Hepatic fluke: symptoms and treatment
What is a liver fluke?
The hepatic fluke is a flatworm that belongs to the class of digenetic flukes. It parasitizes in the biliary tract, as well as in the liver of humans and other warm-blooded animals.
Hepatic flukes are called worms of various kinds, including:
- Lancet fluke.
- Eastern fluke.
- Giant liver fluke.
- Hepatic fasciola.
- Cat fluke, etc.
For humans, a giant fluke and hepatic fasciola are dangerous. These two types of flukes provoke a disease called fascioliasis.
The giant fluke is quite impressive in size, its body can reach 76 mm in length and 12 mm in width.
Hepatic fluke has a leaf-shaped flat body. There are two suction cups on the parasite's head. The length of the liver fluke can reach 20-30 mm, and the width is 12 mm. Immediately after the short esophagus, the parasite has two intestinal loops that blindly end. The worms are hermaphrodites, inside their bodies are unpaired ovaries, a small uterus and two branched testes. In the external environment, parasites secrete large oval eggs, covered with a yellow shell.
Outbreaks of parasitic infestation are both massive and sporadic. The statistical coverage of the population affected by fascioliasis ranges from 2.5 to 17 million people. The main symptoms of human infection with a hepatic fluke are: fever, urticaria, nausea, pain in the right hypochondrium.
Pets (cattle, small cattle, horses, rabbits, donkeys and sheep) are most often the permanent owner of the hepatic fluke, less often humans become infected. The liver fluke can parasitize in the body of wild animals, including kangaroos, beavers, deer, squirrels, etc.
The next hepatic fluke, which parasitizes in the human body, is a trematode of the genus opisthorchis, which provokes a disease called opisthorchiasis.
An adult is a flat parasite, the body of which can reach 18 mm in length and 2 mm in width. The anterior end of the worm's body is pointed, the suction cups are located on the peritoneum and on the upper body (oral sucker). The digestive system of the parasite is not closed; there is an excretory canal at the posterior end of the body.
The trematode has both male and female reproductive organs. For reproduction, one individual parasite in the body is enough.
This parasitic invasion is widespread throughout the world, but the palm belongs to Russia. In some regions, the number of the infected population reaches 75%, which is explained by food traditions (the use of dried, slightly salted or frozen fish). Cases of opisthorchiasis are recorded in Belarus, Kazakhstan, Ukraine, Western Europe, etc.
Another worm - the hepatic fluke, which is capable of parasitizing in the human body - is the lanceolate fluke. This trematode causes a disease called dicroceliosis.
The parasite reaches 15 mm in length and 5 mm in width. Just like other liver flukes, lanceolate flukes are hermaphrodites. They lay eggs that have already developed miracidium. The larva will hatch after it enters the body of the first intermediate host.
It should be noted that dicroceliosis is a rare disease in humans. Medicine knows only a few cases of parasitic invasion by this hepatic fluke. The final owner of the lanceolate fluke is most often small and cattle.
Find out more: Liver fluke systems
- What organs are affected by the hepatic fluke?
- The first signs and symptoms of hepatic fluke
- Ways of infection by the hepatic fluke
- Hepatic fluke treatment
- Prevention of hepatic fluke
What organs are affected by the hepatic fluke?
The hepatic fluke affects the human hepatobiliary system. It includes the liver, intrahepatic and extrahepatic bile ducts, and the gallbladder.
The first signs and symptoms of hepatic fluke
The first signs of a hepatic fluke are associated with the incubation period of the parasite's development.
There are three stages of parasitic invasion:
Symptoms of the hepatic fluke at the stage of the incubation period
The incubation period can last from 7 days to 2 months. It depends on how many parasites have entered the body. At this time, the infected person does not experience any signs of illness.
Symptoms of the hepatic fluke in the acute stage
This stage is also called migration.
It is characterized by general toxic and allergic symptoms, including:
- Increased body temperature. The mark on the thermometer can remain at the level of subfebrile digits, or it can rise to 39-40 ° C. The temperature can rise in waves, and it can be remitting, when daily fluctuations exceed 1-2 degrees.
The patient experiences weakness, headaches, general malaise.
- Of the allergic reactions, urticaria most often appears, which is accompanied by severe itching of the skin. The development of Quincke's edema is not excluded.
- Dyspeptic disorders are characteristic, including pain in the right hypochondrium, nausea and vomiting.
- The liver increases in size, jaundice develops. On palpation, the organ responds with pain.
- Chest pain is a sign of developing myocarditis of an allergic nature. Possible increase in blood pressure, increased heart rate.
- The number of eosinophils and leukocytes in the blood increases.
The acute phase can last for several weeks, after which the symptoms of the disease disappear.
Chronic liver fluke symptoms
Chronitization of the parasitic disease occurs 3-6 months after the invasion.
At the same time, the symptoms that indicate damage to the liver and biliary tract come to the fore:
- The patient experiences frequent paroxysmal pain in the right side.
- During an exacerbation of the disease, jaundice develops.
- The liver remains constantly enlarged.
- The longer the untreated invasion persists, the worse the prognosis. The formation of cirrhosis of the liver, hepatitis, anemia is possible.
- Secondary infection is dangerous, which can provoke liver abscess, purulent cholangitis and cholecystitis.
Medicine knows cases when hepatic flukes developed in the mammary glands, in the brain, in the lung tissue, in the larynx and under the skin. Long-term stress of the immune system causes a person's susceptibility to diseases of various etiologies.
Find out more: Development stages of the hepatic fluke
Ways of infection by the hepatic fluke
Infection with liver fluke and giant fluke occurs when eating plants (garden and wild) that have been watered with water from fresh water bodies, provided that there were invasive worm larvae in it. Infection is possible when drinking unboiled water, if water is swallowed while bathing.
Infection with the liver fluke, which causes opisthorchiasis, occurs when a person eats an infected fish that has not undergone high-quality heat treatment.
Infection with a hepatic fluke of the genus fluke lanceolate occurs when the invasive ants are accidentally swallowed, for example, while eating berries, meadow grasses, vegetables from the garden, etc.
Thus, the route of infection by the liver fluke is food. That is, in order for any worm - a hepatic fluke to begin to parasitize in the human body, it will need to get into the gastrointestinal tract.
Find out more: Development cycle of the hepatic fluke
Hepatic fluke treatment
Treatment of the hepatic fluke consists of two stages. The first stage is preparatory, and the second is aimed at direct elimination of the parasite from the human body.
The first stage of treatment for hepatic fluke
Treatment of this parasitic invasion is carried out in a hospital setting, although if the patient feels well, outpatient management of the patient is possible. If the disease is diagnosed in the exacerbation phase, then the patient is transferred to a sparing diet and desensitizing drugs are prescribed. To eliminate allergic manifestations, drugs such as Suprastin, Tavegil, Zirtek, Zodak, etc. can be prescribed.
As for the diet, when getting rid of the hepatic fluke, the table number five according to Pevzner is considered optimal. Spicy, smoked and fried foods are removed from the menu. It involves steaming, boiling and baking food. After completing the second stage of treatment, the patient is advised to consume more fiber-rich foods, which will help increase intestinal motility and improve bile flow.
To remove toxins from the body, the patient is prescribed Smecta, Polyphepan and other sorbents. To reduce body temperature, it is possible to take Ibuprofen or Butadion. In addition, these medicines act as anti-inflammatory drugs. Glucocorticosteroids are prescribed against the background of myocarditis.
The second stage is the antiparasitic treatment of the hepatic fluke
Antiparasitic therapy begins after the symptoms of the acute phase of the disease subside.
Drugs that are prescribed for the treatment of hepatic fluke:
- Chloxil (taken for 3-5 days).
- Praziquantel (Biltricide). The drug is taken once.
- Triclabendazole. Depending on the severity of the infection, a single or double dose of the drug is possible.
Choleretic drugs are prescribed for the speedy removal of dead parasites from the human body, in addition, they prevent the stagnation of bile. These can be drugs such as Holiver and Holosas.
Control diagnostics with stool analysis and duodenal intubation is carried out 3 months later and six months after treatment.
Taking antibiotics is necessary in case of the development of purulent complications. Surgical intervention with drainage of the liver, bile ducts, etc.
The third stage is the restoration of the body after treatment of the hepatic fluke
Since the hepatic fluke disrupts the work of the digestive system and the functioning of the body as a whole, patients will need to undergo a rehabilitation period.
It may include the following activities:
- Normalization of the gallbladder and liver using a course of choleretic drugs (Holiver, Holosas, Allohol, Holagol, etc.).
- Improving liver function, protecting and restoring it with the help of hepatoprotective drugs. These can be funds such as Ursosan, Galstena, Silymarin, etc.
- Normalization of digestive processes with the help of enzyme preparations (Pancreatin, Creon, Panzinorm, etc.).
- Improving metabolism with multivitamins.
The earlier the disease was detected, the faster and easier it is to achieve a complete recovery. If the invasion of parasites is highly intense, or if a secondary bacterial infection has joined, then the prognosis is significantly worse. Even the death of the patient is not excluded.
Prevention of hepatic fluke
Prevention of hepatic fluke is a set of measures that will prevent the development of the disease:
- Under no circumstances should you drink raw water from reservoirs.
- Vegetables, fruits, garden herbs, berries must be thoroughly washed before eating.
- You should stop eating raw fish.
Government services play an important role in the prevention of hepatic fluke. They are obliged to prevent pollution of water bodies from the ingress of fecal matter into them, to fight the reproduction of molluscs. Preventive measures for deworming livestock, as well as conducting sanitary and educational work among the population are no less important.
Doctors have the task of timely identifying patients who are carriers of the baked fluke and their high-quality treatment. If you suspect a parasitic invasion, you should contact an infectious disease specialist.
Author of the article: Danilova Tatyana Vyacheslavovna | Infectionist
Education: in 2008 received a diploma in General Medicine (General Medicine) at the Pirogov Russian Research Medical University. Immediately passed an internship and received a diploma of a therapist