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A 45 year old woman from China complained of dull, aching pain in the upper abdomen, especially after eating a meal for 3 months. She also reported occasional nausea, vomiting, increasing fatigue and unintended weight loss. She noticed a yellowish discoloration of her skin and eyes. Examination revealed tender hepatomegaly. Blood tests showed elevated liver enzymes, elevated bilirubin and peripheral eosinophilia and abdominal ultrasound revealed dilated bile ducts. A stool examination for ova and cyst was carried out.
- What is the diagnosis?
- How is this infection acquired
- What is the treatment and follow up required?
Case answer – Posted on: 14-Feb-2024
- What is the diagnosis? Clonorchiasis caused by Clonorchis sinensis with operculated egg and visible shoulders. An abopercular knob ranging in 20-30 µm by 11-20 µm
- How is this infection acquired? Consumption of undercooked or raw freshwater fish.
- What is the treatment and follow up required?
- Treatment: Administration of an anti-parasitic drug such as praziquantel, along with supportive measures to manage symptoms and complications
- Follow-up: Regular monitoring of liver function tests and imaging may be required to assess the response to treatment due to the link to cholangiocarcinoma. Health education on safe food preparation practices, especially regarding the consumption of freshwater raw fish is needed.