potassium-permanganate and Fascioliasis

We present an endoscopic approach to patients with fascioliasis resistant to oral pharmacotherapy. A staged study was performed in which the effect of flushing the biliary system with a fasciolicidal solution was evaluated.. In phase I of the study, four agents (povidone iodine, potassium permanganate, chlorhexidine, and sodium bicarbonate) were tested in vitro for their effect on Fasciola worm viability. In phase II, patients resistant to oral pharmacotherapy for fascioliasis were referred for endoscopic retrograde cholangiopancreatography and flushing of the biliary system with the solution found to be most effective in phase I.. Povidone iodine proved to be the most effective solution against Fasciola worm viability. Nine patients had the biliary system flushed with povidone iodine. The presence of a Fasciola worm was demonstrated in the bile duct of all patients. In one patient an extra worm was found in the gallbladder. All patients were negative for Fasciola ova on repeated follow-up stool examination.. We recommend washing the biliary system of patients with fascioliasis resistant to oral pharmacotherapy with povidone iodine because it is effective against the worms in the bile ducts and gallbladder and usually leaves the patient with an intact papilla.

Topics: Administration, Oral; Adolescent; Adult; Animals; Anthelmintics; Anti-Infective Agents, Local; Benzimidazoles; Child; Chlorhexidine; Cholangiopancreatography, Endoscopic Retrograde; Drug Resistance; Fascioliasis; Female; Humans; Injections, Intralesional; Male; Middle Aged; Potassium Permanganate; Povidone-Iodine; Rabbits; Sodium Bicarbonate; Treatment Outcome; Triclabendazole

The efficacy of treating encysted metacercariae (EMC) of Fasciola gigantica with different concentrations (conc.) of acetic acid, citric acid, cetrimide, potassium permanganate and sodium hydroxide, for 15 & 30 minutes was evaluated. The efficacy of these chemicals on the vitality and infectivity of the EMC was evaluated by the development of fascioliasis infection, and the histopathological changes in the livers of experimentally infected Albino rabbits. The results showed that 1% sodium hydroxide had a lethal effect on EMC, 10% to 40% potassium permanganate destroyed the infectivity power of EMC, and acetic acid gave an adverse effect on the EMC in conc. more than 2.5%. But, neither citric acid nor cetrimide affected the vitality or infectivity of EMC and all rabbits acquired fascioliasis.

Topics: Acetic Acid; Animals; Anthelmintics; Anti-Infective Agents, Local; Cetrimonium; Cetrimonium Compounds; Citric Acid; Dose-Response Relationship, Drug; Fasciola; Fascioliasis; Female; Humans; Male; Parasite Egg Count; Potassium Permanganate; Rabbits; Random Allocation; Snails; Sodium Hydroxide; Time Factors

Contamination by fasciolids takes place through ingestion of metacercariae attached to vegetables. Experimental studies were performed with plant-made foods suggesting a role in human contamination in Iran and on the usefulness of potassium permanganate as a preventive tool for killing metacercariae attached to vegetables used in salads in Egypt. In the foods assayed, although viability decreases with time, a high percentage of the metacercariae were still alive 2 and 4 weeks after preparation. Infection of laboratory animals proved that metacercariae kept their infectivity. The 5-minute tests of potassium permanganate effects showed that metacercarial viability was not affected even at the very high doses of 300, 600, and 1,200 mg/L. Careful, subsequent washing of leaves and vegetables with water is therefore needed after its application. A review on similar studies performed with metacercariae belonging to fasciolid and other trematode species affecting humans is included.

Topics: Animals; Cricetinae; Fasciola; Fascioliasis; Female; Food Handling; Food Parasitology; Humans; Mesocricetus; Mice; Potassium Permanganate; Snails; Vegetables

Prevention of human fascioliasis could depend on clearing of the leafy salads from the metacercariae. The present work evaluated the role of some chemicals in detaching and killing this infective stage. It was observed that washing in running water for 10 minutes detached only 50% of the metacercariae. Citric acid in the concentration of (10 ml/L) commercial vinegar (120 ml/L), liquid soap (12 ml/L) and KMnO4 (24 mg/L) detached all metacercariae after 10 minutes exposure. The use of vinegar and KMnO4 is recommended: the first is lethal to other parasites in the vegetables, the second destroyed the metacercariae. Vegetable leaves were not softened and remained fresh.

Topics: Acetic Acid; Animals; Citric Acid; Detergents; Fasciola; Fascioliasis; Food Parasitology; Humans; Potassium Permanganate; Vegetables; Water