Internal Medicine

0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15

908 Liver Fluke Infections

infection, no symptoms or findings, or in heavy infections can find

chronic abdominal aches, fatigue, urticaria, hepatomegaly.

tests

■Basic tests: blood: eosinophilia, may be pronounced

■Basic tests: urine: normal

■Specific tests: Stool for O&P shows eggs. They are hard to distinguish

from other small flukes.

■Other tests: Ultrasound or CT may show defects along intrahepatic

biliary tree. In obstruction, worms found at surgery. Serology, avail-

able in some labs, can be helpful.

differential diagnosis

■Other inflammatory liver diseases, hepatic tumors

management

What to Do First

■Determine severity.

General Measures

■Assess for source of infection.

specific therapy

Indications for Treatment

■All patients

Treatment Options

■Praziquantel for 1 day

■Albendazole for 7 days

Side Effects & Complications

■Mild GI upset may occur.

■Contraindications to treatment: absolute: allergy to medications

■Contraindications to treatment: relative: asymptomatic patient with

few eggs will do well without treatment.

follow-up

Routine

■Stool O&P 2 or more weeks after treatment