Clinical Study of Fascioliasis Among Egyptian Children laying Stress Upon Different Methods of Diagnosis and Treatment

Abstract

The study included 25 children attending the Institute of Research for Tropical Medicine who were diagnosed clinically as Fascioliasis. All cases were treated by 1Omg/kg bodyweight of triclabendazole in a single oral dose. Before treatment, all cases were subjected to clinical examination, abdominal ultrasonography, stool analysis, blood picture determination: liver function tests and serological tests by IHA test (commercially available kits) and ELISA. All patients were followed up for 4 months after treatment. The investigations were repeated at the second and fourth month post treatment. It was found that 84% of the patients suffered from recurrent abdominal pain which was the most common symptom. Other manifestations included right hypochondria! pain (72%), fever (64%), pallor (64%), anorexia (40%), vomiting (20%), Diarrhea (16%) urticarial rashes (4%), right hypochondria! tenderness (16%), palpable liver (44%) and palpable spleen (4%). The hepatic and biliary ultrasonographic findings in Fascioliasis cases showed normal ecchogenic pattern in 44% of the cases, hepatomegaly in 56%, dilatec! common bile duct in 8% of the cases, dilated intrahepatic biliary radicals in 4% and enlarged gall bladder in 4%. Fasciola worm was detected inside the gall bladder in 4% thickened wall of gall bladder in 8%, mud inside gall bladder (4%) and splenomegaly in 12% of cases. The stool analysis was performed by three different methods (direct smear method, simple sedimentation method ana kato-katz method) for three consecutive days before treatment by triclabendazole and all children gave negative stool for fasciola eggs although 7 cases (28%) of them were referred to our institute with positive stool analysis for fasciola eggs.