scholarly journals An unhealthy holiday on Lake Bolsena

2013 ◽  
pp. 39-42
Author(s):  
Lucio Brugioni ◽  
Maurizio Tognetti ◽  
Cristina Gozzi
Keyword(s):  
Abdominal Pain ◽  
Hypereosinophilic Syndrome ◽  
Central Italy ◽  
Clinical Tests ◽  
Opisthorchis Felineus ◽  
Specific Analysis ◽  
Patient Reported ◽  
Stool Samples ◽  
Raw Fish ◽  
Abdominal Echography

A 70-year old man (OL) was hospitalized due to fever (up to 40°C) associated with malaise and abdominal pain. Tests showed hypereosinophilic syndrome, and increased liver and inflammation indexes. Abdominal echography showed a nonhomogeneous liver and the spleen was enlarged. Abdominal computed tomography showed multiple abscesses on the liver. The patient reported that he had recently gone on holiday to Lake Bolsena where he had eaten raw fish. A specialist in infectious diseases confirmed that in that area there is an infestation of Opisthorchis felineus. Analysis of blood and stool samples confirmed the presence of this parasite. The patient was treated with praziquantel with resolution of fever and improvement in clinical tests and general condition. Opisthorchis felineus is a parasite that commonly infects dogs and cats. Infection is sometimes transmitted to man and is usually related to eating raw fish. The parasite enters the liver and its eggs are found in the patient’s stool samples. Acute symptoms are: fever, diarrhea, abdominal pain, and malaise. Hypereosinophilic syndrome and increase in liver index are typical. Chronic infection could result in cholangiocarcinoma. Presence of the parasite is confirmed through specific analysis of blood and stool. Therapy consists of praziquantel or, as second choice, abendazol. In the 20th century, there were 4 epidemics in Italy, on Lakes Trasimeno and Bolsena in Central Italy. The latest epidemic was reported in that area in summer 2012.

MICROBIAL SHIFTS ARE ASSOCIATED WITH PATIENT-REPORTED SYMPTOMS IRRESPECTIVE OF MUCOSAL INFLAMMATION IN PEDIATRIC PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S40-S41
Author(s):  
Jennifer Hellmann ◽  
Allison Ta ◽  
David Haslam ◽  
Kathleen Lake ◽  
Ramona Bezold ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Rectal Bleeding ◽  
Abundant Species ◽  
Fecal Calprotectin ◽  
Mucosal Inflammation ◽  
Patient Reported ◽  
Calprotectin Level ◽  
Inflammatory Bowel ◽  
Stool Samples ◽  
Children And Young Adults

Abstract Objectives Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are characterized by an aberrant host response to intestinal microbiota causing mucosal inflammation and gastrointestinal symptoms. Patient reported outcome measures (PROs) are increasingly utilized in clinical care and research. Our study aim was to determine if fecal microbial shifts were associated with PROs in children and young adults with IBD. Methods A longitudinal prospective single center study of 93 patients tested for association between fecal microbial shifts, mucosal inflammation as measured by fecal calprotectin, and self-reported symptoms including diarrhea, rectal bleeding, and abdominal pain. For CD, abdominal pain and diarrhea determined disease activity or overall PRO. For UC, diarrhea and rectal bleeding were used. Fecal calprotectin and shotgun metagenomic sequencing were performed on all samples. Demographic and clinical characteristics (Table 1) were incorporated into a negative binomial mixed-effects model in “R” to identify differentially abundant species by PRO and fecal calprotectin. Metabolic pathways were mapped using the HUMAnN2 pipeline and compared to overall PRO, individual symptoms and fecal calprotectin level. Results In 70 CD patients with 244 stool samples, there was no association between symptoms and fecal calprotectin. In 23 UC patients with 76 stool samples, increased fecal calprotectin was associated with rectal bleeding (OR 4.93 [1.18, 20.64], p=0.03). Examination of differentially abundant species in those with self-reported active UC showed increased Klebsiella species and reduced Bacteroides. Conversely, UC patients with fecal calprotectin < 100 µg/gm had reduction in Klebsiella and increase in Bifidobacteria and Bacteroides (Figure 1). Analysis of differentially abundant species in those with abdominal pain in CD showed increase in Haemophilus and reduction in Bacteroides. No microbial shifts were identified in CD patients in association with overall PRO, diarrhea, nor with fecal calprotectin < 250 µg/gm. Metabolic pathway analysis showed no differences in those with CD. In UC patients, increases in sulfoglycolysis and ornithine biosynthesis were associated with overall PROs. Conclusions Fecal microbial shifts including decreased commensals such as Bacteroides correlate with UC patient symptoms. Increased fecal calprotectin level was associated with rectal bleeding in these patients, but not diarrhea. In CD, there was no association with fecal calprotectin and symptoms, and microbial shifts were detected in association with abdominal pain. Similarly, metabolic pathways differed relative to patient-reported symptoms in UC, but not in CD. Data suggests that microbial shifts may directly contribute to symptoms in children and young adults with IBD.

Hyper-eosinophilic syndrome: An uncommon cause of chronic abdominal pain in an elderly male

2021 ◽  
pp. 004947552098776
Author(s):  
Dibya L Praharaj ◽  
Bipadabhanjan Mallick ◽  
Preetam Nath ◽  
Sarat C Panigrahi ◽  
Anil C Anand ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Wide Spectrum ◽  
Hypereosinophilic Syndrome ◽  
Connective Tissue Disorder ◽  
Sleep Apnoea ◽  
Chronic Abdominal Pain ◽  
Elderly Male ◽  
Essentially Normal ◽  
Organ Systems ◽  
Obstructive Sleep

Hypereosinophilia is defined as an absolute eosinophil count of ≥1.5 × 109/L, and its presence with involvement of at least one organ system defines the hypereosinophilic syndrome. It may occur with parasitic infestation, connective tissue disorder or rarely in clonal disorders such as eosinophilic leucaemia. Organ systems that may be involved include the cardiovascular, central nervous, respiratory and gastrointestinal systems. In the latter, a wide spectrum of clinical presentation may be seen from trivial, to debilitating or rarely fatal. We report an elderly male with a history of bronchial asthma, obstructive sleep apnoea and food allergy who presented with chronic abdominal pain and weight loss. Abdominal examination and routine evaluation were essentially normal other than a peripheral hyper-eosinophilia. We witnessed a brisk and lasting response to an elimination diet and corticosteroids.

Patient self-reporting of tolerability using PRO-CTCAE: A randomized double-blind placebo controlled phase II trial comparing gemcitabine in combination with adavosertib or placebo in women with platinum resistant epithelial ovarian cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5541-5541
Author(s):  
Ainhoa Madariaga ◽  
Sandra A. Mitchell ◽  
Tyler Pittman ◽  
Lisa Wang ◽  
Valerie Bowering ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Abdominal Pain ◽  
Objective Assessment ◽  
Area Under The Curve ◽  
Recurrent Ovarian Cancer ◽  
Median Number ◽  
Self Report ◽  
Double Blind ◽  
Patient Reported ◽  
Fatigue Severity

5541 Background: A 4 month improvement in OS was demonstrated when Wee1 inhibitor adavosertib (Ad) and gemcitabine (G; arm A) was compared to G and placebo (P; arm B) in a phase 2 trial in recurrent ovarian cancer (NCT02151292). The patient reported outcome version of the CTCAE (PRO-CTCAE) was used to capture self-report of the frequency, severity and/or interference (scored 0-4; higher scores indicating worse symptomatic adverse events [syAEs]). Methods: Ad/P was given orally on D1-2, D8-9, D15-16 with G D1, D8, D15 in a 28-day cycle. English speaking pts in 2 centres completed PRO-CTCAE items electronically in clinic at baseline, D1 and D15 of each cycle and off treatment. An exploratory objective was to characterize syAEs in the first 3 months of therapy. We calculated 12-week area under the curve (AUC12w) as a measure of syAE over time and incremental AUC12w (iAUC12w) for adjustment to baseline syAEs and compared arms A and B using an independent samples t-test. We assessed proportion of scores 3-4 at 6 time-points and compared them using Fisher’s Exact Test at each survey. Results: 51 pts were enrolled and completed ≥1 survey, 47 were evaluable for primary outcome (arm A: 28, B: 19). ECOG status was ≤1 in 44/47 pts. Median number of cycles of therapy were 5 (1-16) in arm A, and 2 (1-16) in B. Survey completion rates were high (arm A 93%, B 95%). Mean AUC12w fatigue severity (A 152 [standard error 9] vs B 112 [10]; p = 0.005) and interference (A 144 [11] vs 98 [15]; p = 0.018), diarrhea frequency (A 70 [12] vs B 33 [9]; p = 0.014), mucositis (A 23 [6] vs B 6 [3]; p = 0.012) and difficulty swallowing severity (A 10 [3] vs B 2 [2]; p = 0.023) were higher in arm A (any grade). There were no statistically significant between-arm differences in abdominal pain, bloating, nausea, vomiting and anxiety. The iAUC12w was significantly higher in arm A vs B for difficulty swallowing severity (A 10.1 [3] vs B -2.7 [4.7]; p = 0.02), mucositis severity (A 19.9 [6.6] vs B -3.1 [6.9]; p = 0.02) and fatigue severity (A 35.2 [8.2] vs B -3.1 [9.8]; p = 0.005). Proportions with high scores (3-4) were only significantly higher at C1D15 for fatigue severity in arm A (A 55% vs B 19%, p = 0.044). No significant differences were seen in other 3-4 scores per survey time. Conclusions: This is the first study evaluating pts self-reported toxicity with adavosertib in a randomized setting, allowing pts self-evaluation of toxicity in the context of improved PFS and OS. Greater fatigue, diarrhea, mucositis and difficulty swallowing were experienced by pts receiving adavosertib and gemcitabine, but score 3-4 reached significance on C1D15 fatigue only. No significant differences were detected in syAE profile for nausea, vomiting, abdominal pain, bloating and anxiety. This approach allows objective assessment of pts perception of toxicity with complex therapy. Clinical trial information: NCT02151292.

scholarly journals Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

2020 ◽  
pp. 94-102
Author(s):  
Enas Sh. Khater ◽  
Abd Alazim A. Al- Faki
Keyword(s):  
Saudi Arabia ◽  
Abdominal Pain ◽  
Clostridium Difficile ◽  
Proton Pump ◽  
Peptic Ulcers ◽  
Pcr Assay ◽  
Kingdom Of Saudi Arabia ◽  
Statistical Significant Difference ◽  
Significant Difference ◽  
Stool Samples

Clostridium difficile infections (CDIs) is considered healthcare-associated infections which cause watery diarrhea to long stayed hospitalized patients and cause increased mortality rate. Aim: Detection of the prevalence and risk factors of C. difficile in Al Quwayiyah General hospital, Riyadh, Kingdom of Saudi Arabia and compairing between GeneXpert® PCR assay and Quikchek complete-enzyme imunoassay QCC, (QCC-EIA) in detection of C. difficile infection and toxicity Materials and Methods: A cross sectional and prospective study was performed for one year started from June 2019 to June 2020. The data collected include demographic, laboratory and clinical data. A total of 104 stool samples were collected from patients presented with diarrhea. GeneXpert® PCR assay and Quikchek complete-enzyme imunoassay QCC (QCC-EIA) were conducted to each stool sample. Results: Only 15(14.4%) of the 104 studied patients had CDI while 89 (85.6%) were non CDI patients, 13 (86.7%) of the CDI patients were males and 2 (13.3%) were females with mean age for CDI cases 61 (±19.9), while non CDI cases involved 55(61.8%) were males and 34 (38.2%) were females with mean age for cases of non CDI, 60 (±18.7) years. Of the CDI and non CDI cases respectively 12 (80%) and 14(15.7%) had fever, 5 (27%) and 6 (6.7%) had vomitting and 7 (46.7%) and 12 (13.5%) of cases had abdominal pain. There was statistical significant difference between patients with fever while no statistical significant difference regarding vomitting and abdominal pain. There was statistical significant difference between patients with peptic ulcers, patients received proton pump inhibitors and patients received broad-spectrum antibiotics, while There was no statistical significant difference between cardiac disease, cerebrovascular disease, diabetes, pulmonary disease, hepatic disease and Renal disease. Gene expert PCR detected 15/104(14.4%) as positive CDI while QCC-EIA detected 21/104 (20.5%) as positive CDI. On comparison between gene expert PCR technique and QCC-EIA the sensitivity of QCC-EIA was 100%, while the specificity was 91%. The Positive Predictive Value was 74%, while the Negative Predictive Value was 100%. Conclusion: The C. difficile infection prevalence rate in the hospital was 14.4%. There was statistical significant difference between patients with peptic ulcers, patients received proton pump inhibitors and patients received broad-spectrum antibiotics. The QCC-EIA can be used as a screening test for the detection of C. difficile toxin in stool samples but should be confirmed with a PCR assay or another confirmatory test Due to its decreased specificity.

scholarly journals Bedside breath tests in children with abdominal pain: a prospective pilot feasibility study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
David C. Wong ◽  
Samuel D. Relton ◽  
Victoria Lane ◽  
Mohamed Ismail ◽  
Victoria Goss ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Abdominal Pain ◽  
Characteristic Curve ◽  
Primary Diagnosis ◽  
Receiver Operator Characteristic Curve ◽  
Breath Tests ◽  
Paediatric Hospital ◽  
Suspected Appendicitis ◽  
Definitive Method ◽  
Patient Reported

Abstract Background There is no definitive method of accurately diagnosing appendicitis before surgery. We evaluated the feasibility of collecting breath samples in children with abdominal pain and gathered preliminary data on the accuracy of breath tests. Methods We conducted a prospective pilot study at a large tertiary referral paediatric hospital in the UK. We recruited 50 participants with suspected appendicitis, aged between 5 and 15 years. Five had primary diagnosis of appendicitis. The primary outcome was the number of breath samples collected. We also measured the number of samples processed within 2 h and had CO2 ≥ 3.5%. Usability was assessed by patient-reported pain pre- and post-sampling and user-reported sampling difficulty. Logistic regression analysis was used to predict appendicitis and evaluated using the area under the receiver operator characteristic curve (AUROC). Results Samples were collected from all participants. Of the 45 samples, 36 were processed within 2 h. Of the 49 samples, 19 had %CO2 ≥ 3.5%. No difference in patient-reported pain was observed (p = 0.24). Sampling difficulty was associated with patient age (p = 0.004). The logistic regression model had AUROC = 0.86. Conclusions Breath tests are feasible and acceptable to patients presenting with abdominal pain in clinical settings. We demonstrated adequate data collection with no evidence of harm to patients. The AUROC was better than a random classifier; more specific sensors are likely to improve diagnostic performance. Trial registration ClinicalTrials.gov, NCT03248102. Registered 14 Aug 2017.

Midthoracic Punctate Midline Myelotomy for Treatment of Chronic, Intractable, Nonmalignant, Abdominal Visceral Pain: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (2) ◽  
pp. E183-E183 ◽  
Author(s):  
Tyler Ball ◽  
Zaid Aljuboori ◽  
Haring Nauta
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Surgical Procedure ◽  
Visceral Pain ◽  
Lower Abdominal Pain ◽  
Clinical History ◽  
Dorsal Column ◽  
Complete Relief ◽  
Patient Reported

Abstract Punctate midline myelotomy (PMM) is a surgical procedure that damages the ascending fibers of the postsynaptic dorsal column (PSDC) pathway to interrupt visceral pain transmission.1-3 It can offer relief to patients with chronic visceral pain conditions that are refractory to other treatments. Here, we present a surgical video of midthoracic PMM in a patient with chronic, intractable, nonmalignant visceral abdominal pain that failed over a decade of medical treatment. We choose T7-8 as the level for laminectomy in patients with pelvic or lower abdominal pain, because the postsynaptic pain fibers transmitting visceral pain sensation from the lower abdominal organs will invariably be caudal to this level. The patient developed immediate and complete relief of her visceral pain after the procedure, which was sustained through the 11-wk follow-up period to date and was able to be weaned off narcotics. Postoperatively, she remained full strength and had no impairment of light touch or proprioception of her lower extremities. Detailed physical examination showed a reduced vibratory sensation on the glabrous skin of her great toes. Regarding patient-reported sensory changes (not detected on physical examination), she reported some numbness on the insides of her feet that had resolved by 11-wk follow-up. She also reported some numbness of the vulva, but not of the vagina. However, by 11-wk follow-up, she reported this had resolved and she had normal sexual function. The only persistent sensation at 11-wk follow-up was slight tingling in her toes that was not bothersome to her.4 The patient presented in the following video consented to both the surgical procedure and the publication of her clinical history and operative video.

Patient reported abdominal pain as a surrogate of the clinical benefit of tipifarnib in pancreatic cancer patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 275-275
Author(s):  
Antonio Gualberto ◽  
Catherine Rose Scholz ◽  
Eric Van Cutsem
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Abdominal Pain ◽  
Cancer Patients ◽  
Clinical Benefit ◽  
Controlled Trial ◽  
Locally Advanced ◽  
Study Entry ◽  
Primary Study ◽  
Patient Reported

275 Background: Tumor CXCL12 expression identifies patients who may benefit from tipifarnib therapy. In pancreatic cancer, CXCL12 is known to decrease abdominal pain by inducing the migration of pain suppressing Schwann cells to tumor lesions. Given the association between CXCL12 and pain suppression, we investigated whether the absence of patient reported abdominal pain could be a surrogate of clinical benefit from tipifarnib in pancreatic cancer patients. Methods: We conducted a retrospective analysis of a randomized placebo-controlled trial comparing gemcitabine plus tipifarnib (GT) versus gemcitabine plus placebo (GP) in pancreatic adenocarcinoma patients. Tipifarnib was given at 200 mg bid orally continuously; gemcitabine at standard dosing. Primary study end point was overall survival. Results: 688 patients were enrolled of whom 155 (22.5%) reported no abdominal pain at study entry, 81 received GT and 74 GP. Baseline characteristics were balanced in the subset of patients with no reported abdominal pain (GT,GP): median age (63,59), female gender (35%,43%), ECOG 0-1 (89%,90%), metastatic disease (64%,70%), 6-month weight loss >10% (48%,39%), 6-month jaundice history (51%,45%), and prior Whipple surgery (16%,13%). Subjects receiving GT who did not report abdominal pain at study entry had higher frequency of locally advanced disease (36% vs 24%) and 6-month jaundice (51% vs 38%), and lower frequency of lung (6% vs 14%) and peritoneum (4% vs 13%) metastases than those reporting pain. No differences in survival were observed in the overall study. Median overall survival for GT was 193 vs 182 days for GP. Notably, absence of abdominal pain at study entry was associated with higher median survival in the GT arm (no pain, pain): 305 vs 176 days, HR=0.52, p<0.0001, whereas no significant effect was observed in the control arm: 184 vs 182 days. A trend for better survival with GT was observed in subset of patients with no abdominal pain at study entry (GT,GP): 305 vs 184 days, p=0.058. Conclusions: Absence of abdominal pain may serve as a surrogate of clinical benefit from tipifarnib in pancreatic cancer. (Van Cutsem et al. JCO 2004;22:1430-8; NCT00005648; Trial Sponsor: J&J PRD). Clinical trial information: NCT00005648.

Patient-reported complications associated with Campylobacter jejuni infection

2009 ◽  
Vol 138 (7) ◽  
pp. 1004-1011 ◽  
Author(s):  
D. SCHÖNBERG-NORIO ◽  
L. MATTILA ◽  
A. LAUHIO ◽  
M.-L. KATILA ◽  
S.-S. KAUKORANTA ◽  
...  
Keyword(s):  
Campylobacter Jejuni ◽  
Medical Records ◽  
Joint Pain ◽  
Cross Sectional Study ◽  
Antimicrobial Treatment ◽  
Musculoskeletal Symptoms ◽  
Cross Sectional ◽  
Positive Stool ◽  
Patient Reported ◽  
Stool Samples

SUMMARYThis study aimed to investigate the occurrence of complications, especially musculoskeletal symptoms, after sporadic Campylobacter jejuni enteritis of domestic origin in Finland. This multi-centre cross-sectional study was conducted during a seasonal peak in 2002. Questionnaires were sent to Campylobacter-positive patients, representing different geographical areas, 2 months after collection of positive stool samples. Medical records were viewed in several cases. Besides antimicrobial susceptibility testing C. jejuni isolates were serotyped. A total of 235 patients (58%) returned the questionnaire and 201 C. jejuni-positive patients were finally included in the study. Musculoskeletal symptoms associated with C. jejuni enteritis were frequent (39%); joint pain was most commonly reported (81%). The incidence of reactive arthritis was 4% and that of Achilles enthesopathy and/or heel pain was 9%. Stomach ache during enteritis was associated with the later development of joint pain. Antimicrobial treatment was common but did not prevent complications.

scholarly journals FOOD SENSITIZATION IN CHILDREN WITH OPISTHORCHIS FELINEUS INVASION

2015 ◽  
Vol 69 (1-2) ◽  
pp. 64-68 ◽  
Author(s):  
L. M. Ogorodova ◽  
O. S. Fedorova ◽  
M. M. Fedotova ◽  
T. A. Evdokimova
Keyword(s):  
Epidemiological Data ◽  
Specific Ige ◽  
Infected Group ◽  
Food Allergens ◽  
Opisthorchis Felineus ◽  
Total Ige ◽  
Stool Samples ◽  
Bet V1 ◽  
Food Sensitization ◽  
Reduced Risk

Aim: to determine the mechanism of food sensitization in children with chronic Opisthorchis felineus invasion. Patients and methods: during the epidemiological study the groups of patients (7–10 years) with chronic opisthorchiasis (n =237) and children without chronic opisthorchiasis (n =496) were formed. The investigation included interviewing of parents / guardians, measurement of total IgE, specific IgE to food allergens and component-resolved diagnostic, real-time PCR in stool samples. Results: the chronic opisthorchiasis invasion in children is associated with reduced risk of food sensitization, compared with non-infected group (9,7 vs 16,94%, OR =0,53; 95% CI 0,31–0,88; p =0,01). Opisthorchiasis of high intensity negatively correlated with increased level of specific IgE to food allergens in serum (OR =0,46; 95% CI 0,24–0,91; p =0,023). The association between level of total IgE and intensity of opisthorchiasis combinated with food sensitization was found. The sensitization to allergens class I (cyp c1, cor a11, gal d2, pru p3) is more prevalent in patients with opisthorchiasis, in uninfected children the sensitization to bet v1-homologues (mal d1, pru p1, cor a1, ara h8) is most common. Conclusions: the epidemiological data on the effect of the Opisthorchis felineus invasion on mechanisms of food sensitization in children were obtained.

scholarly journals АCUTE INFECTION OF OPISTHORCHIS FELINEUS IN MOSCOW: CASES FROM DELIVERED FISH AND CASES IN TOURISTS TRAVELLED TO ENDEMIC REGIONS IN RUSSIA

2019 ◽  
Vol 11 (1) ◽  
pp. 76-83
Author(s):  
A. M. Bronshtejn ◽  
S. S. Kozlov ◽  
N. A. Malyshev ◽  
S. V. Burova ◽  
M. S. Maksimova ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Moscow Region ◽  
Abramis Brama ◽  
Opisthorchis Felineus ◽  
History Of ◽  
Raw Fish ◽  
Leuciscus Idus

We describe the human acute opisthorchiasis outbreaks in Moscow region acquired from eating raw Leuciscus idus, Abramis brama and Aspius aspius in 10 patiens: 5 delivered fish from Tyumen and Sverdlovsk regions and 5 – from fish during their travelling to Tomsk and Astrakhan regions. Although, 18 people had identical history of consumption raw fish 10 had clinical symptoms of which the most frequent one was febrile eosinophilic syndrome. Other 8 people had no clinical symptoms. Eggs of O.felineus were found in 10 patients. Due to risk of cholangiocarcinoma in patients infected with O.felineus we recommend one day of praziquantel 25 mg/kg TID. Although opisthorchiasis is not frequently reported in Moscow region, it should be considered in cases of unexplained acute febrile eosinophilic syndrome with cholestasis, especially when patients confirm the ingestion of raw fish.

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