clonorchiasis

Clonorchiasis: A Liver Fluke Infection

Clonorchiasis, also known as Chinese liver fluke disease, is a parasitic infection caused by the liver fluke Clonorchis sinensis. This infection affects the bile ducts and liver of humans and other mammals.

• Causes: Clonorchiasis is acquired by eating raw or undercooked fish, crabs, or crayfish from areas where the parasite is found. The infection occurs when the parasite's eggs are ingested and hatch in the human body.
• Symptoms: Most infections are asymptomatic, but when present, symptoms include:
  • Jaundice
  • Indigestion
  • Biliary inflammation
  • Bile duct obstruction
  • Liver cirrhosis (in severe cases)
• Geographic Distribution: Clonorchiasis is most commonly found in Eastern Asia, including Korea, China, and Vietnam.
• Transmission: The infection can be transmitted to humans through the consumption of contaminated fish or seafood.

References:

[1] - Clonorchiasis is a zoonotic hepatobiliary disease caused by Clonorchis sinensis, otherwise known as the liver fluke, which targets the bile ducts. [6] [2] - Clonorchiasis is infection with the liver fluke Clonorchis sinensis. Infection is usually acquired by eating undercooked freshwater fish. [15]

Note: The information provided is based on the search results and may not be an exhaustive or definitive description of clonorchiasis.

Diagnostic Tests for Clonorchiasis

Clonorchiasis, a parasitic infection caused by the liver fluke Clonorchis sinensis, can be diagnosed using various methods. Here are some of the diagnostic tests used to detect this infection:

• Microscopic Identification: The most common method is microscopic identification of eggs in stool specimens [1]. This test is usually performed on multiple stool samples and involves concentration techniques to increase sensitivity.
• Serologic Testing: Serologic testing, such as ELISA (Enzyme-Linked Immunosorbent Assay), can be used to detect antibodies against Clonorchis sinensis. However, this method cannot distinguish between current and past infections [10].
• Imaging Studies: Imaging studies, including ultrasound, CT, or MRI, can help diagnose clonorchiasis by showing characteristic biliary tract dilatations with filling defects due to flukes [5][13]. These tests are particularly useful in cases where the diagnosis is unclear.
• PCR (Polymerase Chain Reaction): PCR tests can be used to detect eggs in stool and serologic tests can be used for diagnosis. However, serologic tests cannot distinguish between current and past infections [3].
• Stool Kato-Katz Test: The stool Kato-Katz test is a widely used method that involves pressing stool through a mesh to prepare a sample for microscopic examination [13]. Performing repeated tests improves sensitivity.
• Excretory and Secretory Products (ESPs): ESPs are considered superior to crude extract in diagnosing clonorchiasis, with a sensitivity of 93.1% [15].

It's worth noting that diagnosis of clonorchiasis is often based on finding eggs in the feces or duodenal contents, and eggs typically become detectable in the stool only 3 to 4 weeks after infection [4][12].

Treatment Options for Clonorchiasis

Clonorchiasis, also known as liver fluke infection, is a parasitic disease caused by the consumption of raw or undercooked fish containing the larvae of the parasite Clonorchis sinensis. The primary treatment options for clonorchiasis are:

• Praziquantel: This is the first-line treatment for clonorchiasis and has been shown to be highly effective in treating the infection. Praziquantel works by killing the parasites in the bile ducts and intestines.
• Albendazole: This is an alternative drug that can be used to treat clonorchiasis, especially in cases where praziquantel is not available or tolerated.

Dosage and Administration

The recommended dosage for praziquantel is 25 mg/kg of body weight taken three times a day for two days. Albendazole can also be administered at a dose of 400-800 mg per day for three days.

Other Treatment Options

In some cases, biliary obstruction may require surgical intervention to relieve the blockage and allow the bile to flow freely. Additionally, family members and close contacts of individuals with clonorchiasis should be screened and treated if necessary to prevent further transmission.

References

• Praziquantel is recommended by WHO for treatment of clonorchiasis [5].
• The first-line treatment for clonorchiasis and opisthorchiasis is praziquantel, with albendazole as an alternative drug [8].
• To control morbidity, anthelmintic treatment is needed, and at present, only one drug (praziquantel) is recommended against clonorchiasis and opisthorchiasis [9].

Differential Diagnoses of Clonorchiasis

Clonorchiasis, a parasitic infection caused by the liver fluke Clonorchis sinensis, can be challenging to diagnose due to its similarity with other biliary tract diseases. The following conditions are considered differential diagnoses for clonorchiasis:

• Acute or chronic hepatitis: Inflammation of the liver, which can be caused by various factors, including viral infections, toxins, and autoimmune disorders.
• Cancer along the bile ducts: Malignancies that affect the bile ducts, such as cholangiocarcinoma.
• Hepatocholedocholithiasis with recurrent pyogenic cholangitis: A condition characterized by the presence of stones in the bile ducts and recurring bacterial infections.
• Sclerosing cholangitis: A chronic disease that causes inflammation and scarring of the bile ducts, leading to narrowing and obstruction.
• Caroli's disease: A rare congenital disorder that affects the bile ducts, causing them to dilate and form cystic structures.

These differential diagnoses are important to consider when evaluating patients with suspected clonorchiasis. Accurate diagnosis is crucial for effective treatment and management of the condition.

References:

• [12] Differential diagnoses of clonorchiasis include acute or chronic hepatitis, cancer along the bile ducts, hepatocholedocholithiasis with recurrent pyogenic cholangitis, sclerosing cholangitis, and Caroli's disease.
• [14] Differential diagnoses of clonorchiasis include acute or chronic hepatitis of other aetiologies (eg, fascioliasis), cancer of the biliary system, hepatocholedocholithiasis with recurrent pyogenic cholangitis, sclerosing cholangitis, and Caroli's disease.
• [66] Complications as a consequence of chronic clonorchiasis can include pyogenic cholangitis.