Molecular Evidence of Human Fasciolosis Due to Fasciola gigantica in Iran: A Case Report

Abstract

Fascioliasis is a foodborne zoonotic disease caused by the two parasite species Fasciola hepatica and F. gigantica. In spite of the presence of both species of Fasciola in the livestock, to our knowledge, to date, no cases of human F. gigantica infection have been reported in Iran officially. Here, we report such a case in a 25 yr old woman referred to The Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2016. CT imaging and MRCP revealed an ill-defined lesion of segments of liver. Specific ELISA produced a positive result besides detecting egg of the parasite via stool exam. The identification of parasite species was performed by the DNA extracted from the eggs and sequencing ITS-1, in addition to comparison to GenBank retrieved sequences, using the BLAST search tool. The sample showed 100% identity with F. gigantica. She was treated for fasciolosis with a single dose of Egaten® 10 mg/kg with positive response. This is the first case of human fasciolosis due to F. gigantica reported in Iran.

Keywords: Diagnosis; ELISA; Fasciola gigantica; Iran; PCR.

Fig. 1:

Location of Mianeh District, Mianeh, East Azerbaijan Province, Iran

Fig. 2:

Egg of Fasciola from patient’s fece sample under the microscope (40X) (Original figure)

Fig. 3:

Phylogenetic tree based on 700 bp nucleotides of ITS1 gene showing relationships between Fasciola hepatica, Fasciola gigantica and our specimen using maximum likelihood method. Fascioloides magna (AN: EF051080) was used as outgroup. Numbers at the nodes indicate percentage of bootstrap support obtained in 1,000 replicates. The scale bar indicates the p-distance of the branches