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Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection

Parasitic co-infection is commonly observed in natural populations, yet rare in the laboratory. Multiparasitism can have negative effects on the host, ranging from the atypical manifestations to increased mortality, consequently, it may be misdiagnosed and treated with unsuitable anthelmintic medici...

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Autores principales: Wang, Meng, Liu, Wei, Xiong, Ziman, Li, Zhen, Li, Jiansha, Xu, Xin, Zhang, Meng, Xing, Mingyou, Ning, Qin, Wu, Di, Qi, Junying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132012/
https://www.ncbi.nlm.nih.gov/pubmed/35646994
http://dx.doi.org/10.3389/fmed.2022.881356
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author Wang, Meng
Liu, Wei
Xiong, Ziman
Li, Zhen
Li, Jiansha
Xu, Xin
Zhang, Meng
Xing, Mingyou
Ning, Qin
Wu, Di
Qi, Junying
author_facet Wang, Meng
Liu, Wei
Xiong, Ziman
Li, Zhen
Li, Jiansha
Xu, Xin
Zhang, Meng
Xing, Mingyou
Ning, Qin
Wu, Di
Qi, Junying
author_sort Wang, Meng
collection PubMed
description Parasitic co-infection is commonly observed in natural populations, yet rare in the laboratory. Multiparasitism can have negative effects on the host, ranging from the atypical manifestations to increased mortality, consequently, it may be misdiagnosed and treated with unsuitable anthelmintic medicines. Therefore, reliable diagnosis is critical for appropriate treatment of parasitic co-infection. Herein, we report a case of a 31-year-old woman with persistent eosinophilia and hypoechoic liver lesion on ultrasound. The microscopic examination of multiple stool specimens did not find any pathogens. The patient had serum specific anti-Trichinella IgG antibody by Dot enzyme-linked immunosorbent assay (Dot-ELISA). After treatment with albendazole, contrast-enhanced magnetic resonance imaging (MRI) revealed more lesions in the liver. Subsequently, liver biopsy was performed in this patient and Fasciola hepatica was identified using metagenomic next-generation sequencing (mNGS) as well as polymerase chain reaction. After treatment with triclabendazole, which is the only anthelmintic drug specifically available against this fluke, her eosinophil count returned normal, and the liver lesions were significantly regressed. This case highlights the diagnostic challenge posed by parasitic co-infection, which merits more in-depth evaluation to confirm the diagnosis.
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spelling pubmed-91320122022-05-26 Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection Wang, Meng Liu, Wei Xiong, Ziman Li, Zhen Li, Jiansha Xu, Xin Zhang, Meng Xing, Mingyou Ning, Qin Wu, Di Qi, Junying Front Med (Lausanne) Medicine Parasitic co-infection is commonly observed in natural populations, yet rare in the laboratory. Multiparasitism can have negative effects on the host, ranging from the atypical manifestations to increased mortality, consequently, it may be misdiagnosed and treated with unsuitable anthelmintic medicines. Therefore, reliable diagnosis is critical for appropriate treatment of parasitic co-infection. Herein, we report a case of a 31-year-old woman with persistent eosinophilia and hypoechoic liver lesion on ultrasound. The microscopic examination of multiple stool specimens did not find any pathogens. The patient had serum specific anti-Trichinella IgG antibody by Dot enzyme-linked immunosorbent assay (Dot-ELISA). After treatment with albendazole, contrast-enhanced magnetic resonance imaging (MRI) revealed more lesions in the liver. Subsequently, liver biopsy was performed in this patient and Fasciola hepatica was identified using metagenomic next-generation sequencing (mNGS) as well as polymerase chain reaction. After treatment with triclabendazole, which is the only anthelmintic drug specifically available against this fluke, her eosinophil count returned normal, and the liver lesions were significantly regressed. This case highlights the diagnostic challenge posed by parasitic co-infection, which merits more in-depth evaluation to confirm the diagnosis. Frontiers Media S.A. 2022-05-11 /pmc/articles/PMC9132012/ /pubmed/35646994 http://dx.doi.org/10.3389/fmed.2022.881356 Text en Copyright © 2022 Wang, Liu, Xiong, Li, Li, Xu, Zhang, Xing, Ning, Wu and Qi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Wang, Meng
Liu, Wei
Xiong, Ziman
Li, Zhen
Li, Jiansha
Xu, Xin
Zhang, Meng
Xing, Mingyou
Ning, Qin
Wu, Di
Qi, Junying
Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title_full Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title_fullStr Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title_full_unstemmed Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title_short Case Report: “Area of Focus” Atypical Trichinellosis and Fascioliasis Coinfection
title_sort case report: “area of focus” atypical trichinellosis and fascioliasis coinfection
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132012/
https://www.ncbi.nlm.nih.gov/pubmed/35646994
http://dx.doi.org/10.3389/fmed.2022.881356
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