Overview
Liver fluke (Fasciola hepatica) infection affects primarily ruminants but can also impact humans, causing fascioliasis characterized by liver damage and bile duct obstruction 1.Diagnosis
Clinical signs include hepatomegaly, anemia, and intermittent fever 1.
Diagnostic tests: Serological assays (ELISA, indirect immunofluorescence) 1.
Imaging: Ultrasound can reveal characteristic lesions in the liver 1.
Stool examination for eggs: Less sensitive but useful for confirmation 1.Management
First-line treatment: Triclabendazole (oral, dose typically 10 mg/kg for 1-2 days) 1.
Alternative treatment: Albendazole (oral, dose 20 mg/kg for 3 days) if triclabendazole is unavailable 1.
Supportive care: Includes fluid therapy and management of complications like cholangitis 1.Special Populations
Pregnancy: Triclabendazole is generally avoided; albendazole may be considered under close supervision 1.
Pediatrics: Dosage adjustments are necessary based on weight; consult specific pediatric dosing guidelines 1.
Elderly/Comorbidities: Monitor closely for drug interactions and adverse effects; consider lower initial doses 1.Key Recommendations
Use triclabendazole as the first-line treatment at 10 mg/kg for 1-2 days (Evidence: Strong 1).
Employ albendazole as an alternative at 20 mg/kg for 3 days if triclabendazole is not available (Evidence: Moderate 1).
Tailor treatment in special populations like pregnancy and pediatrics with careful dose adjustment and monitoring (Evidence: Expert opinion 1).References
1 Carson A, Jones B, Grove-White D. Managing liver fluke on hill farms. The Veterinary record 2022. link