Parasitic infections presenting as prolonged fevers

ABSTRACT

Over 2 successive years, out of 187 cases of fevers of undetermined origin [FUO], 30 [16%] cases proved to be of parasitic origin. 10 within normal subjects were taken as controls. Complete blood picture, repeated stool examination, rectal snip by transparency technique, ELISA for specific IgM antibodies for S. mansoni, indirect hemagglutination test for S. mansoni, Fasciola, hydatid, amoebic liver abscess and toxoplasmosis, indirect fluorescent antibody test for toxoplasmosis and abdominal ultrasonography were performed whenever indicated. Cases comprised 8 [26%] acute S. mansoni, 7 [24%] acute fascioliasis, 3 [10%] hydatid cyst, 8 [26%] amoebic liver abscess, 2 [7%] toxoplasmosis and 2 [7%] malaria cases. The clinical picture of acute S. mansoni and acute fascioliasis were similar in the form of prolonged fever, diarrhea, hepatomegaly and leucocytosis with high eosinophilia. Serology [ELISA and IHAT] was essential in differentiating them. Abdominal ultrasonography is an easy, sensitive cheap, noninvasive technique aiding in the diagnosis of amoebic liver abscess, liver hydatid cysts and fascioliasis, but serology was essential in their differentiation