Fasciola hepatica is a parasitic ttrematode and infects livers of various mammals and rarely infects human liver. Frequently eosinophilia is detected in laboratory findings, but it is generally mild or moderate as with other parasitic infections. Here we present a patient with Fasciolosis as the cause of severe hypereosiphilia.

A 66-year-old female patient presented with weight loss, nausea and abdominal pain for one month. Her physical examination was unremarkable except for mild hepatomegaly. Her laboratory tests were as follows; leukocytes 29900/mm3, eosinophils 21550/mm3 (%71.9), ALP 379 IU/L, LDH 278 IU/L, GGT 53 IU/L, CRP 30 mg/dl. All other etiological tests including primary secondary causes were negative.Abdominal MRI revealed focal patchy nodular lesions. Fasciola hepatica IHA (1/2560) was positive.

After the diagnosis, the patient was administered 2 doses of triclabendazole (10 mg/mg) at 5 day intervals. In the 3rd month of the treatment, the control eosinophil count decreased to 480/ mm3, and the patient was free of any symptoms.

Severe eosinophilia (>5000/mm3) is generally associated with malignant diseases, hypereosinophilic syndrome or primary hematologic disorders. But it would be useful to consider fasciolosis in hypereosinophilia patients who are sheep and cattle breeder and present with gastrointestinal system complaints such as jaundice and abdominal pain.