Capillariasis, hepatic - Altmeyers Encyclopedia

Synonym(s)

hepatic capillariasis; Hepatic capillariasis

Definition
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Nematode infection by Capillaria hepatica.

Pathogen
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Capillaria hepatica (nematode, threadworm). Infection through soil-hand-mouth contact and geophagy.
Adults are 5-10 cm long and localized in the liver. They lay eggs 60 x 30 µm in size into the liver parenchyma, but these are not released until after the death of the host.
The eggs are then eaten by the carnivorous mammal, digested and excreted with the stool. If the eggs are ingested orally, the larvae hatch in the small intestine, break through the mucosa and reach the portal vein system, where they mature into adults after 4 weeks.

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Occurrence/Epidemiology
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Worldwide occurrence, mainly in rodents, human infections are rare (about 30 cases published so far).

Manifestation
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Mainly occurring in small children.

Clinical features
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Eosinophilic hepatitis, high fever, pronounced hepatomegaly, eosinophilia, leukocytosis. Cutaneous larva migrans caused by Capillaria hepatica has been described in individual cases. Itchy papules or papulovesicles, possibly accompanied by environmental oedema, are visible at the site of entry. In addition, there are tortuous, thread-like, very itchy, strongly reddened ducts, which lengthen by 1-2 cm per day.

Diagnosis
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Microscopy: detection of eggs in liver puncture or other organ biopsies.

Therapy
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So far the optimal therapy is still unclear, according to literature albendazole and thiabendazole seem to be effective, dosage and duration of therapy are still unclear.