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1
Esteban JG, Bargues MD, Mas-Coma S, 1998. Geographical distribution, diagnosis and treatment of human fascioliasis: a review. Res Rev Parasitol 58 :13–42.
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Mas-Coma S, Bargues MD, Esteban JG, 1999. Human fasciolosis. Dalton JP, ed. Fasciolosis. New York: CAB International Publishing, 411–434.
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Mas-Coma S, 2005. Epidemiology of fascioliasis in human endemic areas. J Helminthol 79 :207–216.
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Mas-Coma MS, Esteban JG, Bargues MD, 1999. Epidemiology of human fascioliasis: a review and proposed new classification. Bull World Health Organ 77 :340–346.
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Esteban JG, Gonzalez C, Bargues MD, Angles R, Sánchez C, Náquira C, Mas-Coma S, 2002. High fascioliasis infection in children linked to a man-made irrigation zone in Peru. Trop Med Int Health 7 :339–348.
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Marcos L, Maco V, Terashima A, Samalvides F, Espinoza JR, Gotuzzo E, 2004. Hiperendemicidad de fasciolosis humana en el Valle del Mantaro: factores de riesgo de la infección por Fasciola hepatica. Rev Gastroenterol Peru 24 :158–164.
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Maco V, Marcos L, Terashima A, Samalvides F, Miranda E, Espinoza JR, Gotuzzo E, 2002. Fas2-ELISA y la técnica de sedimentación rápida modificada por lumbreras en el diagnóstico de la infección por Fasciola hepatica. Rev Med Hered 13 :49–57.
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Keiser J, Engels D, Buscher G, Utzinger J, 2005. Triclabendazole for the treatment of fascioliasis and paragonimiasis. Expert Opin Investig Drugs 14 :1513–1526.
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Natural History, Clinicoradiologic Correlates, and Response to Triclabendazole in Acute Massive Fascioliasis
Fascioliasis is highly endemic in the Andean region of South America. Newer serological assays have improved our ability to diagnose acute fascioliasis. The diagnosis was established by Fasciola hepatica serology (Fas2-ELISA or Western blot) in 10 patients. Identifiable exposure included ingestion of watercress (N = 8), alfalfa juice (N = 5), and lettuce (N = 1). Computed tomography of the abdomen showed hepatomegaly (N = 9), track-like hypodense lesions with subcapsular location (N = 8), and subcapsular hematoma (N = 2). Radiologic sequelae included cyst calcifications detectable at least 3 years after treatment. Stool examinations were negative for F. hepatica eggs; serology was positive (Arc II [N = 2], Fas2-ELISA [N = 6], Western blot [N = 2]). The syndrome of eosinophilia, fever, and right upper quadrant pain, elevated transaminases without jaundice, hypodense liver lesions on CT, and an appropriate exposure history suggests acute fascioliasis. Fascioliasis is specifically treatable with a single dose of triclabendazole.