Familial Trichostrongylus Infection Misdiagnosed as Acute Fascioliasis

To the Editor: Human fascioliasis, infection with Fasciola spp. flukes, is highly pathogenic in both acute and chronic phases and can result in death (1). This disease has been recently emerging, in part linked to climate and global changes (2). Human Fasciola infection has been reported in 5 continents and is related to the disease’s wide spread in livestock. Guilan Province in northern Iran is a fascioliasis-endemic area where the largest human epidemics have occurred, together affecting ≈15,000 persons (3). In 2014, 3 sisters (ages 35, 33, and 38) and their 41-year-old brother (patients 1–4, respectively) sought medical care at the same time, all with a 3-week history of symptoms. The pa…