{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:03:06Z","timestamp":1790391786507,"version":"4.1.0"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,6]]},"abstract":"<jats:p>A 23-year-old recent emigrant from Afghanistan presented in August 2017 with severe wheezing and dyspnea that required hospital admission. Her illness was associated with marked peripheral blood eosinophilia (9,900\u201315,600\/\u00b5L; 45.2\u201368%), as well as mild nausea, epigastric pain, and decreased appetite. She had lived until 3 months earlier in close proximity to cattle in her home in Kabul and did not recall eating watercress or other leafy plants associated with <jats:italic>Fasciola hepatica<\/jats:italic> transmission. Computerized tomography scanning showed bilateral ground-glass lung consolidations and multiple distinctive hypo-attenuating linear, tubuliform, and nodular liver lesions, including a large subcapsular hematoma. Numerous tests for rheumatological and malignant disorders were negative. <jats:italic>Fasciola hepatica<\/jats:italic> infestation was suspected on epidemiological, clinical, and radiographic grounds, and was confirmed by immunoblotting at the Centers for Disease Control (CDC). Multiple stool ova and parasite examinations were negative and endoscopic retrograde cholangiopancreatography did not identify trematodes. Her acute respiratory illness resolved with asthma-targeted therapies and her eosinophilia resolved with triclabendazole, which was obtained from CDC via an FDA Investigational New Drug application. Fascioliasis is uncommon in the United States, but the prolonged warfare and civil strife in Afghanistan and adjacent areas may lead to increased incidence outside the endemic region. Her case also demonstrates how hepatic imaging features of fascioliasis can be pathognomonic in clinical scenarios with eosinophilia and appropriate epidemiology and clinical features. We also highlight her relatively unusual presentation with symptoms of Loeffler-like syndrome alone.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0625","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T07:29:40Z","timestamp":1546932580000},"page":"588-590","source":"Crossref","is-referenced-by-count":19,"title":["Case Report: Hepatic Fascioliasis in a Young Afghani Woman with Severe Wheezing, High-Grade Peripheral Eosinophilia, and Liver Lesions: A Brief Literature Review"],"prefix":"10.4269","volume":"100","author":[{"given":"Martin","family":"Krsak","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayana U.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Poeschla","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Parasitology","first-page":"1665","article-title":"Human fascioliasis infection sources, their diversity, incidence factors, analytical methods and prevention measures","volume":"145","author":"Mas-Coma","year":"2018"},{"key":"b2","series-title":"Travel Med Infect Dis","first-page":"636","article-title":"Fascioliasis: a worldwide parasitic disease of importance in travel medicine","volume":"12","author":"Ashrafi","year":"2014"},{"key":"b3","series-title":"Curr Opin Infect Dis","first-page":"409","article-title":"Recent developments in the epidemiology, diagnosis, and treatment of Fasciola infection","volume":"31","author":"Webb","year":"2018"},{"key":"b4","series-title":"Acta Trop","first-page":"157","article-title":"Epidemiological analysis of human fascioliasis in northeastern Punjab, Pakistan","volume":"156","author":"Qureshi","year":"2016"},{"key":"b5","series-title":"Infect Dis Clin North Am","first-page":"399","article-title":"Trematode infections: liver and lung flukes","volume":"26","author":"Furst","year":"2012"},{"key":"b6","series-title":"J Helminthol","first-page":"207","article-title":"Epidemiology of fascioliasis in human endemic areas","volume":"79","author":"Mas-Coma","year":"2005"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"852","article-title":"Development of two FhSAP2 recombinant-based assays for immunodiagnosis of human chronic fascioliasis","volume":"95","author":"Shin","year":"2016"},{"key":"b8","series-title":"Rev Soc Bras Med Trop","first-page":"445","article-title":"Efficacy and tolerability of two single-day regimens of triclabendazole for fascioliasis in Peruvian children","volume":"48","author":"Maco","year":"2015"},{"key":"b9","series-title":"World J Gastroenterol","first-page":"4899","article-title":"Clinical presentation and management of Fasciola hepatica infection: single-center experience","volume":"17","author":"Kaya","year":"2011"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"222","article-title":"Natural history, clinicoradiologic correlates, and response to triclabendazole in acute massive fascioliasis","volume":"78","author":"Marcos","year":"2008"},{"key":"b11","series-title":"Turk J Pediatr","first-page":"109","article-title":"A pediatric case of fascioliasis with eosinophilic pneumonia","volume":"58","author":"Bayhan","year":"2016"},{"key":"b12","series-title":"Med Clin (Barc)","first-page":"764","article-title":"Eosinophilic pulmonary disease caused by Fasciola hepatica. 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