the evaluation. In this review, it was found that Fasciola hepatica infection is not rare in Türkiye, but clinicians were not aware of this and did not consider this infection in the differential diagnosis. It is seen that diagnostic methods such as serological and stool microscopy are not used adequately due to the fact that Fasciola hepatica infection is not considered in the differential diagnosis and the diagnosis methods is not available in every center. As Fasciola hepatica infection is not considered in the preliminary diagnosis and these diagnostic methods are not used sufficiently, we see that cases are often confused with primary or metastatic liver tumors in abdominal imaging, and therefore unnecessary invasive procedures are performed. In regions where Fasciola hepatica infection is endemic, Fasciola hepatica infection should be considered before performing a major surgical procedure in patients with typical clinical findings, elevated liver and cholestasis enzymes, and eosinophilia, and characteristic computed tomography or ultrasonography findings, and noninvasive diagnostic methods should be used first.