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This Is XXXXXXX R. McDaniel, M.D. Did You Not Get

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Posted on Mon, 29 Jul 2019
Question: This is XXXXXXX R. McDaniel, M.D. Did you not get a copy of my case inquiry?
This is an XXXXXXX male of about 54 years old. He reports toe have been in good health until about 2 years ago he ate a raw fish sandwitch. He immediately had gastric distress and he was diagnosed to have tape worm, amoeba and giardia that responded to therapy. However, if a short time his abdomen became distended an about 5 liters of asiatic flud was drained off. His health continued to deteriorate and he was found to have a bilirubin of 14 with Alk P'se of 240 with mild elevations in liver enzymes. Anemia of 9 Hgb. All tests for hepatitis were negative. I put him on aloe oligosaccharides and his bilirubin dropped 2 units to 12 in 4 to 6 weeks. Alkaline P'ase dropped to 100 and mildly elvevated enzymes decreased a few units. His history is negative for toxic medications or exposures. I have found a case in XXXXXXX on Google Scholar for a tape worm elevation of bilirubin due to infestation in the bilirary tree. . I seem to recall from lecture over 50 years ago that giradia and other parasites can get into the bile ducts. If parasitic, what agent might rid a yet to be diagnosed agent from the billiary tree?

HRMcD
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Follow up: Dr. Dr. Michelle Gibson (2 minutes later)
I sent this last week and did not find an answer on the E mail received and only got a this site cannot be opened on another inquiry sent to me. ??

HRMcD
doctor
Answered by Dr. Dr. Michelle Gibson (1 hour later)
Brief Answer:
praziquantel or triclabendazole may be used

Detailed Answer:
HI

As you stated, parasites can affect the biliary tract, particularly liver flukes such as Clonorchis sinesis and Opisthorchis viverrini.
Infection can also occur with fascioliasis.

Current recommendations if any of these are confirmed by testing such as one of the various stool tests techniques to detect these pathogens include: (1)praziquantel for opisthorchis
(2)triclabendazole for fascioliasis
(3)praziquantel can also be used to treat clonorchis

Hope this helps
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Dr. Michelle Gibson

General & Family Physician

Practicing since :2001

Answered : 16845 Questions

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This Is XXXXXXX R. McDaniel, M.D. Did You Not Get

I sent this last week and did not find an answer on the E mail received and only got a this site cannot be opened on another inquiry sent to me. ?? HRMcD