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[Hepatic fascioliasis in children: uncommon clinical manifestations]
M Almendras-Jaramillo1, J Rivera-Medina, J Seijas-Mogrovejo
1Departamento de Pediatria, Universidad Peruana Cayetano Heredia, Lima, Peru.
Insights
This review details four pediatric cases of Fasciola hepatica infection in Peru. Diagnosis involved identifying parasite eggs, with most patients responding to treatment, though one fatality occurred.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Clinical Epidemiology
Background:
- Fasciola hepatica is a parasitic liver fluke that can cause significant morbidity in children.
- Understanding its clinical presentation and evolution is crucial for timely diagnosis and management.
Observation:
- Four pediatric cases of Fasciola hepatica infection were reviewed retrospectively.
- Patients presented with diverse symptoms including fever, hepatomegaly, edema, gastrointestinal hemorrhage, jaundice, and hemobilia.
- Diagnosis was confirmed by detecting parasite eggs in fecal samples.
Findings:
- Clinical manifestations varied, with some patients exhibiting severe complications like esophageal varices and cirrhosis.
- Three out of four patients responded well to bithionol treatment.
- One patient succumbed to systemic failure, highlighting the potential severity of the infection.
Implications:
- Early diagnosis of Fasciola hepatica in children is vital for effective treatment and preventing severe complications.
- Case reviews like this contribute to a better understanding of the disease spectrum in pediatric populations.
- Further research into optimal treatment strategies and outcomes for pediatric fascioliasis is warranted.
Abstract:
The present review has the objective to identify clinical epidemiologic characteristics and evolution for four children with Fasciola hepatica evaluated at the Pediatric Gastroenterology Unit at the Children's Health Institute, Lima, Peru, between 1988 and 1992. The first patient was a 9-year old girl who had fever, leg edema, collateral circulation and hepatomegaly, predominantly at the right lobe. The second was a 6-year old by who had upper gastrointestinal hemorrhage and fever; endoscopic diagnosis demonstrated hemobilia. The third case was a 12-year old boy who presented generalized edema. The fourth patient was a 9-year old boy with jaundice, fever and upper gastrointestinal hemorrhage. Esophageal varices and cirrhosis were present. In the four patients the diagnosis was made by the identification of parasite eggs in the feces. The first three cases responded satisfactorily to treatment with bithionol; the fourth patient died because of systemic failure.