ICD-10: B66.3

Fascioliasis, classified under ICD-10 code B66.3, is a parasitic infection caused by the liver fluke Fasciola hepatica or Fasciola gigantica. This condition primarily affects the liver and biliary system and is often associated with the consumption of contaminated water plants or drinking contaminated water. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Fascioliasis can present in two main phases: the acute phase and the chronic phase.

Acute Phase

The acute phase typically occurs after the ingestion of metacercariae (the infective stage of the fluke). Symptoms may appear within a few days to weeks and can include:

• Fever: Often low-grade but can be higher in some cases.
• Abdominal Pain: Usually in the right upper quadrant, reflecting liver involvement.
• Nausea and Vomiting: Common gastrointestinal symptoms.
• Diarrhea: May occur, sometimes with a biliary colic-like presentation.
• Hepatomegaly: Enlargement of the liver due to inflammation and fluke migration.

Chronic Phase

If untreated, fascioliasis can progress to a chronic phase, which may manifest as:

• Chronic Abdominal Pain: Persistent discomfort in the upper abdomen.
• Jaundice: Yellowing of the skin and eyes due to bile duct obstruction.
• Weight Loss: Resulting from malabsorption and chronic illness.
• Anemia: Due to chronic blood loss or nutritional deficiencies.
• Biliary Obstruction: Leading to cholangitis or pancreatitis in severe cases.

Signs and Symptoms

The signs and symptoms of fascioliasis can vary significantly among patients, but common findings include:

• Fever: Indicative of an inflammatory response.
• Tenderness in the Right Upper Quadrant: Upon physical examination, tenderness may be noted.
• Elevated Liver Enzymes: Laboratory tests often reveal elevated levels of liver enzymes (ALT, AST) and alkaline phosphatase.
• Eosinophilia: A significant increase in eosinophils in the blood is often observed, reflecting an allergic response to the parasite.
• Imaging Findings: Ultrasound or CT scans may show biliary dilation, liver abscesses, or the presence of the fluke itself.

Patient Characteristics

Fascioliasis is more prevalent in certain populations and geographic areas, particularly in regions where the fluke is endemic. Key patient characteristics include:

• Geographic Location: Higher incidence in areas with livestock farming, particularly in South America, the Middle East, and parts of Asia.
• Occupational Exposure: Individuals working in agriculture or aquaculture are at increased risk due to potential exposure to contaminated water or plants.
• Dietary Habits: Consumption of raw or undercooked water plants, such as watercress, is a significant risk factor.
• Age and Gender: While fascioliasis can affect individuals of any age, it may be more common in adults due to dietary habits. There is no strong gender predisposition.

Conclusion

Fascioliasis, represented by ICD-10 code B66.3, presents with a range of clinical symptoms that can vary from acute to chronic manifestations. Early recognition of the signs and symptoms, along with an understanding of patient characteristics and risk factors, is essential for timely diagnosis and treatment. If you suspect fascioliasis in a patient, consider obtaining a detailed history regarding dietary habits and potential exposure to contaminated water sources, as this can guide further diagnostic testing and management strategies.

Fascioliasis is a parasitic infection caused by the liver flukes Fasciola hepatica and Fasciola gigantica. This condition is classified under the ICD-10 code B66.3, which specifically pertains to fascioliasis. Below is a detailed overview of the clinical description, symptoms, diagnosis, and treatment options associated with this condition.

Clinical Description

Fascioliasis primarily affects the liver and bile ducts of humans and other mammals. The infection is typically acquired through the ingestion of contaminated water or aquatic plants, particularly watercress, that harbor the encysted larvae of the fluke. The lifecycle of the Fasciola fluke involves several stages, including a snail intermediate host, which is crucial for the development of the larvae.

Symptoms

The clinical manifestations of fascioliasis can vary significantly, ranging from asymptomatic cases to severe illness. Symptoms may include:

• Acute Phase: This phase occurs shortly after infection and may present with:
• Fever
• Abdominal pain, particularly in the right upper quadrant
• Nausea and vomiting
• Diarrhea

• Hepatomegaly (enlarged liver)

• Chronic Phase: If left untreated, the infection can progress to a chronic phase characterized by:

• Jaundice (yellowing of the skin and eyes)
• Biliary colic (pain due to bile duct obstruction)
• Cholangitis (inflammation of the bile duct)
• Liver abscesses

Diagnosis

Diagnosis of fascioliasis typically involves a combination of clinical evaluation and laboratory tests. Key diagnostic methods include:

• Serological Tests: Detection of specific antibodies against Fasciola species can confirm the diagnosis.
• Stool Examination: Identification of Fasciola eggs in stool samples is a definitive method for diagnosis, although eggs may not be present in the early stages of infection.
• Imaging Studies: Ultrasound, CT scans, or MRI may be used to visualize liver lesions or biliary obstruction caused by the flukes.

Treatment

The treatment of fascioliasis primarily involves the use of antiparasitic medications. The most commonly used drug is triclabendazole, which is effective against both adult and immature flukes. Other supportive treatments may include:

• Symptomatic Management: Addressing symptoms such as pain and jaundice.
• Surgical Intervention: In cases of severe biliary obstruction or abscess formation, surgical procedures may be necessary to remove the flukes or drain abscesses.

Conclusion

Fascioliasis, classified under ICD-10 code B66.3, is a significant public health concern in areas where the fluke is endemic. Early diagnosis and treatment are crucial to prevent complications associated with this parasitic infection. Awareness of the transmission routes and symptoms can aid in the prevention and management of fascioliasis, particularly in at-risk populations.

Fascioliasis, classified under the ICD-10-CM code B66.3, is a parasitic infection caused by the liver flukes Fasciola hepatica and Fasciola gigantica. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the alternative names and related terms associated with fascioliasis.

Alternative Names for Fascioliasis

1. Liver Fluke Infection: This term broadly refers to infections caused by various species of liver flukes, including Fasciola hepatica.
2. Fasciolosis: This is often used interchangeably with fascioliasis, particularly in veterinary contexts, but it can also refer to the human infection.
3. Fasciola Infection: A general term that may refer to infections caused by any species of the Fasciola genus.
4. Fascioliasis Hepatica: This term emphasizes the liver involvement in the infection, derived from the Latin name for the liver fluke.

Related Terms

1. Helminthiasis: A broader term that encompasses infections caused by helminths (parasitic worms), including flukes like Fasciola.
2. Parasitic Infection: A general term that includes any disease caused by parasites, including protozoa, helminths, and ectoparasites.
3. Biliary Obstruction: A potential complication of fascioliasis, where the flukes can obstruct the bile ducts, leading to further health issues.
4. Cholangitis: Inflammation of the bile duct system, which can occur as a result of fascioliasis.
5. Zoonotic Disease: Since fascioliasis can be transmitted from animals to humans, it is classified as a zoonotic disease.

Conclusion

Fascioliasis is a specific parasitic infection with various alternative names and related terms that reflect its clinical implications and the organisms involved. Understanding these terms is crucial for accurate diagnosis, treatment, and communication within the healthcare community. If you need further information on fascioliasis or related conditions, feel free to ask!

Fascioliasis, caused by the liver fluke Fasciola hepatica, is a parasitic infection that primarily affects the liver and bile ducts. The diagnosis of fascioliasis, particularly for the ICD-10 code B66.3, involves several criteria and methods to confirm the presence of the infection. Below are the key diagnostic criteria and methods used:

Clinical Presentation

1. Symptoms: Patients may present with a range of symptoms, including:
   - Abdominal pain, particularly in the right upper quadrant
   - Fever
   - Nausea and vomiting
   - Jaundice (yellowing of the skin and eyes)
   - Hepatomegaly (enlarged liver)
   - Anorexia and weight loss

2. Epidemiological History: A history of exposure to contaminated water or consumption of raw or undercooked aquatic plants (such as watercress) can support the diagnosis, as these are common transmission routes for the parasite.

Laboratory Tests

1. Serological Tests:
   - ELISA (Enzyme-Linked Immunosorbent Assay): This test detects antibodies against Fasciola hepatica and can be useful in diagnosing fascioliasis, especially in cases where eggs are not found in stool samples.

2. Stool Examination:
   - Microscopic Examination: The presence of Fasciola eggs in stool samples is a definitive diagnostic criterion. However, eggs may not be present in all cases, particularly in the early stages of infection.

3. Imaging Studies:
   - Ultrasound: This imaging technique can reveal changes in the liver and bile ducts, such as thickening of the bile duct walls or the presence of flukes.
   - CT or MRI: These imaging modalities can provide detailed images of the liver and biliary system, helping to identify complications associated with fascioliasis.

Differential Diagnosis

It is essential to differentiate fascioliasis from other conditions that may present with similar symptoms, such as:
- Other liver fluke infections
- Biliary obstruction due to gallstones
- Hepatitis or other liver diseases

Conclusion

The diagnosis of fascioliasis (ICD-10 code B66.3) relies on a combination of clinical evaluation, epidemiological history, laboratory tests, and imaging studies. A thorough assessment is crucial for accurate diagnosis and effective treatment. If you suspect fascioliasis, it is advisable to consult a healthcare professional for appropriate testing and management.

Fascioliasis, classified under ICD-10 code B66.3, is a parasitic infection caused by the liver fluke, primarily Fasciola hepatica and Fasciola gigantica. This infection is typically acquired through the consumption of contaminated water or aquatic plants, particularly watercress. The disease can lead to significant liver and biliary tract complications if left untreated. Here, we will explore the standard treatment approaches for fascioliasis, including pharmacological interventions, supportive care, and preventive measures.

Pharmacological Treatment

1. Antiparasitic Medications

The primary treatment for fascioliasis involves the use of antiparasitic drugs. The most commonly prescribed medications include:

• Triclabendazole: This is the drug of choice for treating fascioliasis. It is effective against both adult and immature flukes. The typical dosage is 10 mg/kg, administered as a single dose or in two doses taken 12 hours apart. Triclabendazole has been shown to significantly reduce the parasite load and alleviate symptoms associated with the infection[1][2].

• Praziquantel: While not as effective as triclabendazole for fascioliasis, praziquantel may be used in cases where triclabendazole is unavailable or contraindicated. It is generally more effective against other types of trematodes and may be used in combination therapy[3].

2. Supportive Care

In addition to antiparasitic treatment, supportive care is crucial for managing symptoms and complications associated with fascioliasis. This may include:

• Pain Management: Analgesics may be prescribed to alleviate abdominal pain and discomfort.
• Nutritional Support: Patients may require dietary adjustments to manage symptoms and ensure adequate nutrition, especially if there are liver function impairments.
• Monitoring and Management of Complications: Regular follow-up is essential to monitor liver function and address any complications, such as cholangitis or biliary obstruction, which may require additional interventions[4].

Preventive Measures

Preventing fascioliasis is critical, especially in endemic areas. Key preventive strategies include:

• Education and Awareness: Informing communities about the risks associated with consuming raw or undercooked aquatic plants and contaminated water sources.
• Water Management: Ensuring access to clean water and proper sanitation can significantly reduce the risk of transmission.
• Food Safety Practices: Encouraging the thorough washing and cooking of vegetables, particularly watercress, can help prevent infection[5].

Conclusion

Fascioliasis, while a significant health concern in certain regions, can be effectively treated with the appropriate use of antiparasitic medications, particularly triclabendazole. Supportive care plays a vital role in managing symptoms and preventing complications. Additionally, implementing preventive measures is essential to reduce the incidence of this parasitic infection. Regular monitoring and community education are key components in the fight against fascioliasis and its associated health impacts.

References

1. ICD-10 International statistical classification of diseases and related health problems.
2. Guidebook on treatment approaches for helminthiases.
3. International Statistical Classification of Diseases - 10th Revision.
4. Foodborne zoonotic trematode infections in humans.
5. Helminthiases includes flukes, tapeworms, and filarial infections.