1/4. Case studies in international medicine.family physicians in the united states are increasingly called on to manage the complex clinical problems of newly arrived immigrants and refugees. Case studies and discussions are provided in this article to update physicians on the diagnosis and management of potentially unfamiliar ailments, including strongyloidiasis, hookworm infection, cysticercosis, clonorchiasis and tropical pancreatitis. albendazole and ivermectin, two important drugs in the treatment of some worm infections, are now available in the united states.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Clonorchis-associated cholangiocarcinoma: a report of two cases with unusual manifestations.Two cases of Clonorchis-associated cholangiocarcinoma are described along with their cholangiographic features to illustrate the spectrum of pathology ascribed to the injurious effects of the flukes on the bile duct epithelium. This includes adenomatous hyperplasia, extensive fibrosis, and carcinoma. The first case was also complicated by hepatic abscesses, left hepatic lobar atrophy, gastrobiliary and biliarocutaneous fistulae. The second case features an unusually dilated pancreatic duct containing pancreaticoliths that was found later to consist of hyperplastic bile duct epithelium, presumably carried by worm migration in the biliary tree. liver sections from both patients showed typical features of hepatic clonorchiasis with the cancer. A knowledge of the wide spectrum of clinical presentation of clonorchiasis, particularly cholangiocarcinoma, might aid Western physicians in averting this serious sequela through prompt eradication of the helminthic infection and early recognition and treatment of its complications.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/4. cholangiocarcinoma associated with liver fluke infection: a preventable source of morbidity in Asian immigrants.In the far east infection with the liver flukes clonorchis sinensis and opisthorchis viverrini is the most frequently documented cause of cholangiocarcinoma. liver fluke infection in the united states remains a health problem for more than 500,000 Southeast Asian refugees who have immigrated to this country since 1975. Recent surveys have revealed that up to 26% of Asian immigrants have an active liver fluke infection. However, the common clinical manifestations of this condition, as well as the possibility of developing such long-term sequelae as cholangiocarcinoma, remain unknown to many physicians providing care for this population. This report describes a clinically unsuspected C. sinensis infection associated with cholangiocarcinoma in an elderly Chinese immigrant, and emphasizes the importance of early diagnosis and treatment of all liver fluke infections in the prevention of bile duct neoplasms in high risk populations.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/4. Acute clonorchiasis.A 42-year-old Chinese woman developed 3 weeks of swinging fever, rash, malaise, and discomfort at the right upper quadrant of the abdomen. Acute clonorchis sinensis infection eventually became evident and the patient responded to praziquantel. Although acute infestation is usually asymptomatic, occasional cases suffer severe symptoms and present difficulties in clinical diagnosis. clonorchiasis is endemic in South East Asia. With the increasing popularity of travel to these countries and the global migration of Asians, physicians need to be aware of the condition. Treatment with praziquantel is effective and prevents the serious sequelae of chronic infection.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |