Clinical Presentation

 

Clonorchiasis is asymptomatic in many infected individuals, especially if the worm burden is not high. It is very difficult to distinguish an infection with Clonorchiasis from an infection with any other liver fluke. Different regions produce infections with differing levels of severity.  For example, infections in Japan tend to be mild to moderate, whereas in Hong Kong most infections are considered heavy (Tropical Medicine Central Resource). 

Acute Phase (1-3 weeks after ingestion of metacercariae)
Fever
Indigestion
Epigastric and right upper quadrant pain
Nausea
Diarrhea
Leukocytosis
Eosinophilia

Second Phase (months-years after ingestion of metacercariae)
Diarrhea
Anorexia
Prolonged low-grade fever
Liver tenderness/increased frequency of palpable liver
Progressive hepatomegaly with episodes of jaundice

Chronic Phase (can last up to 30 years)
Cirrhosis (unusual)
Ascites
Anasarca
Cachexia (sheep rot)
Hyperbilirubinemia
Jaundice
Formulation of calculi (in the intrahepatic duct, common bile duct, and/or gallbladder)
Cholangitis
Pancreatitis
Cholangiocellular carcinoma of the liver*
(Tropical Medicine Central Resource)

*This manifests in approximately 2-3% of those infected, a figure that is increasing with improved methods of diagnosis. Possible mechanisms of carcinogensis due to liver fluke infections (liver flukes are promoters and not initiators of cholangiocarcinoma):
1-Hyperplasia of bile duct epithelium and carcinogen exposure. 
2-Increased formation of endogenous carcinogen.
3-Activation of drug metabolizing enzymes.
(Khurana 2005)

 

Home    History of Discovery    Epidemiology    Life Cycle    Clinical Presentation    Diagnosis    Enterotest    Images    Treatment    Public Health and Prevention    References    Web Links