Microbiology
A fluke. F. hepatica and F. gigantica. Stool studies have poor yield, serology is good.
Epidemiologic Risks
Associating with sheep and cattle (and other animals) who contaminate water in Africa, Australia, China, Europe, South America.
Eating water grown plants wild-grown watercress in Europe & morning glory in Asia or otherwise drinking contaminated water.
Syndromes
Liver fluke. It lives in the bile ducts as excretes its eggs.
Several phases:
1) incubation period of a few days to three months with little to no symptoms.
2) invasive with: fever, malaise, abdominal pain, gastrointestinal symptoms, urticaria, anemia, jaundice, and respiratory symptoms.
3) latent with fewer symptoms and ultimately into a
4) chronic or obstructive phase for months to years with inflammation of the bile ducts, gall bladder, gall stones, and fibrosis.
Treatment
Triclabendazole is the treatment of choice, you have to call the CDC for it.
Seroreversion (loss of detectable antibodies) occurs 6 to 12 months after curative therapy.
Bithionol 30 to 50 mg/kg qod for 10 x 15 doses. Perhaps nitazoxanide.
Notes
May be associated with liver cancer but is not the cause of all cancers as one alt med provider suggested: The Bizarre Claims of Hulda Clark.