The male patient in Hoa Binh was transferred to the Tropical Disease Center (Bach Mai Hospital) for treatment on August 15 with abdominal pain, fever, jaundice, fatigue, and dark urine.
About 1 month before being hospitalized, the patient's illness became increasingly severe. He went to many places for examination but the cause was not found.
Many liver flukes crawled out of the patient's bile duct.
Associate Professor - Dr. Do Duy Cuong, Director of the Center for Tropical Diseases, said that from the lower level, the patient had an abdominal CT scan and discovered dilated bile ducts in the liver, was diagnosed with bile duct tumor and was transferred to Bach Mai Hospital, where a bile duct drainage tube was placed.
However, during the treatment, doctors discovered many adult liver flukes about 0.5 - 1 cm in size crawling out through the bile duct, and stool tests found fluke eggs.
The patient was diagnosed with a small liver fluke infection in the liver causing obstruction and infection of the bile duct, from which bacteria entered the blood causing accompanying sepsis. This is the cause of easy misdiagnosis with sepsis or bile duct cancer.
After being treated with specific antiparasitic drugs and antibiotics, the patient is now stable, alert, fever-free, jaundice has improved, bile obstruction has improved, and the drainage tube no longer has worms coming out, and he can be discharged in the next few days.
Get sick from eating raw food
Associate Professor Do Duy Cuong emphasized that the above patient is a rare case in Vietnam as well as in the world. The reason is that diagnosing small liver flukes is often difficult, requiring the placement of a duodenal catheter to test for the eggs; never before have so many adult flukes emerged from the bile ducts as well as small liver fluke eggs found in the stool.
Associate Professor - Dr. Do Duy Cuong examines a patient with small liver flukes who is currently recovering.
Medical history shows that this patient often eats raw fish. According to Associate Professor Cuong, liver fluke is a common parasitic infection in Vietnam and has been on the rise recently due to the habit of eating raw fish and undercooked food. The disease can cause serious complications, affecting health.
Liver flukes are divided into two main types: small liver flukes and large liver flukes. People infected with small liver flukes are often infected by eating fish or snails containing uncooked fluke larvae or eating raw fish from ponds, lakes, or freshwater fish.
After eating, the larvae enter the stomach, down the duodenum and then up the bile duct to the liver, causing damage to the bile duct and dilation of the bile duct in the liver.
As for large liver flukes, people are often infected by eating raw vegetables that grow underwater (coriander, watercress, water spinach, celery...) that are infected with fluke larvae. The disease causes abscesses in the liver and can be confused with many other liver diseases such as bacterial abscesses, liver tumors or liver cysts...
Associate Professor Cuong recommends that people should eat cooked food and drink boiled water, not eat uncooked fish, snails, raw vegetables, and aquatic vegetables; wash hands thoroughly before eating and take deworming medicine regularly.
If you suspect you have the disease, you must go to a medical facility for examination, testing, diagnosis and timely treatment. In addition, doctors at the grassroots level also need to be trained, take note of medical history, medical history and perform additional tests to confirm the worm to diagnose and use drugs according to the treatment regimen of the Ministry of Health.
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