Mechanism for symptoms:
(1) mechanical obstruction to biliary ducts, predisposing to infection
(2) allergic response to parasite allergens
(3) toxic effects of metabolites on biliary tract epithelium
Most patients will be totally asymptomatic or have only minor symptoms. These patients may only be detected on stool examination for ova and parasites.
Acute clinical findings:
(1) right upper quadrant pain, discomfort or aching
(2) high fever
(3) malaise, fatigue, nausea, vomiting, or anorexia
(4) diarrhea or constipation (change in bowel habits)
(5) urticarial skin rash
(6) lymphadenopathy
(7) arthralgias
(8) obstructive jaundice
(9) eosinophilia
(10) abnormal liver function tests
(11) variable hepatosplenomegaly
(12) parasite eggs seen in stool or duodenal aspirates
Long term complications:
(1) cholelithiasis, either as stones or sludge
(2) acute, subacute or chronic cholangitis
(3) acute, subacute or chronic cholecystitis
(4) hepatic abscess
(5) cholangiocarcinoma
