Liver fluke

Liver fluke's disease overview

What is

What is liver fluke?

liver fluke is a species of parasites when penetrating the body of the people through the digestive tract, causing pathology in many organs.

Where is the liver?

Liver fluke live in the human body, mainly in the liver and bile ducts. Liver fluke infection is a chronic disease, which can last for decades, including large liver fluke and small liver fluke .

People infected with small liver fluke distributed in many parts of the world. Opisthorchis Viverrini is sick for about 3 million people in Laos, Cambodia, Thailand and the south of our country. Meanwhile, Clonorchis Sinensis is a small liver fluke distributed mainly in Japan, China, Taiwan and the northern provinces of our country. Small liver tapeworm disease spreads from North to South in Vietnam, noted about 21 provinces, the rate of infection varies in each region, the highest in Binh Dinh, Phu Yen, Nam Dinh, Ninh Binh.

Infection with large liver fluke Fasciola hepatica is common in Europe, South America and Africa; While Fasciola Gigantica is distributed mainly in Asia. In our country, liver fluke is more common than small liver fluke with more than 40 provinces and cities, the highest in the Central and Central Highlands.

Causes of Liver fluke's disease

Liver fluke is divided into two groups: large liver fluke and small liver fluke.

Small liver fluke has 3 types including: Clonorchis sinensis; Opisthorchis Viverrini; Opisthorchis Felineus

Large liver fluke has 2 types including: Fasciola hepatica; Fasciola Gigantica.

Characteristics of large liver fluke:

This is a parasite shaped like a leaf, flat body should be called liver fluke. Large liver fluke is many times larger than small liver fluke, about 30 x 10-12mm. The liver fluke and male and female genitalia on a body should be classified as a bipolar group.

Tapeworm eggs are discharged into the outside environment with thin skin so it is easy to fail. Water environment is a necessary condition for eggs to grow into larvae and adult tapeworms to cause disease. In the terrestrial environment, under the influence of the sun, both eggs and adult tapeworms are very easy to die, hard to survive.

Large liver fluke infected with herbivores such as sheep and cattle. Infection with large liver fluke in humans is only random because the patient eats raw vegetables growing underwater such as watercresses, rods, coriander or drinking contaminated water. The main host of small liver fluke includes humans, dogs and cats, otters, the process of penetration and disease for people of the liver fluke can be divided into 2 stages:

The stage of entering the liver:

After using contaminated food or water, tapeworm larvae along the gastrointestinal tract down to duoden into the peritoneal cavity to the liver, penetrate through the liver to penetrate and cause disease in the liver parenchyma. At this time, the body's immune system reacts by producing antibodies against liver fluke. Antibodies appear in the blood at least 2 weeks from the flukes. Blood tests can identify antibodies but do not mean a solid diagnosis of liver fluke.

In the process of entering the liver parenchyma, the liver fluke can go to other organs to create a scenery of the liver and liver, such as the abdominal wall, the stomach wall, the intestinal wall.The stage of penetration into the biliary system:

After parasitic into the liver parenchyma, the liver fluke can enter the bile ducts and parasites for a long time. Here, mature tapeworm eggs follow the biliary tract to the intestines, and out of the stool, spread to others in the community. Adult liver fluke can reside in biliary tract for decades.

Symptoms of Liver fluke's disease

Common symptoms of liver fluke include:

Abdominal pain in the liver: usually smoldering, spreading behind the back or to the left, to the upper region. Sometimes patients only feel uncomfortable, bloating, and nausea.

Gastrointestinal disorders

fever: may have a high fever with chilling, or just fleeting.

Dizziness, sweating.

Skin pale due to anemia, or jaundice, urticaria.

Liver is swollen or cirrhosis, which can be touched clinically depending on the severity of the disease.

There may be fluid in the abdomen

fatigue, anorexia, weight loss.

Most people infected with liver fluke do not show clinical symptoms or not specific symptoms, so patients often ignore and do not know until complications appear. . So when there are any suspect symptoms, patients should visit at medical facilities.

Transmission route of Liver fluke's diseaseLiver fluke

Liver fluke disease in people spread mainly through the gastrointestinal tract. People who eat food or drinking water with follicles or larvae will be infected with parasites that enter the liver parenchyma and bile conductive system. Here, adult liver fluke lays eggs and discharged into the outside water environment through stool and continues to spread. The disease can be transmitted from patients to healthy people in the gastrointestinal tract in the same way.

People at risk for Liver fluke's disease

The risks are likely to be higher than the liver fluke infection than others including:

Living in the epidemic area with a high rate of people infected with liver fluke, such as Vietnam and other Southeast Asian countries, China, Korea, Taiwan, Eastern Europe, ... P>

Living in the river, near cattle breeding areas such as buffaloes, cows, sheep, ...

There is a habit of eating raw vegetables, or raw fish.

History has ever eaten raw fish in epidemiological areas.

The disease affects more women than men.

Prevention of Liver fluke's disease

Measures to help reduce the rate of liver fluke infection:

Ensure the principle of boiling cooking and drinking

Use water from clean water, ensure hygiene

Do not eat raw fresh plants underwater near cattle breeding areas.

Fruit or vegetables before eating must be washed, soaked in disinfectant solution such as acetic acid 6% for about 10 minutes.

Propaganda and education on the transmission of liver fluke disease, how to keep the environment in common environment such as no indiscriminate defecation.

If there is an epidemic, it is necessary to set up a steering committee and a quick control area.

Patients if they suspect that they are infected with liver tapeworms, they need to go to the medical facility immediately for examination and treatment as soon as possible.

Diagnostic measures for Liver fluke's disease

To diagnose a liver fluke, the doctor needs to coordinate information about epidemiological characteristics, clinical symptoms and subclinical tests. Testing is a method for diagnosis to identify the disease and the degree of disease, including:

Dog, duodenum or bile fluid by kato method: Founding liver fluke eggs in feces or in duodenum fluid, bile fluid that allows diagnosis to determine the situation of infection Liemia. The rate of vision in the samples is not high. Patients need to be sampled for continuous tests for 3 days.

Blood formula: The number of white blood cells, the advantage of eucalyptus.

Serum tests to find antibodies of liver fluke in the blood by Elisa immune method. Antibodies may last long after successful treatment, so it is not used to diagnose the disease. IgG, IGM, IGE antibodies always increase in cases of liver fluke infection.

Test in skin

Abdominal ultrasound: Give images of liver parenchyma damage to honeycomb or fluid under the liver, images of abscesses. The liver fluke on ultrasound can be observed with the image like a leaf, flat if large size. The abdominal ultrasound along with the stool examination is chosen as the screening tests in epidemiological areas with a high rate of liver fluke infection.

CT scan: Survey the image of biliary tract better than abdominal ultrasound. The expansion of bile ducts, without clogging is a characteristic image in liver fluke disease

magnetic resonance imaging

Liver fluke's disease treatments

Drugs

Treatment of liver fluke is mainly medical treatment with parasitic kills. The drugs should be indicated early and at the right dose. Triclabendazole is the first drug, treating a large liver fluke with a dose of 10mg/kg, taking the only dose. Praziquantel is a specific medicine for small liver fluke, a dose of 75mg/kg, indicated for 1-2 days depending on the level of infection, drink 3 times a day, each time 4-6 hours apart . Take the tapeworm after eating. Pay attention to contraindicated drugs such as pregnant and lactating women, who are in the acute phase of bile or other acute liver diseases such as liver failure, heart failure, acute kidney failure , engineer operating engineers, people allergic to the ingredients of the drug. Headache, nausea, rashes, liver pain may be the unwanted effects of the drug, usually just fleeting right after taking the drug and without any treatment.

Corticosteroids are indicated in the acute phase of the disease when symptoms become more serious. The drug should only be used in a short time, and a doctor's guidance.

When the disease is detected in a late stage, complications such as cholangitis or a lot of liver parenchyma damage, the doctor will probably consider surgery to remove the liver parenchyma. . > Monitoring and evaluating results

After taking the medicine, the patient is kept monitoring at a medical facility for at least 3 days.

Patients need to be re -examined at 2 timelines: after 3 months and after 6 months of treatment to evaluate the following characteristics:

Clinical symptoms

Blood formula: Number of white blood cells

Abdominal ultrasound: Check the size of the liver lesions

Soi, bile fluid looking for liver fluke.

If the disease does not get better, it is necessary to set other distinct diagnosis such as: viral hepatitis, liver abscess caused by other parasites, liver tumors, ... P>

Can use triclabendazole for the second time with a dosage of 1, 20mg/kg, drink 2 times/day 12 hours apart.

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