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Fasciolosis has been diagnosed in cattle, goats, sheep and horses in southern and southeastern Brazil. Effective alternative treatments are the targets of study. One promising alternative is the use of plant extracts. The aim of this study was to perform phytochemical analysis of extracts of Eugenia uniflora L., Harpagophytum procumbens, Psidium guajava L. and Stryphnodendron adstringens, and to evaluate the in vitro efficacy of these extracts on ovicidal activity in Fasciola hepatica. Plant extracts were analyzed for phytochemical properties. F. hepatica eggs were collected directly from the gallbladders of animals diagnosed as positive for fasciolosis on post mortem examination. One hundred eggs were incubated with 3 ml of each extract at concentrations of 0.10%, 0.25% and 0.50%, albendazole 0.50% (positive control) or tap water (negative control). To determine anti larval efficacy of each plant extract, hatched eggs were counted and the averages were used. Phytochemical analysis revealed the presence of phenolic compounds, tannins and terpenes in most extracts. E. uniflora L. extract was 100% effective at 0.10%, H. procumbens was effective at 0.25% and P. guajava L. and S. adstringens extracts were 100% effective at all concentrations tested. Taken together, the data suggested that ovicidal activity in F. hepatica is due to the presence of these bioactive compounds.(AU)

A fasciolose tem sido diagnosticada em bovinos, caprinos, ovinos e equinos no sul e sudeste do Brasil, sendo que tratamentos alternativos mais eficazes são alvos de estudo. Umas das alternativas promissoras é o uso de extratos vegetais no controle dessa e outras enfermidades. O objetivo deste estudo foi realizar a análise fitoquímica dos extratos de Eugenia uniflora L., Harpagophytum procumbens, Psidium guajava L. e Stryphnodendron adstringens, além de avaliar a eficácia in vitro desses extratos na atividade ovicida em Fasciola hepatica. Os extratos vegetais foram obtidos e analisados para determinação fitoquímica. Ovos de F. hepatica foram coletados diretamente das vesículas biliares de animais diagnosticados como positivos para fasciolose no exame post mortem. Cem ovos foram incubados com três mililitros de cada extrato nas concentrações de 0,10%, 0,25% e 0,50%, de albendazol a 0,50% (controle positivo) e água de torneira (controle negativo). Para determinar a eficácia de cada extrato vegetal os ovos eclodidos foram contados, e a média utilizada para os cálculos de eficácia. A análise fitoquímica revelou a presença de compostos fenólicos, taninos e terpenos na maioria dos extratos. O extrato de E. uniflora L. apresentou eficácia de 100% na concentração de 0,10%, o de H. procumbens a 0,25% e os extratos de P. guajava L. e S. adstringens apresentaram 100% de eficácia em todas as concentrações testadas. Assim, sugere-se que a atividade ovicida em F. hepatica seja devido à presença desses compostos bioativos.(AU)

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On a farm with permanent history of fasciolasis a study was performed aimed to know the efficacy of triclabendazole (TCBZ) and then to contrast with that of nitroxynil. Thirty-nine cattle naturally infected with Fasciola hepatica were randomly allocated into 4 experimental groups: Group 1 (control) was left untreated. Group 2 was treated with of 12 mg/kg body weight (bw) of TCBZ by oral route. Group 3 treated with 24 mg/kg bw TCBZ orally. Group 4 was treated with 10 mg/kg bw of nitroxynil subcutaneously. The anthelmintic efficacy was calculated as the percentage of reduction in faecal egg count (FEC) at 14 and 28 d post-treatment. Results indicated that there were no significant differences in the percentage of FEC reduction between control group and the groups treated with 12 or 24 mg/kg of TCBZ. On the contrary, the treatment with nitroxinyl significantly reduced the FEC and decreased the percentage of positive animals. In conclusion, Fasciola hepatica is reported for first time as resistant to TCBZ in Chile, which highlights the need of rotating drugs and assessing the efficacy of the administered drug in order to avoid the selection of resistant worms.(AU)

Em uma fazenda com histórico de fasciolose permanente, foi realizado um estudo com o objetivo de conhecer a eficácia do triclabendazol (TCBZ) e depois contrastar com o do nitroxinil. Trinta e nove bovinos naturalmente infectados com Fasciola hepatica foram distribuídos aleatoriamente em 4 grupos experimentais: Grupo 1 (controle), sem tratamento. O grupo 2 foi tratado com 12 mg/kg de peso vivo (PV) do TCBZ por via oral (VO). Grupo 3 tratado com 24 mg/kg de PV TCBZ por VO. O grupo 4 foi tratado com 10 mg /kg de PV Nitroxinil via subcutânea. A eficácia anti-helmíntica foi calculada comparando a percentagem de redução na contagem de ovos fecais (FEC) 14 e 28 dias pós tratamento. Não houve diferença significativa na porcentagem de redução FEC entre o grupo controle e os grupos tratados com 12 ou 24 mg/kg de TCBZ. Entretanto, o tratamento com nitroxinil reduziu significativamente o FEC e diminuiu a porcentagem de animais positivos. Em conclusão, a Fasciola hepatica é relatada pela primeira vez como resistente ao TCBZ no Chile, o que destaca a necessidade de realizar uma rotação em relação aos medicamentos anti-helmínticos e avaliar a eficácia do mesmo, a fim de evitar a seleção de vermes resistentes.(AU)

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Describir la distribución demográfica y clínica de la fasciolosis hepática, así como las complicaciones y asociaciones entre diversos factores y la enfermedad en un hospital de referencia. Material y métodos: Estudio descriptivo y retrospectivo de tipo serie de casos, se incluyeron todos los pacientes con diagnóstico de fasciolosis hepática por primera vez entre 2003 a 2010 en el Hospital Nacional Cayetano Heredia, se analizaron variables demográficas y clínicas incluyendo las complicaciones y el tratamiento. Resultado: Se encontraron 68 historias clínicas aptas para el estudio, el promedio de edad fue 36 años, Ancash fue el departamento de nacimiento y procedencia más frecuente. La mayoría se diagnosticó en fase crónica, el síntoma más frecuente fue dolor abdominal y se presentó complicaciones en 6 pacientes: 3 abscesos hepáticos, 1 hematoma subcapsular, 1 colangitis y 1 colangitis más colecistitis. Se encontraron las siguientes asociaciones: edad menor de 15 años con la fase crónica e hiporexia, ser estudiante con un coprológico positivo; y entre el nacimiento de una zona endémica con la ausencia de desarrollar complicaciones. Conclusiones: La fasciolosis hepática tiene una presentación clínica poco específica, por lo que los antecedentes epidemiológicos o alimentarios, y especialmente la eosinofilia deben orientar el diagnóstico...

To describe the demographic and clinical aspects of hepatic fascioliasis as well as the complications and associations between various factors and the disease in a reference hospital. Methods: This is a descriptive and retrospective case series study; we included all patients who had a recent diagnosis of hepatic fascioliasis from 2003 to 2010 in the Hospital Nacional Cayetano Heredia. Demographic and clinical variables were analyzed including complications and treatment received. Results: 68 medical records were found eligible for the study. The mean age was 36 years. Ancash department was the most frequent place of origin and residence. Most of them were diagnosed in the chronic phase, the most common symptom was abdominal pain and eight patients had complications: 3 hepatic abscess, 1 subcapsular hematoma, 1 cholangitis and 1 cholangitis plus cholecystitis. There were the following associations: Age under 15 years with chronic phase and hyporexia, being a student with a positive stool analysis; and between being born in an endemic area with the absence of complications. Conclusions: Hepatic fascioliasis has unspecific clinical presentation so the epidemiological or dietary history and specially eosinophilia should guide the diagnosis...

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Hepatic fascioliasis is produced by a platyhelminth, trematode: the hepatic Fasciola. In recent years, its incidence has increased in all countries, including Latin America. The diagnosis is based on clinical and epidemiological background information, hemogramm with eosinophil count; Ig G ELISA; and copro-parasitological and duodenal aspirate in search of parasite eggs. Images are useful, endoscopic ultrasound, Computed Tomography (CT), abdominal Magnetic Resonance Imaging (MRI), especially in case of complications. The endoscopic retrograde cholangiopancreatography (ERCP) is useful both for diagnosis and treatment (extraction of adult Fasciola), as it was in hte present clinical case. This parasite can also be found incidentally in the course of a surgery planned for other reasons. In the present clinical case we present a 41-year-old patient, farmer, with apparent ingestion of water and contaminated aquatic vegetables. Initially he presented only fever and hypereosinophilia; with fascioliasis diagnosis. The pathology recurred after 18 month with biliary obstruction. The clinical and epidemiological background information was a fundamental tool for diagnosis, together with abdominal CT. Initially it evolved with bad response to several antiparasitic treatments and then it progressed positively. After that, the pathology recurred with complications. ERCP was performed to extract adult Fasciola. Currently in symptomatic remission after endoscopic intervention and drug treatment.

La fascioliasis hepática es producida por un platelminto, tremátodo: la Fasciola hepática. En los últimos años ha incrementado su incidencia en todos los países, incluyendo América Latina. El diagnóstico se basa en los antecedentes clínicos, epidemiológicos, hemograma con recuento de eosinófilos; IgG Elisa; copro-parasitológicos y aspirado duodenal en búsqueda de huevo de parásitos. Las imágenes son de utilidad, endosonografía, tomografía computada (TC), resonancia magnética (RM) abdominal, especialmente en caso de complicaciones. La colangio-pancreatografía retrógrada endoscópica (CPRE) es útil tanto como para el diagnóstico como para el tratamiento (extracción de fasciolas adultas), como se realizó en el presente caso clínico. Este parásito también se puede encontrar incidentalmente en el transcurso de una cirugía por otros motivos. Presentamos el caso de un paciente de 41 años, originario de una zona rural, agricultor, con ingesta aparente de agua y vegetales acuáticos contaminados. Cursó inicialmente sólo con fiebre e hipereosinofilia; con diagnóstico de fascioliasis. Al cabo de 18 meses su patología recurrió con cuadro clínico de obstrucción biliar. El antecedente clínico y epidemiológico fue una herramienta fundamental para el diagnóstico, además, de la TC abdominal. Evolucionó inicialmente con mala respuesta a varios tratamientos antiparasitarios, y luego mejoró. Posteriormente, su patología recurrió con complicaciones. Se realizó CPRE con extracción de Fasciolas adultas. Actualmente, se encuentra en remisión sintomática mantenida, después de la intervención endoscópica y el tratamiento medicamentoso.

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We report a 60 years old female admitted for pain in the right upper quadrant of the abdomen, vomiting and fever. Initial laboratory showed leukocytosis with 56 percent of eosinophils. An abdominal CAT scan showed a subcapsular fluid collection in the liver. The patient was operated and the presence of a subcapsular hematoma was confirmed. Blood serological tests were positive for Fasciola hepatica. The patient was treated with tricabendazole and after one year of follow up, is in good conditions.

Presentamos el caso de una paciente de sexo femenino de 60 años de edad, ingresada en nuestro centro hospitalario por cuadro agudo de dolor abdominal en hipocondrio derecho asociado a vómitos y fiebre. Destaca la presencia de leucocitosis con eosinofilia de 56 por ciento. La tomografía computarizada abdominal muestra una colección subcapsular hepática. Durante su evolución presenta abdomen agudo, realizándose una laparoscopía exploratoria que confirma un hematoma subcapsular con presencia de hemopentoneo de escasa cuantía. La serología confirma infección por fasciola hepática. Se realizó su tratamiento con triclabendazol en monodosis. Además, realizamos una revisión de la literatura nacional e internacional sobre el tema, sus manifestaciones clínicas, métodos diagnósticos y tratamiento.

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Hepatic fasciolasis is a worldwide spread zoonoses mainly affecting cattle-raising countries. It is caused by the trematode Fasciola hepßtica and it is characterized by abdominal pain, fever, nausea and vomitus, weight loss, diahrrea, paleness, general malaise, and hypereosinophilia. Immunological diagnosis as well as stool eggs count may be performed. Hepatic subcapsular and intraparenchymatous hematoma is an infrequent complication of human fascioliasis. Nevertheless, for establishing a proper diagnosis and treatment, any suspicion of its presence must be carefully discarded through, clinical epidemiology, laboratory and imaging exams and procedures. The aim of this study is to expand knowledge on this unfrequently dealt pathology in medical literature by presenting four case reports related to patients undergoing a two-year treatment. All of them had been referred from Departamento de Cajamarca, Peru.

La fasciolasis hepática es una zoonosis mundialmente difundida, sobre todo en los países productores de ganado; causada por la fasciola hepática. Se manifiesta por dolor abdominal, fiebre, nauseas y vómitos, baja de peso, diarrea, palidez, malestar general e hipereosinofilia. El diagnóstico es inmunológico y también puede hacerse por recuento de huevos en heces. El hematoma subcapsular e intraparenquimatoso hepático es una complicación rara de la fasciolasis humana pero se debe tener un alto índice de sospecha uniendo epidemiología, clínica, laboratorio e imaginologia para un adecuado diagnóstico y tratamiento. El propósito de reportar estos casos es dar a conocer una patología poco frecuente en la literatura, con una casuística de cuatro pacientes tratados en el lapso de dos años, todos referidos del Departamento de Cajamarca.

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PURPOSE OF REVIEW: Tissue parasites of humans are still prevalent in most regions of the world, and are also seen more frequently in developed countries due to increasing travel patterns. In particular, Echinococcus infections still account for hepatic and pulmonary pathology, cysticercosis is a major cause of seizures and epilepsy, and fascioliasis also causes significant liver pathology. This review summarizes current knowledge on clinical and epidemiologic aspects of zoonotic disease caused by tissue helminths. RECENT FINDINGS: Tissue helminth infections remain as a public health concern. Recent research has provided new insights into clinical disease in humans and improved methods for diagnosis, treatment and control, arising mostly from the application of new techniques for immune and molecular diagnosis, availability of data from controlled trials, and development of new vaccines. Specific antiparasitic therapies are now better characterized, and new control tools are available. SUMMARY: Recent research has provided new diagnostic technologies applicable to diagnosis, treatment and control, but effective interventions to reduce transmission are rarely applied. Despite some progress in their control, these zoonoses continue to be a major public health problem in many regions both in developing countries and in some more developed ones.

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Con la finalidad de evaluar la eficacia, determinar la presencia de huevos post dosificación y medir la respuesta de los parámetros peso, condición corporal y producción de leche en vacunos sometidos a la dosificación del Triclabendazole al 10 por ciento en el tratamiento de fasciolasis, se utilizaron 70 vacunos raza Holstein y Brown Swiss de diferente edad (54 vacas en producción) procedentes de diferentes zonas de la campiña de Cajamarca. Se realizó tablas de frecuencias, histogramas, pruebas de t entre las diferentes variables, llegando a las siguientes conclusiones: El triclabendazole al 10 por ciento tiene una eficacia del 100 por ciento contra Fasciola hepática, en el ganado vacuno de diferentes edades, El triclabendazole, administrado a dosis de 10 mg/kg de peso es eficaz en un 100 por ciento en 60 días y un 96 por ciento hasta los 90 días, registrándose un 68 por ciento de efectividad hasta los 120 días pos dosificación, Los pesos promedios y la condición corporal registrados al inicio del experimento con los pesos del final del experimento de 54 vacas en producción estadísticamente fueron similares (P mayor 0.05), La dosificación con triclabendazol al 10 por ciento es una medida de control permitiendo un funcionamiento ideal, lo cual se ve reflejado con el incremento de la producción láctea (P menor 0.1) en un 11.5 por ciento.

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