Fascioliasis: Image Findings, Diagnosis, and Treatment

Abstract

Fascioliasis is zoonotic helminthiasis caused by Fasciola hepatica or F. gigantica that is occasionally reported in South Korea. Humans can become infected through contaminated water, aquatic plants, or the consumption of raw liver. The infection typically presents with non-specific symptoms such as indigestion or fatigue, but can progress to more severe conditions like jaundice or hepatomegaly as the parasite penetrates the liver and resides in the biliary tract. Sonographically, hepatic fascioliasis appears as ill-defined, scattered hypoechoic nodules or mixed-echogenic geographic lesions, sometimes accompanied by track-like lesions. Diagnosis can be challenging without prior suspicion, as it often requires specific imaging findings or laboratory tests, including detecting eggs in stool or antibodies via Enzyme-Linked Immunosorbent Assay. The primary treatment is triclabendazole, which is highly effective in both the acute and chronic phases of the disease. This infection necessitates a cautious diagnostic and treatment approach, especially in cases without a clear history of parasitic infection, as it can be easily overlooked.