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Fig. 21.23 Fasciola hepatica, adult fluke. Whole mount.

Fig. 21.24 Fasciola hepatica (left) and F. gigantica (right).

Fig. 21.25 Fasciolopsis buski, adult fluke. Whole mount. (Courtesy of Dr. Herman Zaiman).

 

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Fascioliasis

Fascioliasis is an infection by the sheep liver fluke Fasciola hepatica (Figs. 21.23 and 21.24). This fluke, which commonly infects sheep, cattle and other herbivores, is also an important parasite of man in many countries of the world. Fasciola gigantica is a larger species of Fasciola with a host range somewhat similar to F. hepatica, but this large fluke only rarely infects man (Figs. 21.24 & 21.26). F. hepatica was initially described by Jean DeBrie in 1379 and was later identified in the livers of sheep and goats in 1547 and in humans in 1600. In 1883, Thomas described the biological cycle, the first to be established for a trematode.

So far as is known, Fasciolopsis buski, the giant intestinal fluke of man (Fig. 21.25) has not been identified radiographically in the intestines of man, although it is the largest human fluke, measuring 2-7 cm in length by 1-2 cm in width, and can cause inflammation and ulceration of the duodenal and jejunal mucosa. It occurs throughout Southeast Asia, Indonesia, China and India. It has been estimated that there may be 10 million people in East Asia infected with this fluke, yet its radiological identification remains unreported.

Synonyms

Sheep liver rot. Fascioliasis hepatica. Febrile fasciolitic eosinophilic syndrome. Distoma hepaticum.

Geographic Distribution

Fasciola hepatica is found worldwide with a high infection rate among herbivorous animals. In the Americas it is found from the United States to Argentina, and in Europe, in Russia, Hungary, Germany, Spain, Italy, Holland, England and France. In Africa it occurs in Algeria, Egypt, Somalia and South Africa; in Asia it is found in China, Tibet, Siberia, Syria and the Middle East. It is also seen in Australia and Hawaii. Serious epidemics have occurred in recent decades in England, France, Germany and Cuba. F. gigantica (the giant liver fluke) is a common parasite of herbivorous animals, particularly cattle, in Africa, Asia and Hawaii. Several infections in man have been reported (Fig. 21.26). Its life cycle, pathology and clinical symptomatology are similar to those of F. hepatica.

Fig. 21.26 Fasciola gigantica. Human liver showing periportal fibrosis as a result of worms in the biliary ducts.

Copyright: Palmer and Reeder