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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2024; 14(01): 020-023
DOI: 10.1055/s-0044-1786718
Case Report

Eosinophilia in an Indian Patient with Helminthic Infection Unresponsive to Albendazole and Diethylcarbamazine: An Enigmatic Case of Human Fascioliasis

Debadrita Ray
1   Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ganesh C. P.
1   Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Yogendra Kumar
1   Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Deba Prasad Dhibar
2   Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Abhishek Mewara
1   Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Arka De 
1   Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations Funding None.
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Abstract

Human fascioliasis is a zoonosis caused by Fasciola hepatica and Fasciola gigantica. Population migration, globalization of food trade, climate change, and drug resistance are contributing to the re-emergence of Fasciola infection in several countries with increased recognition even in nonendemic regions. Helminthic infections are prevalent in India and are a common cause of eosinophilia in Indian patients who are often empirically treated with antihelminthic agents. However, human fascioliasis is rarely reported in India and does not respond to commonly used antihelminthic agents like albendazole, mebendazole, praziquantel, and diethylcarbamazine (DEC). We report a case of a young female with abdominal pain and eosinophilia who did not respond to empirical treatment with albendazole and DEC. She was diagnosed with Fasciola hepatica on endoscopic retrograde cholangiopancreatography and was treated with nitazoxanide that led to complete resolution of symptoms and normalization of eosinophil counts.

Keywords

hypereosinophilia - Fasciola hepatica - fascioliasis - trematode

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.


Ethical Statement

The authors followed applicable EQUATOR Network (www.equator-network.org/) guidelines, notably the CARE guideline, during the conduct of this report.


Author Contributions

D.R. helped in manuscript writing; G.C.P. contributed to data collection and manuscript writing; Y.K. was involved in data collection; D.P.D. helped in data collection and critical revision; A.M. contributed to parasitological analysis, data collection, and critical revision; A.D. helped in manuscript writing, data collection, and critical review. The manuscript has been read and approved by all the authors, and each author believes that the manuscript represents honest work.


Note

The case was presented at the 31st annual conference of the Indian National Association for Study of the Liver (INASL), August 3–6, 2023.




Publication History

Received: 29 January 2024

Accepted: 28 March 2024

Article published online:
29 May 2024

© 2024. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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