Fasciola hepatica

Jump to navigation Jump to search
Common liver fluke
Fasciola hepatica - adult worm
Fasciola hepatica - adult worm
Scientific classification
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda
Subclass: Digenea
Order: Echinostomida
Family: Fasciolidae
Genus: Fasciola
Species: F. hepatica
Binomial name
Fasciola hepatica
(Linnaeus, 1758)


This page is about microbiologic aspects of the organism(s).  For clinical aspects of the disease, see Fasciolosis.

Fasciolosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Fasciolosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

Endoscopy

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Fasciola hepatica On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Fasciola hepatica

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Fasciola hepatica

CDC on Fasciola hepatica

Fasciola hepatica in the news

Blogs on Fasciola hepatica

Directions to Hospitals Treating Fasciolosis

Risk calculators and risk factors for Fasciola hepatica

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Fasciola hepatica, also known as the common liver fluke or sheep liver fluke, is a parasitic flatworm of the class Trematoda, phylum Platyhelminthes that infects liver of a various mammals, including man. The disease caused by the fluke is called fascioliasis (also known as fasciolosis). F. hepatica is world-wide distributed and causes great economic losses in sheep and cattle.

Life cycle

In order to complete its life cycle, F. hepatica requires an aquatic snail as an intermediate host such as Galba truncatula, in which the parasite can reproduce asexually. From the snail, minute cercariae emerge and swim through pools of water in pasture, and encyst as metacercariae on near-by vegetation. From here, the metacercariae are ingested by the ruminant, or in some cases, by humans eating un-cooked foods such as water-cress. Contact with low pH in the stomach causes the early immature juvenile to begin the process of excystment. In the duodenum, the parasite breaks free of the metacercariae and burrows through the intestinal lining into the peritoneal cavity. The newly excysted juvenile does not feed at this stage, but once it finds the liver parenchyma after a period of days, feeding will start. This immature stage in the liver tissue is the pathogenic stage, causing anaemia and clinical signs sometimes observed in infected animals. The parasite browses on liver tissue for a period of up to 5-6 weeks and eventually finds its way to the bile duct where it matures into an adult and begins to produce eggs. Up to 25,000 eggs per day per fluke can be produced, and in a light infection, up to 500,000 eggs per day can be deposited onto pasture by a single sheep.

Disease biology

File:Egg of Fasciola hepatica 08G0041 lores.jpg
Egg of F. hepatica

In the United Kingdom, Fasciola hepatica is a frequent cause of disease in ruminants - this is most common between March and December. Cattle and sheep are infected when they consume the infectious stage of the parasite from low-lying, marshy pasture. The effects of liver fluke are referred to as fascioliasis, and include anaemia, weight loss and sub-mandibular oedema. Diarrhea is only an occasional consequence of liver fluke. Liver fluke is diagnosed by yellow-white eggs in the faeces. They are not distinguishable from the eggs of Fascioloides magna, although the eggs of F. magna are very rarely passed in sheep, goats or cattle.

A serious consequence of the liver damage caused by fascioliasis is that latent Clostridium novyi spores can be activated by the low oxygen conditions in the damaged tracts the parasite forms in the liver - this can lead to "black disease", caused by Clostridium novyi type B or immune-mediated haemolytic anaemia (IMHA) leading to haemoglobinuria caused by Clostridium novyi type D.

Treatment

The drug of choice in the treatment of fasciolosis is triclabendazole, a member of the benzimidazole family of anthelmintics. The drug works by preventing the polymerisation of the molecule tubulin into the cytoskeletal structures, microtubules. However, resistance of F. hepatica to triclabendazole has already been recorded in Australia[1] and Ireland.[2]

Antimicrobial Regimen

  • Fasciola hepatica
  • Preferred regimen: Triclabendazole 10 mg/kg PO one dose[3]
  • Note: Two-dose (double-dose) triclabendazole therapy can be given to patients who have severe or heavy Fasciola infections (many parasites) or who did not respond to single-dose therapy.

Footnotes

Template:FootnotesSmall

References

  • Template:Aut (1995): Resistance of Fasciola hepatica to triclabendazole. Australian Veterinary Journal 72: 275–276.
  • Template:Aut (1998): Vaccines in control of liver fluke infections in ruminants: current status and prospects. Irish Veterinary Journal 51: 520–525.

ar:فاشيولا كبدية cs:Motolice jaterní de:Großer Leberegel lt:Kepeninė siurbikė sl:Veliki metljaj Template:WikiDoc Sources

  1. Overend & Bowen 1995
  2. Mulcahy & Dalton 1998
  3. "Parasites - Fascioliasis".