Hepatic capillariosis, a case report and review of the literature

Capillaria hepatica (CH) is a worldwide zoonotic nematode, found in the liver of rodentsincluding rats. Humans are rarely infected as incidentally second host. Pica is a risk factor forgetting infected, as it is more common in children. The most common symptoms arepersistent fever, weight loss, hepatomegally and peripheral eosinophilia. Imaging modalitiessuch as ultrasound, CT scan and MRI are useful for diagnosis. Serologic methods likeIndirect Immunoflorscent test and ELISA are also suggested, however, presence of crossreaction with echinococcus granulosus and echinococcus multilocularis is one of theirlimitations. Finally, liver biopsy and presence of parasite ova and typical histology is the bestmethod of diagnosis. Until 2011, 72 cases of hepatic capillariosis have been reported. Wereport a 4 year-old boy who was admitted to the hospital with high grade fever, chills andweight loss. Ultrasound showed a 58x51x47 mm relatively well-defined irregular isoechomass the right liver lobe. Histological examination showed liver tissue involved by extensivenecrotizing granulomatous inflammation with severe eosinophilic infiltration and manyforeign body giant cells containing fragments of degenerating round worms as well as fewunembryonated ova. Our case is the first case report from Iran who was diagnosed byhistological examination of the resected liver mass.