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)
Epigastric and right upper quadrant pain
Second Phase (months-years after ingestion of metacercariae)
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)
Cachexia (sheep rot)
Formulation of calculi (in the intrahepatic duct, common bile duct, and/or gallbladder)
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.
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