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Pathogenesis and clinical manifestations

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  • Clonorchiasis may be asymptomatic if there is only light infection.
  • Clinical manifestations are usually apparent if the worm load increases to 500-1000 flukes.

During migration of the flukes:

  • patients may present with eosinophilia, fever, childs, mild jaundice and tender hepatomegaly.

Dead flukes may cause:

  • biliary obstruction - this may lead to recurrent attacks of suppurative cholangitis with or without hepatic choledocholiathis.

The occurrence of biliary stones in conjunction with clonorchiasis is associated with an increased incidence of Salmonella typhi carriage.

There is an increased incidence of cholangiocarcinoma in patients with severe, long-standing disease.

Acute pancreatitis may occur because the adult worm may also infest the pancreatic ducts.


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