Fasciolopsiasis: a rare case report from a tertiary care hospital in South Odisha, India

Fasciolopsiasis is a disease caused by largest intestinal fluke, Fasciolopsis buski.Two species of intestinal flukes cause human infection in defined geographic areas worldwide. The large Fasciolopsis buski is endemic in Southeast Asia and is the most common human intestinal Trematode whereas the smaller heterphyes is found in the Nile Delta of Egypt. Human acquires the infection after eating raw freshwater plants contaminated with the infective Metacercariae. Most individuals infected with Fasciola buski infection are asymptomatic, however in heavy F. buski infection patient may have pain abdomen, diarrhea and malabsorption. We are reporting a rare case of Fasciola buski infection where a 35 year female, laborour, native of south odisha with a history of frequent drinking of water from Chilika lake ( The largest brackish water lake in Asia) complained of pain abdomen, vomiting and diarrhea for 3 months, Physical examination showed pallor, icterus, edema with hepatosplenomegaly. Laboratory investigation showed she had iron deficiency anemia, hypoalbuminimia, Ultrasonography of abdomen showed multiple cysts in liver and kidney, CT scan abdomen showed multiple cysts in liver and kidney and stool examination showed both eggs and live adult worms which was identified as Fasciola buski on gross morphology.She was successfully treated with Praziquantel . Detection of both eggs of F,buski and adult worm in stool with presence of multiple cysts in liver and kidney with features of Malabsorption is extremely rare and raises the possibility of unidentified cases in that region.