{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:50:31Z","timestamp":1767772231238,"version":"3.41.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T00:00:00Z","timestamp":1652227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Parasitic co-infection is commonly observed in natural populations, yet rare in the laboratory. Multiparasitism can have negative effects on the host, ranging from the atypical manifestations to increased mortality, consequently, it may be misdiagnosed and treated with unsuitable anthelmintic medicines. Therefore, reliable diagnosis is critical for appropriate treatment of parasitic co-infection. Herein, we report a case of a 31-year-old woman with persistent eosinophilia and hypoechoic liver lesion on ultrasound. The microscopic examination of multiple stool specimens did not find any pathogens. The patient had serum specific anti-<jats:italic>Trichinella<\/jats:italic> IgG antibody by Dot enzyme-linked immunosorbent assay (Dot-ELISA). After treatment with albendazole, contrast-enhanced magnetic resonance imaging (MRI) revealed more lesions in the liver. Subsequently, liver biopsy was performed in this patient and <jats:italic>Fasciola hepatica<\/jats:italic> was identified using metagenomic next-generation sequencing (mNGS) as well as polymerase chain reaction. After treatment with triclabendazole, which is the only anthelmintic drug specifically available against this fluke, her eosinophil count returned normal, and the liver lesions were significantly regressed. This case highlights the diagnostic challenge posed by parasitic co-infection, which merits more in-depth evaluation to confirm the diagnosis.<\/jats:p>","DOI":"10.3389\/fmed.2022.881356","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T18:34:40Z","timestamp":1652294080000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: \u201cArea of Focus\u201d Atypical Trichinellosis and Fascioliasis Coinfection"],"prefix":"10.3389","volume":"9","author":[{"given":"Meng","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziman","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiansha","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingyou","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Ning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junying","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/1756-3305-7-229","article-title":"Influence of nutrition on infection and re-infection with soil-transmitted helminths: a systematic review","volume":"7","author":"Yap","year":"2014","journal-title":"Parasit Vectors."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.DMIH2-0013-2015","article-title":"Parasites","author":"Theel","year":"2016","journal-title":"Microbiol Spectr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.ijheh.2017.05.007","article-title":"The impact of sanitation on infectious disease and nutritional status: a systematic review and meta-analysis","volume":"220","author":"Freeman","year":"2017","journal-title":"Int J Hyg Environ Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/B978-0-12-407706-5.00005-8","article-title":"Patterns and processes in parasite co-infection","volume":"82","author":"Viney","year":"2013","journal-title":"Adv Parasitol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"4707","DOI":"10.1007\/s00436-016-5240-x","article-title":"Survey of trichinella infection from domestic pigs in the historical endemic areas of Henan province, central China","volume":"115","author":"Jiang","year":"2016","journal-title":"Parasitol Res."},{"key":"B6","first-page":"332","article-title":"[A national survey on current status of the important parasitic diseases in human population]","volume":"23","year":"2005","journal-title":"Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2584","DOI":"10.1007\/s00261-021-02952-w","article-title":"'Curved tunnel' sign on MRI: a typical radiological feature in hepatic trichinellosis","volume":"46","author":"Xiong","year":"2021","journal-title":"Abdom Radiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1086\/605574","article-title":"Laboratory diagnosis of infections due to blood and tissue parasites","volume":"49","author":"Rosenblatt Jon","year":"2009","journal-title":"Clin Infect Dis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3389\/fmed.2017.00240","article-title":"Clinical and biological markers in hypereosinophilic syndromes","volume":"4","author":"Khoury","year":"2017","journal-title":"Front Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1038\/s41395-018-0083-y","article-title":"Beyond O&P times three","volume":"113","author":"Mohapatra","year":"2018","journal-title":"Am J Gastroenterol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.ijpara.2016.11.005","article-title":"Explaining parasite aggregation: more than one parasite species at a time","volume":"47","author":"Morrill","year":"2017","journal-title":"Int J Parasitol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.pt.2018.11.007","article-title":"Importance of sequence and timing in parasite coinfections","volume":"35","author":"Karvonen","year":"2019","journal-title":"Trends Parasitol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"S292","DOI":"10.1093\/infdis\/jiz286","article-title":"Next generation sequencing and bioinformatics methodologies for infectious disease research and public health: approaches, applications, and considerations for development of laboratory capacity","volume":"221","author":"Maljkovic Berry","year":"2020","journal-title":"J Infect Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"773145","DOI":"10.3389\/fmed.2021.773145","article-title":"Case report: fascioliasis hepatica precisely diagnosed by metagenomic next-generation sequencing and treated with albendazole","volume":"8","author":"Zhang","year":"2021","journal-title":"Front Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1089\/fpd.2011.0861","article-title":"Reviews on trichinellosis (IV): hepatic involvement","volume":"8","author":"Neghina","year":"2011","journal-title":"Foodborne Pathog Dis."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.3389\/fmicb.2017.01472","article-title":"Current research of trichinellosis in China","volume":"8","author":"Bai","year":"2017","journal-title":"Front Microbiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.wem.2019.12.003","article-title":"The disease ecology, epidemiology, clinical manifestations, and management of trichinellosis linked to consumption of wild animal meat","volume":"31","author":"Diaz","year":"2020","journal-title":"Wilderness Environ Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1186\/s13071-020-04309-6","article-title":"Trichinella spiralis co-infection exacerbates plasmodium berghei malaria-induced hepatopathy","volume":"13","author":"Mei","year":"2020","journal-title":"Parasit Vectors."},{"key":"B19","doi-asserted-by":"publisher","first-page":"579801","DOI":"10.3389\/fimmu.2020.579801","article-title":"Eosinophils control liver damage by modulating immune responses against fasciola hepatica","volume":"11","author":"Frigerio","year":"2020","journal-title":"Front Immunol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1469-0691.2011.03575.x","article-title":"Acute fascioliasis\u2013clinical and epidemiological features of four patients in Chile","volume":"18","author":"Fica","year":"2012","journal-title":"Clin Microbiol Infect."},{"key":"B21","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.exppara.2016.07.010","article-title":"Controversial aspects of the life cycle of Fasciola hepatica","volume":"169","author":"Moazeni","year":"2016","journal-title":"Exp Parasitol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/00004836-200403000-00017","article-title":"Hepatobiliary fascioliasis: clinical and radiologic features and endoscopic management","volume":"38","author":"Sezgin","year":"2004","journal-title":"J Clin Gastroenterol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1148\/radiology.174.3.2406786","article-title":"Hepatobiliary fascioliasis: noninvasive imaging findings","volume":"174","author":"Van Beers","year":"1990","journal-title":"Radiology."},{"key":"B24","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1046\/j.1365-3156.1996.d01-43.x","article-title":"MR findings in human fascioliasis","volume":"1","author":"Han","year":"1996","journal-title":"Trop Med Int Health."},{"key":"B25","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1111\/liv.12281","article-title":"Hepatic lesions and eosinophilia in an urban dweller","volume":"34","author":"Sivagnanam","year":"2014","journal-title":"Liver Int."},{"key":"B26","doi-asserted-by":"publisher","first-page":"102032","DOI":"10.1016\/j.parint.2019.102032","article-title":"The effect of Trichinella spiralis on muscular activity of experimentally infected mice","volume":"76","author":"Marian","year":"2020","journal-title":"Parasitol Int."},{"key":"B27","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1017\/S0031182021000056","article-title":"Therapeutic efficacy of mebendazole and artemisinin in different phases of trichinellosis: a comparative experimental study","volume":"148","author":"Allam","year":"2021","journal-title":"Parasitology."},{"key":"B28","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1111\/j.1365-2885.2006.00735.x","article-title":"Assessment of the main metabolism pathways for the flukicidal compound triclabendazole in sheep","volume":"29","author":"Virkel","year":"2006","journal-title":"J Vet Pharmacol Ther."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.881356\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T18:34:44Z","timestamp":1652294084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.881356\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,11]]},"references-count":28,"alternative-id":["10.3389\/fmed.2022.881356"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.881356","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2022,5,11]]},"article-number":"881356"}}