Sakru Nermin, Korkmaz Metin, Demirci Mustafa, Kuman Aydınten, Ok Ulgen Zeki
Department of Medical Microbiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
Turkiye Parazitol Derg. 2011;35(2):77-80. doi: 10.5152/tpd.2011.20.
Fasciola hepatica, a liver fluke of sheep and cattle, may accidentally infect humans. The main signs and symptoms of the fasciolosis are eosinophilia, abdominal pain and hepatomegaly and may also be attributed to Cystic Echinococcosis (CE) caused by Echinococcus granulosus, which is a prevalent infection in Turkey.
Sera samples of 226 CE suspected cases were tested for anti-F. hepatica antibodies by an excretory secretory ELISA (ES-ELISA) and for anti-E. granulosus antibodies by ELISA and indirect hemagglutination (IHA) tests. Cases which were seropositive for fasciolosis were further evaluated radiologically and examined for F. hepatica eggs.
Five (2.2%) and 96 (42.4%) of the 226 CE suspected cases were found seropositive for fasciolosis and CE, respectively. Although the radiological findings strongly suggested that there was fasciolosis in three cases, F. hepatica eggs were detected in two patients only.
These data suggest that human fasciolosis is not as rare as previously reported in Turkey. F. hepatica infection should be suspected especially in the presence of eosinophilia, abdominal pain and liver lesions.
肝片吸虫是牛羊的一种肝吸虫，可意外感染人类。肝片吸虫病的主要体征和症状为嗜酸性粒细胞增多、腹痛和肝肿大，也可能归因于由细粒棘球绦虫引起的囊性棘球蚴病（CE），这是土耳其的一种常见感染。
对226例疑似CE病例的血清样本进行检测，通过排泄分泌酶联免疫吸附测定（ES-ELISA）检测抗肝片吸虫抗体，通过酶联免疫吸附测定和间接血凝试验（IHA）检测抗细粒棘球绦虫抗体。对肝片吸虫病血清学阳性的病例进一步进行放射学评估并检查肝片吸虫卵。
226例疑似CE病例中，分别有5例（2.2%）和96例（42.4%）肝片吸虫病和CE血清学阳性。尽管放射学检查结果强烈提示3例存在肝片吸虫病，但仅在2例患者中检测到肝片吸虫卵。
这些数据表明，人类肝片吸虫病在土耳其并不像之前报道的那样罕见。特别是在出现嗜酸性粒细胞增多、腹痛和肝脏病变时，应怀疑肝片吸虫感染。
