Abstract:

The patient was a 45-year-old female peasant from Heze City of Shandong Province. While The patient was working in Henan Province, in June and July 2020, she was admitted to the local hospital due to recurrent hyperthermia without inducement. The patient was treated with levofloxacin and piperacillin-tazobactam, but the symptoms did not improve. The PET-CT results showed increased liver volume and uneven hepatic density without obvious occupation. The histopathology examination of the liver biopsy specimen was considered to be a parasitic infection, while the species was yet to be determined. On August 12th, 2020, the patient was transferred to the Affiliated Gastroenterology Hospital of Shandong First Medical University. The physical examination showed recurrent hyperthermia (About 42 ℃) and fatigue. Laboratory tests showed increased peripheral blood eosinophil count (5.49 × 10⁹/L) and decreased haemoglobin was 93 g/L. No parasite eggs were found in the stool sample. The patient had a habit of eating leftovers and drinking unboiled water. The patient had poor residential sanitation with rats. The rats in the residence were captured and dissected. The rat histopathology examination showed a large amount of eggs and cross-section of adult worms in the rat liver parenchyma. The patient blood samples was tested for serum antibodies against common human parasites by ELISA. The results showed only weak reactivities to trichinella. The B ultrasonography showed an enlarged liver with uneven density. The liver biopsy slides was reviewed and a small number of parasite eggs were found in the liver parenchyma, with lymphocytes and eosinophile infiltration and granulomatosis. The eggs in the liver tissue of the patient were the same as liver tissue of the rat, which were identified as Capillaria hepatica eggs. The patient was administrated with albendazole [20 mg/(kg·d)]. Her temperature returned to the normal range after 72 h. The patient had no obvious discomfort, and she was discharged after 7 d. One month later, the patient returned to the hospital for follow-up and recovered well.

Key words: Capillaria hepatica, Liver, Infection