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KMID : 0425120140520020193
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Parasites, Hosts and Diseases
2014 Volume.52 No. 2 p.193 ~ p.196
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A Case of Fasciola hepatica Infection Mimicking Cholangiocarcinoma and ITS-1 Sequencing of the Worm
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Kang Bong-Kyun
Jung Bong-Kwang
Lee Yoon-Suk
Hwang In-Kyeom
Lim Hye-Mi
Cho Jae-Eun
Hwang Jin-Hyeok
Chai Jong-Yil
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Abstract
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Fascioliasis is a zoonotic infection caused by Fasciola hepatica or Fasciola gigantica. We report an 87-year-old Korean male patient with postprandial abdominal pain and discomfort due to F. hepatica infection who was diagnosed and managed by endoscopic retrograde cholangiopancreatography (ERCP) with extraction of 2 worms. At his first visit to the hospital, a gallbladder stone was suspected. CT and magnetic retrograde cholangiopancreatography (MRCP) showed an intraductal mass in the common bile duct (CBD) without proximal duct dilatation. Based on radiological findings, the presumed diagnosis was intraductal cholangiocarcinoma. However, in ERCP which was performed for biliary decompression and tissue diagnosis, movable materials were detected in the CBD. Using a basket, 2 living leaf-like parasites were removed. The worms were morphologically compatible with F. hepatica. To rule out the possibility of the worms to be another morphologically close species, in particular F. gigantica, 1 specimen was processed for genetic analysis of its ITS-1 region. The results showed that the present worms were genetically identical (100%) with F. hepatica but different from F. gigantica.
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KEYWORD
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Fasciola hepatica, Fasciola gigantica, sheep liver fluke, bile duct cancer, molecular diagnosis, ITS-1
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