The liver fluke Opisthorchis viverrini is found in Vietnam, Thailand, Laos, and Cambodia. It may infect humans.
Eggs are initially ingested by snails. These eggs hatch, and freshwater fish are infected with the cercariae. In fish, the cercariae encyst. Humans become infected after ingesting raw, undercooked, salted, pickled, or smoked freshwater fish that contains these larval parasites. Adult worms in humans live in the bile and pancreatic ducts.
The majority of patients are asymptomatic, but some patients may develop fever and abdominal pain 2-4 weeks after acute exposure. Skin findings including urticaria are rarely found. Laboratory evaluation may reveal peripheral eosinophilia. Patients who suffer with chronic infection may present with abdominal pain and weight loss. Obstruction of the bile ducts may lead to cholangitis or liver abscess.
Diagnosis is made by identifying eggs in the stool. Adult worms may be seen during endoscopic retrograde cholangiopancreatography (ERCP) or occasionally during ultrasound of the gallbladder. Treatment is with praziquantel or albendazole.
This infection has been associated with cholangiocarcinoma in the endemic region.
Opisthorchis viverrini infection
Alerts and Notices
Important News & Links
Synopsis

Codes
ICD10CM:
B66.0 – Opisthorchiasis
SNOMEDCT:
90281006 – Infection by Opisthorchis viverrini
B66.0 – Opisthorchiasis
SNOMEDCT:
90281006 – Infection by Opisthorchis viverrini
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Other liver fluke infection (Clonorchis sinensis or Fasciola gigantica) – also endemic in Southeast Asia
- Infection with an intestinal fluke (including Haplorchis taichui and Echinostoma species)
- Schistosomiasis
- Strongyloidiasis
- Ascariasis (can cause biliary obstruction)
- Primary sclerosing cholangitis
- Cholangiocarcinoma
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:07/26/2017
Last Updated:07/26/2017
Last Updated:07/26/2017