According to Dr. Dao Bach Khoa, Ho Chi Minh City Hospital for Tropical Diseases, the patients are mainly female (68%), with an average age of 40, coming from 24 provinces and cities from Quang Ngai and south. Of these, 44 cases live in Ho Chi Minh City, 40 cases live in the Central provinces; 23 complicated cases require hospitalization. All patients have the habit of eating raw vegetables.
Notably, 2 cases of liver abscess due to large liver flukes in pregnant women and 3 cases of severe disease progression, late hospitalization, risk of abscess rupture required coordination with surgical specialists. However, the disease can be effectively treated if diagnosed and treated early.
Dr. Tran Nguyen Cao Loi, Ho Chi Minh City Hospital for Tropical Diseases, said that in March 2023, the hospital received two pregnant women from Khanh Hoa and Thu Duc who were admitted with increasing epigastric pain accompanied by fever and nausea. They often ate raw vegetables sent from their hometown in Binh Dinh. Ultrasound showed a liver abscess measuring 5×8 cm in the 16-week pregnant woman and 7×8.4 cm in the 28-week pregnant woman.
Ultrasound image of liver abscess caused by large liver fluke. Photo: BVCC
Because these were two complicated cases, difficult to handle and treat, a consultation was held between the entire hospital and the inter-hospital department of surgery and obstetrics to find the best intervention solution. After that, the patient was treated with Triclabendazole and closely monitored for clinical developments and fetal condition. After 1 week of hospitalization, the patient had no more fever or abdominal pain and was discharged for outpatient follow-up.
Fascioliasis remains a global health problem. WHO considers Vietnam an endemic area for fascioliasis. Currently, 47 provinces and cities have recorded cases of fascioliasis. The most affected areas are the central coastal region.
There are two types of liver flukes that cause disease in humans: Fasciola hepatica and Fasciola gigantica. The liver flukes parasitize, reproduce and mature in herbivores such as buffalo, cows and sheep and are excreted in feces into the outside environment. People get sick by eating raw vegetables that grow in water without washing them thoroughly or drinking uncooked water contaminated with worm larvae.
Treatment will be individualized depending on the severity of the condition. For mild cases, patients will be treated with a single dose of Triclabendazole, an effective oral medication for treating large liver flukes. For severe cases, depending on the progression, patients may be given a repeat dose of the medication or additional antibiotics if a bacterial superinfection is suspected.
"Fascioliasis is not a rare disease. Not drinking raw water or eating raw vegetables growing in water are effective measures to prevent this disease," Dr. Loi advised.
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