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Questions and Answers
What is a potential outcome of severe Fasciola infection?
What is a potential outcome of severe Fasciola infection?
Which laboratory method is considered the most effective for diagnosing Fascioliasis?
Which laboratory method is considered the most effective for diagnosing Fascioliasis?
What symptom is indicative of an allergic reaction to Fasciola parasite byproducts?
What symptom is indicative of an allergic reaction to Fasciola parasite byproducts?
Which immunodiagnostic test can detect Fasciola antigen in stool?
Which immunodiagnostic test can detect Fasciola antigen in stool?
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What is the reason why stool analysis is of limited use in diagnosing Fascioliasis?
What is the reason why stool analysis is of limited use in diagnosing Fascioliasis?
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What blood examination result is commonly associated with Fasciola infections?
What blood examination result is commonly associated with Fasciola infections?
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What is the primary method of infection for Fasciola species?
What is the primary method of infection for Fasciola species?
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What is the effective treatment for Fasciola infection?
What is the effective treatment for Fasciola infection?
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What type of liver condition can occur due to periductal fibrosis caused by flukes?
What type of liver condition can occur due to periductal fibrosis caused by flukes?
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Which of the following statements is true regarding the geographical distribution of Fasciola species?
Which of the following statements is true regarding the geographical distribution of Fasciola species?
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Which method is NOT used for radiological diagnosis of Fasciola infection?
Which method is NOT used for radiological diagnosis of Fasciola infection?
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What is a recommended method for preventing Halzoun?
What is a recommended method for preventing Halzoun?
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During what stage do Fasciola larvae penetrate the small intestine?
During what stage do Fasciola larvae penetrate the small intestine?
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What major complication can arise from the migration of immature flukes in Fasciola infections?
What major complication can arise from the migration of immature flukes in Fasciola infections?
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What differentiates a spurious infection from true fascioliasis?
What differentiates a spurious infection from true fascioliasis?
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Study Notes
Fasciola Species
- Fasciola species are parasitic flatworms, specifically liver flukes.
- Two main species are Fasciola hepatica and Fasciola gigantica.
- Fasciola hepatica infects sheep, while Fasciola gigantica infects cattle.
- Both species are found in Egypt.
- Infection causes the disease fascioliasis.
- Global distribution (worldwide), but distribution of species varies.
Objectives
- Recognize Fasciola hepatica and Fasciola gigantica.
- Understand their geographical distribution.
- Learn about their life cycle.
- Understand their mode of infection.
- Recognize pathogenesis.
- Identify clinical signs of infection.
- Identify diagnostic methods.
- Detail treatment methods.
- Discuss prevention and control methods.
- Define and differentiate "spurious" and true fascioliasis.
- Define parasitic pharyngitis (Halzoun).
Life Cycle
- Infection occurs through ingestion of contaminated vegetables or water containing encysted metacercariae.
- Metacercariae encyst in freshwater vegetation.
- Humans or animals ingest the contaminated vegetation.
- The metacercariae excyst in the small intestine and migrate to the liver.
- They reside in the bile ducts of the liver.
- Eggs are shed in feces.
Pathogenesis
- Metacercariae penetrate the small intestine and migrate to the peritoneum (lining of the abdominal cavity).
- They cause destruction and necrosis of liver tissue.
- Migration causes inflammation and hemorrhage.
- Obstruction of the bile ducts (mechanical, inflammation, and fibrosis).
- Proline excretion from flukes leads to hyperplasia (excess growth) of biliary epithelium and thickening of duct walls.
- Periductal fibrosis and pressure atrophy on adjacent liver tissues.
- Secondary bacterial infection (manifestations including hepatitis).
- Liver cirrhosis from severe infection.
- Eggs may become trapped in the parenchyma causing minute abscesses.
- Flukes may migrate to other locations (ectopic lesions).
Clinical Picture
- Mild infections may be asymptomatic, causing no noticeable symptoms.
- Digestive disturbances (diarrhea).
- Fever and allergic reactions (urticaria, bronchial asthma).
- Pain and tenderness in the right upper abdomen (right hypochondrium).
- Enlarged tender liver (hepatomegaly).
- Cholangitis (inflammation of bile duct); cholecystitis (inflammation of gallbladder); and obstructive jaundice (a yellowish discoloration of skin).
Diagnosis
- Clinical diagnosis: Fever, hepatomegaly, marked eosinophilia.
- Laboratory diagnosis (Stool Examination): Eggs are oval with an operculum, are thin-shelled, and measure approximately 140 x 70 μm.
- Stool analysis for eggs is limited (eggs appear in stool after 3-4 months/prepatent period and not detectable during chronic phase).
- Laboratory diagnosis (Immunological Tests): Enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay, and immunoelectrophoresis to detect Fasciola antigen in stool or antibodies in serum.
- Laboratory diagnosis (Blood Examination): High eosinophilia (up to 80%), anemia possible
- Radiological imaging: Percutaneous cholangiography, ultrasonography, and endoscopic retrograde cholangiography to visualize the bile ducts and liver tissue.
Treatment
- Triclabendazole (single oral dose of 10 mg/kg).
- Bithionol (Dichlorophenol) (30-50 mg/kg every other day for 10 doses).
Prevention and Control
- Mass treatment.
- Proper washing and cooking of aquatic plants.
- Soaking of vegetables in vinegar or potassium permanganate.
- Safe water supply.
- Snail control.
Parasitic Pharyngitis (Halzoun)
- Ingestion of raw (uncooked) infected sheep, goat, or rabbit liver causes the condition called Halzoun.
- Inflammation of the pharynx and subsequent blockage of air passages.
- Treatment: gargling with alcohol, emetics, tracheostomy.
- Control: ensure proper cooking and preparation of animal products (especially liver).
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Description
This quiz explores the essential aspects of Fasciola species, specifically Fasciola hepatica and Fasciola gigantica. It covers their geographical distribution, life cycle, mode of infection, and clinical signs of fascioliasis, along with diagnostic and treatment methods. Test your knowledge on this significant group of parasitic flatworms and their impact on livestock health.
