{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T06:21:05Z","timestamp":1773642065693,"version":"3.50.1"},"reference-count":5,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Acute Suppurative Obstructive Cholangitis (AOSC) typically resolves post-ERCP. However, a 53-year-old male had persistent hyperbilirubinemia and leukocytosis (WBC 28.12\u00d710\n                    <jats:sup>9<\/jats:sup>\n                    \/L) along with marked eosinophilia (20.26\u00d710\n                    <jats:sup>9<\/jats:sup>\n                    \/L) despite standard antibiotic therapy. Systematic diagnosis ruled out residual calculi, Endoscopic Nasobiliary Drainage (ENBD) dysfunction, biliary neoplasms, and sclerosing cholangitis. A history of undercooked freshwater fish consumption and eosinophilia prompted suspicion of occult liver fluke infection, despite negative initial stool tests. Diagnostic treatment with albendazole resulted in a decrease in WBC and eosinophil counts; subsequent detection of liver flukes in ENBD fluid and positive liver fluke IgG confirmed the diagnosis. At 2-month follow-up, all markers normalized. This case highlights the diagnostic value of eosinophilia in guiding the identification of parasitic infections in refractory post-ERCP inflammation, and the utility of diagnostic therapy when direct evidence is lacking.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1726277","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:23:18Z","timestamp":1773638598000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustained abnormal bilirubin and leukocyte levels after ERCP with acute suppurative obstructive cholangitis: a case report with 2 months follow-up observation"],"prefix":"10.3389","volume":"17","author":[{"given":"Jie","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahao","family":"Mo","sequence":"additional","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jintang","family":"Xiong","sequence":"additional","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaming","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e352","DOI":"10.1002\/deo2.352","article-title":"A case of acute obstructive suppurative pancreatic ductitis complicated with acute cholangitis diagnosed only after the removal of a pancreatic duct stent","volume":"4","author":"Oura","year":"2024","journal-title":"DEN Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"100258","DOI":"10.1016\/j.clinsp.2023.100258","article-title":"Efficacy of ultrasound-guided percutaneous transhepatic biliary drainage for acute obstructive suppurative cholangitis combined with septic shock","volume":"78","author":"Meng","year":"2023","journal-title":"Clinics (Sao Paulo)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2025.108","article-title":"An unusual cause of acute obstructive suppurative cholangitis","volume":"58","author":"Iribe","year":"2025","journal-title":"Clin Endosc"},{"key":"B4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3390\/tomography10010005","article-title":"Primary sclerosing cholangitis: diagnostic criteria","volume":"10","author":"Cazzagon","year":"2024","journal-title":"Tomography"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.46400","article-title":"Associations of liver fluke infection and cholangiocarcinoma: A scoping review","volume":"15","author":"Sivanand","year":"2023","journal-title":"Cureus"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1726277\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:23:19Z","timestamp":1773638599000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1726277\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":5,"alternative-id":["10.3389\/fimmu.2026.1726277"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1726277","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]},"article-number":"1726277"}}