Case #442 – April, 2017

A 6-year-old child from a community in rural southeastern United States presented with severe upper right abdominal pain, fever, chills, decreased appetite and weight loss. The child expired 2 weeks after being admitted for symptoms that included hepatitis. At autopsy, a liver biopsy was obtained and processed. Figures A and B show what was observed on a hematoxylin and eosin (H & E) stained liver tissue section at 100x and 500x oil magnification respectively. What is your diagnosis? Based on what criteria?

Figure A

Figure B

This was a case of hepatic capillariasis, a rare but serious illness that is most often found at autopsy. Morphologic features shown in the figures were:

Numerous eggs located in the parenchyma of the liver.
Oval-shaped eggs with a thick striated shell and polar prominences consistent with C. hepatica.

More on: hepatic capillariasis

Images presented in the dpdx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.