Abstract
Introduction: Fascioliasis, a zoonosis caused by Fasciola hepatica, is a significant public health problem in the Bolivian highlands, especially among children. Although the disease is usually benign, in undiagnosed cases, it can progress to severe forms such as liver cirrhosis. Case report: We describe a 5-year-old patient from an endemic area who presented with ab-dominal distension, hepatomegaly, ascites, and edema. Laboratory tests revealed severe hy-poalbuminemia, coagulopathy, eosinophilia, and a cholestatic pattern. Imaging confirmed chronic liver disease with portal hypertension. The patient’s condition deteriorated, leading to neurological complications and death associated with sepsis and malnutrition. Discussion: This case demonstrates a consistent pathophysiological progression from chronic parasitic in-fection to liver fibrosis and cirrhosis. It highlights the diagnostic challenges in advanced stages and the reliance on clinical and epidemiological criteria in settings with limited ac-cess to confirmatory tests. It also reveals shortcomings in early diagnosis and timely access to treatment. Conclusions: Chronic fascioliasis caused by Fasciola hepatica can progress to liver cirrhosis in children, although this is rare, confirming its potential as a cause of severe chronic liver disease. In Bolivia, it is not a rare disease but rather an invisible one. Access to early diagnosis remains limited. Controlling this disease requires an intersectoral approach involving health, education, and basic sanitation. Fascioliasis should be considered a priority differential diagnosis for liver disease in childhood.
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Copyright (c) 2026 Giovanni Callizaya-Macedo, José Miguel Cussi Romero, Jhossmar Cristians Auza-Santivañez, José Antonio Lagos Monasterios, Angel Simon Chuquimia Calderon, María Angela Murillo Alcázar, Daniela Nicole Pacheco de la Torre, Freddy Ednildon Bautista-Vanegas (Author)