Capillaria hepatica

Capillaria hepatica is a rare tissue nematode infection. The disease is similar to visceral larva migrans with hepatitis and eosinophilia. Reservoirs include rats and other domestic and wild animals.

CASES/YEAR
3 (US); 60 (Global)
CATEGORY
Tissue Nematodes
AGENT TYPE
Helminths
OTHER NAMES
Hepatic capillariasis;
ACUITY
Subacute/Chronic
INCUBATION
3 weeks to 1 month; [CCDM]
INITIAL SYMPTOMS
Acute or subacute hepatitis with hepatomegaly and eosinophilia; [CCDM]
PRECAUTIONS
Not transmitted from person to person. [CCDM, p. 93]
COMMENTS
Rats and other domestic and wild animals are reservoirs for this zoonotic nematode. Infection occurs after eating soil contaminated by feces containing the eggs. The disease is similar to visceral larva migrans with hepatitis and eosinophilia. Infection can spread to the lungs and other organs. [CCDM, p. 91-4] The disease is indistinguishable clinically from visceral larva migrans except the liver is more enlarged in Capillaria hepatica infections. In addition to eosinophilia, leukocytosis is present. [Guerrant, p. 786] Fever may be present. [Klenzak J, Mattia A, Valenti A, Goldberg J. Hepatic capillariasis in Maine presenting as a hepatic mass. Am J Trop Med Hyg. 2005 May;72(5):651-3.]
DIAGNOSTIC
Identify eggs or worms in liver biopsy; Eggs do not appear in the stool; [CCDM]
SCOPE
Only 30 case reports in the world: North and South America, Africa, Asia, Europe, and some Pacific islands; [CCDM]
SIGNS & SYMPTOMS
  • >fever
  • G hepatomegaly
  • G liver function test, abnormal
  • G nausea, vomiting
  • H anemia
  • H eosinophilia
  • H hypergammaglobulinemia
  • H leukocytosis
  • H splenomegaly
  • *hepatitis
ANTIMICROBIC

Yes

VACCINE

No

ENTRY
Ingestion
SOURCE
Fecally Contaminated Soil, Soil or Dust (Ingesting or Inhaling), Eating Contaminated Food, Eating Contaminated Produce
RESERVOIR
Monkeys, Rodents, Wild Animals
RISK FACTORS
  • Eat soil containing infective eggs
TREATMENT
"Thiabendazole and albendazole effectively kill the worms in the liver." [CCDM]
DRUG LINK
CDC - Capillariasis
REFERENCES FOR CASES/YEAR
1. (US) 1/20 X global cases/yr; See global explanation.
2. (Global) Only 30 case reports in the world; [CCDM, p. 92] Rare infection of humans; [ID, p. 2365] Guesstimate: 60 cases/year;