Case Report
Volume 1 Issue 4
Randrianarivony Mahefa Harilala*, Ratsimbazafy Solohery Jean Noel, Sojandrimalala Eliane N, Rakotoson Julien, Paidia, Rahantamalala Ida Marie, Ralamboson Solofo and Vololontiana Hanta Marie Danielle
March 27, 2023
Abstract
Parasitic migration into the bile ducts is less common. Few cases of parasitic cholitis were reported despite Madagascar being a parasitic endemic country. Our goal is to report the case and stimulate the search for Gilbert's disease in free bilirubin cholitis. A 24-year-old Malagasy woman is hospitalized for febrile jaundice. She is not obese and had no history of vesicular lithiasis. The interrogation reveals the absence of deworming for several years. The clinical examination showed pain on palpation of the right hypochondrium. An abdominal ultrasound showed an intravesicular rail image and extrahepatic bile duct dilation. Biology revealed an elevation of alkaline phosphatase and gamma GT associated with an elevation of predominantly free total bilirubin. There was no anemia or eosinophilia. Blood culture series had come back negative as well as viral serologies (hepatitis A, B, C and HIV). The hemolysis balance was negative. Microscopic examination of the stool for KAOP showed the presence of numerous roundworm eggs. The diagnosis of parasitic cholitis is made associated with Gilbert's disease. The clinico-biological evolution is favorable after deworming associated with antibiotic therapy. A control abdominal CT scan was normal after a one-month setback.
Keywords: jaundice; bilirubin; abdominal ultrasound; Madagascar; parasitosis
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