Request Sent And New Questions And Fee Found. OK I

Posted on Wed, 31 Jul 2019

Question: Request sent and new questions and fee found. OK I suspect a US trained specialist would be useless. An infectious disease of tropical disease experienced physician could be of value. Best if from Japan,China, Korea, or Singapore. Central or South XXXXXXX XXXXXXX might be knowledgeable?
XXXXXXX R. McDaniel, M.D. I will use Visa for your fee

Answered by Dr. Shinas Hussain (4 hours later)

Brief Answer:
Please ask your query.

Detailed Answer:
Hi,

Please proceed with the query in details.
I’m a physician (medical practitioner) from XXXXXXX

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Shinas Hussain (2 days later)

I cannot find a response to my submitted case? HRMcD

Answered by Dr. Shinas Hussain (4 hours later)

Brief Answer:
Please type your query.

Detailed Answer:
Hi,
please type your query here.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shinas Hussain (18 hours later)

I have sent a very brief history of this case of hyper-bilirubinemia with Alk P'as elevated more than liver enzymes. It all started when he ate raw fish two years ago. He had a gastric upset and tape worm, giardia and amoeba were identified. He soon had abdominal distention 4+ and over 5 liters of fluid drained off. He has been chronically ill ever since, 9 gram hemoglobin.Bilirubin up to 14 total. On aloe oligosaccharides for 4 to 6 weeks his bilirubin dropped to 12 and alkaline P'ase dropped from over 240 to 100 with mild reduction in slightly elevated liver enzymes. All liver virus tests are negative. History of chemical or medication exposure is negative. Multiple clinics including the Mayo Clinic fail to make a diagnosis. Mayo suggests a liver transplant. I regard this as insane and incompetent medical management. There has to be a cause. I found a case in XXXXXXX much like this due to intraductal tape worm. Your view would be nice to have. HRMcD

Answered by Dr. Shinas Hussain (22 hours later)

Brief Answer:
Liver fluke is a probable cause.

Detailed Answer:
Hello,
Liver transplantation is not required at present because the enzyme level is falling.
Liver fluke is a probable cause rather than tape worm.
Diagnosis of clonorchiasis is by finding eggs in the feces or duodenal contents. The eggs are difficult to distinguish from those of similar species of flukes. Occasionally, the diagnosis is made by identifying adult flukes in surgical specimens or by doing percutaneous transhepatic cholangiography.
Consult a microbiologist or infectious disease specialist to make a diagnosis.
Wishing all the best.
Thanks

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Above answer was peer-reviewed by : Dr. Prasad