Opisthorchiasis: From Polymorphic Clinical Manifestations to Modern Diagnostic Challenges
DOI:
https://doi.org/10.52556/2587-3873.2025.2(104).22Keywords:
opisthorchiasis, periorbital edema, duodenalsoundingAbstract
Opisthorchiasis is a parasitic zoonosis with variable geographic distribution and recognized oncogenic potential, often underdiagnosed in non-endemic regions. The absence of pathognomonic signs, the polymorphic clinical presentation, and the latent course complicate early diagnosis and can lead to misinterpretations, including confusion with nonspecific hepatobiliary or dermatological conditions. We present the case to a 34-year-old patient with epidemiological risk factors (raw fish consumption, Barcelona, in 2016), whose clinical manifestations included cutaneous symptoms (periorbital edema, intensely pruritic maculopapular eruptions) and gastrointestinal complaints (dyspepsia, alternating constipation and diarrhea, general asthenia), initially suggestive of allergic or digestive disorders. Definitive diagnosis was established through biliary intubation with microscopic examination, revealing the presence of Opisthorchis spp. eggs. Etiotropic therapy with praziquantel (Biltricide) 600 mg 1x3 times/day for 2 days, administered according to standard protocols was well tolerated and led to complete remission of clinical manifestations, with no recurrence at follow-up. The peculiarity of this case lies in its atypical presentation, mimicking allergic and gastrointestinal disorders, reflecting diagnostic challenges reported in the literature. This case highlights the necessity of including opisthorchiasis in the differential diagnosis of patients with nonspecific hepatobiliary symptoms and relevant epidemiological exposure, as well as the essential role of an interdisciplinary approach in preventing chronic evolution and oncological complications.
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