Introduction: Diabetic foot infections (DFIs) remain a significant clinical problem despite advances in the treatment of diabetes mellitus. This study aims to contribute to the body of knowledge in this field by evaluating the epidemiological characteristics, treatment processes, and outcomes of patients diagnosed with DFIs. Materials and Methods: We retrospectively analyzed the characteristics, treatments, and outcomes of patients with DFIs who were admitted between October 2020 and November 2023. All data were analyzed using Statistical Package for the Social Sciences version 22.0, and statistical significance was set at p < 0.05. Results: The mean age of the 129 patients included in the study was 61.27 ± 9.75 years, and 74.4% were male. Overall, 90.7% of diabetic foot ulcers were classified as perfusion, extent/size, depth/tissue loss, infection, and sensation (PEDIS) grades 3 and 4. Staphylococcus aureus was the most frequently detected pathogen among patients with positive culture results. Osteomyelitis was detected in 85.3% of the patients, and 55.8% of the cases were treated with antibiotic therapy and/or debridement without amputation. The rate of piperacillin-tazobactam use was higher among patients with osteomyelitis who underwent surgical treatment. A higher rate of surgical treatment was observed in patients with higher PEDIS scores (p = 0.004). Conclusion: The results of our study indicate that most patients recovered with antibiotic therapy and/or debridement without amputation.
Introduction: Long-acting injectable antiretroviral therapy (LAI-ART) offers an alternative to daily oral treatment and represents an important innovation in human immunodeficiency virus (HIV) care. Although LAI-ART has recently been approved in Türkiye, it has not yet been integrated into clinical practice because of the lack of reimbursement. This study explored awareness, attitudes, and preferences regarding LAI-ART among people living with HIV in Türkiye. Materials and Methods: This cross-sectional survey was conducted between April and August 2025 among adults with HIV receiving ART at a university-affiliated infectious diseases outpatient clinic in Türkiye. Eligible participants (≥18 years) attending routine follow-up visits were invited to complete a structured, anonymous questionnaire assessing sociodemographic and clinical characteristics, as well as awareness, attitudes, and preferences regarding LAI-ART. The primary outcome was willingness to accept LAI-ART if recommended by a physician, whereas secondary outcomes included awareness, preferred administration setting, and perceived advantages and disadvantages. Results: The mean age of the participants was 37.8 years, 91% were male, and the total sample comprised 200 participants. Most participants (92%) reported that their condition was well controlled, 66% were receiving single-tablet regimens, and a greater pill burden was associated with lower adherence (p = 0.045). Awareness of LAI-ART was moderate, with 30% of participants unaware of its existence; men were more informed than women. If recommended by their physicians, 79% indicated a willingness to adopt injectable therapy. The perceived advantages included freedom from daily pills (85%) and reduced concerns about forgetfulness (72%), whereas the primary concern was fear of side effects (51%). No significant association was found between recent missed doses and willingness to switch (p = 0.57). Conclusion: Overall, the participants demonstrated strong interest in LAI-ART, highlighting the need for targeted educational initiatives, particularly for women, as well as strategies to address concerns regarding adverse effects and injection scheduling.
Introduction: The prolonged duration of drug treatment and the need for combination therapy in brucellosis increase the risk of drug-related problems. One of the most significant drug-related problems is drug–drug interactions. The aim of this study was to identify potential drug interactions that may occur during the treatment of patients with brucellosis, investigate their causes, and contribute to clinical practice. Materials and Methods: This retrospective study included 76 patients admitted to the Infectious Diseases and Clinical Microbiology Clinic of Ege University Faculty of Medicine Hospital between January 2016 and November 2022 because of brucellosis and/or its complications. Drug interactions among the antibiotics used by the patients and between these antibiotics and other medications were investigated. Lexicomp® and Micromedex® were used as interaction databases. The severity and number of drug interactions identified in each database were assessed. Additionally, gender, age, occupation, the presence of comorbidities, and comparisons of database results across other medication groups were evaluated. Data were analyzed using SPSS version 27. Ethics committee approval was obtained, and verbal informed consent was obtained from all patients. Results: Of the 76 patients included in the study, 49 were male, the mean age was 47.23 ± 14.16 years, and 53.95% had comorbidities. The mean number of drug interactions per patient was 4.88 ± 2.88 in LC and 2.63 ± 1.81 in MM. Significant associations were found between age, comorbidities, ciprofloxacin use, and the number of drug interactions in both databases (p < 0.05). When the interactions between antibiotics used for brucellosis and other medications were examined, the most common were decreased efficacy of doxycycline (97.30%), increased efficacy of gentamicin (54.17%), and decreased efficacy of rifampin (58.05%). The medications most commonly associated with decreased efficacy were statins, neurologic drugs, and antihypertensive agents (p = 0.001). Conclusion: In this study, we focused on drug interactions during antibiotic treatment. Long-term treatment and polypharmacy can lead to drug interactions. This can negatively affect treatment effectiveness and prolong the duration of therapy.
BK virus (BKV)-associated nephropathy (BKVN) is a complication that can lead to graft loss after kidney transplantation. The primary approach to this disease is reduction of immunosuppressive therapy; however, some cases are non-responsive to this strategy. This case report presents a patient with BKVN that was non-responsive to immunosuppressive reduction and was treated with intravenous immunoglobulin (IVIG). A 62-year-old male patient with a history of kidney transplantation from a living donor 2 years earlier presented with deterioration of renal function. High BKV loads were detected, and the diagnosis of BKVN was confirmed by renal biopsy. Despite discontinuation of mycophenolate mofetil, the viral load continued to increase, and graft function continued to deteriorate. Subsequently, the patient was treated with IVIG. BKV levels in plasma and urine decreased, but renal function showed only minimal improvement. This case highlights the effectiveness of IVIG in resistant BKVN and underscores the role of proactive screening methods in preventing graft rejection.
Lupus vulgaris is a form of cutaneous tuberculosis (TB) that commonly affects the face and neck. It is typically treated with standard anti- TB therapy (ATT). However, adverse drug reactions may alter treatment strategies. We report a case of a female patient with a red plaque on the left cheek, diagnosed as lupus vulgaris. Standard ATT was initiated but subsequently discontinued due to signs and symptoms of drug-induced liver injury (DILI). The treatment regimen was modified to levofloxacin, ethambutol, and streptomycin, with the gradual reintroduction of rifampicin. Reintroduction of isoniazid led to intolerance symptoms and was therefore discontinued. The patient declined reintroduction of pyrazinamide due to fear of recurrence of the same symptoms. Consequently, a modified regimen of levofloxacin, streptomycin, ethambutol, and rifampicin was continued in intensive phase, followed by rifampicin and ethambutol in continuation phase. Marked clinical improvement was observed. This case demonstrates successful individualized management of lupus vulgaris with a modified regimen in the setting of DILI, representing the first reported use of this approach.
Dapsone is used for Pneumocystis jirovecii pneumonia (PCP) prophylaxis in patients with human immunodeficiency virus (HIV) infection who cannot tolerate trimethoprim–sulfamethoxazole (TMP-SMX), the first-line agent. Methemoglobinemia is a known adverse effect of dapsone, usually associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency, but it may also occur in patients with normal enzyme activity. We report a case of early-onset methemoglobinemia in a newly diagnosed HIV-infected patient without G6PD deficiency receiving dapsone for PCP prophylaxis. A 24-year-old male with a CD4 T-cell count of 32/mm3 developed decreased oxygen saturation approximately 72 hours after starting dapsone. Despite minimal symptoms, methemoglobin levels increased up to 11.5%. Dapsone was discontinued, and the patient was treated with methylene blue with rapid improvement. Although dapsone-induced methemoglobinemia is well described, reports in HIV-infected patients receiving dapsone for PCP prophylaxis are limited. This case highlights that methemoglobinemia may occur without G6PD deficiency and emphasizes early recognition.
Brucellosis is a zoonotic infection with diverse clinical manifestations; however, thyroid involvement is exceedingly rare. Non-suppurative Brucella thyroiditis may clinically mimic subacute (De Quervain) thyroiditis, potentially leading to diagnostic delay. We report the case of a 50-year-old female livestock worker who presented with fatigue, sore throat, and right-sided cervical swelling. Laboratory evaluation revealed suppressed thyroid-stimulating hormone levels. Neck ultrasonography demonstrated thyroid nodules without evidence of lymphadenopathy. Brucella serology was positive, and Brucella spp. was isolated from blood culture, confirming microbiologically proven bacteremia. The patient was treated with streptomycin and doxycycline, followed by rifampicin and doxycycline, for a total treatment duration of 45 days, resulting in complete clinical recovery. In addition, a literature review identified six previously reported cases of non-suppurative Brucella thyroiditis. Most patients presented with painful thyroid swelling and transient thyrotoxicosis. Blood culture positivity was uncommon, whereas serological testing remained the primary diagnostic tool. All reported cases responded favorably to doxycycline-based combination therapy. In endemic regions, brucellosis should be considered in patients presenting with thyroid inflammation and biochemical thyrotoxicosis, particularly among individuals with occupational exposure to livestock. Early recognition and appropriate antimicrobial therapy can prevent misdiagnosis, unnecessary corticosteroid use, and invasive procedures.
Fever is one of the most common symptoms observed in infectious diseases. However, non-infectious causes should also be considered in the differential diagnosis. In patients presenting with a common symptom such as fever, it is important to keep adrenal insufficiency in mind as a rare but possible underlying cause. A 54-year-old woman with a history of coronary artery disease, hypertension, and hypothyroidism presented with complaints of fatigue, weakness, nausea, vomiting, abdominal pain, headache, and fever. Her past medical history was notable for a previous pituitary adenoma surgery. Laboratory tests revealed elevated C-reactive protein (65 mg/L) and procalcitonin levels (33.2 ng/mL). To investigate a possible infectious etiology, neck, thoracic, and abdominal computed tomography, transthoracic echocardiography, blood and urine cultures, and other infectious disease workups were performed, but no pathology was identified. Pituitary magnetic resonance imaging revealed a macroadenoma. Laboratory findings showed hyponatremia and decreased early morning cortisol levels (1.82 μg/dL), while adrenocorticotropic hormone (ACTH) levels were within the normal range. A high-dose ACTH stimulation test confirmed the diagnosis of secondary adrenal insufficiency. The patient showed a dramatic clinical improvement after glucocorticoid replacement therapy and was discharged with an appropriate treatment plan. When investigating the cause of fever, a thorough medical history, repeated physical examinations, and appropriate use of laboratory and imaging studies are essential. Common etiologies should be considered first, and if no diagnosis is established, rare causes must be carefully evaluated.
Introduction: Achromobacter infections are increasingly recognized among high-risk patient populations; however, data regarding factors associated with mortality remain limited. This study aimed to evaluate the clinical, microbiological, and treatment-related predictors of 30-day mortality in adult patients with Achromobacter spp. infections. Materials and Methods: This retrospective, single-center study included adult patients (≥18 years) diagnosed with Achromobacter species infections between 2016 and 2025. Demographic characteristics, comorbidities, clinical severity parameters, microbiological findings, and treatment-related variables were analyzed. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of 30-day all-cause mortality. Results: A total of 218 patients were included in the analysis, and the 30-day mortality rate was 18.3%. In the multivariable analysis, a higher Charlson comorbidity index score, the presence of septic shock, and delayed initiation of targeted antimicrobial therapy (≥72 hours) were independently associated with increased mortality. Age and the use of immunosuppressive therapy were excluded from the multivariable model because of collinearity with comorbidity burden. Carbapenem resistance was not associated with mortality in either the univariable or multivariable analyses. Conclusion: Mortality in Achromobacter spp. infections appears to be primarily driven by host vulnerability, disease severity, and the timing of targeted antimicrobial therapy rather than antimicrobial resistance alone. Early risk stratification and prompt initiation of appropriate targeted therapy are therefore critical for improving clinical outcomes in this high-risk population.
Introduction: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections, particularly among older adults. The recent introduction of adult RSV vaccines in Türkiye necessitates an assessment of physicians’ knowledge and recommendation behaviors regarding this new vaccine. This study aimed to evaluate physicians’ knowledge, attitudes, and early recommendation practices toward the RSV vaccine and to identify factors associated with vaccine recommendation. Materials and Methods: This cross-sectional study was conducted via an online survey among 223 physicians across Türkiye using voluntary participation. Demographic characteristics, professional experience, and vaccination practices were analyzed using the Mann–Whitney U test and logistic regression analysis. Results: The mean knowledge score was 7.6 ± 2.1 (on an 11-point scale), indicating moderate awareness. Only 10.3% of participants had recommended the RSV vaccine in the past 3 months, reflecting limited early uptake, while 42.6% were aware of its licensure for adults aged ≥60 years. Knowledge scores were significantly higher among faculty members and infectious diseases specialists compared with general practitioners and other specialties (p = 0.019 and p = 0.011, respectively). In multivariable analysis, higher knowledge score remained an independent predictor of vaccine recommendation (adjusted odds ratio = 1.54, 95% confidence interval: 1.12–2.11; p = 0.007). The most frequently reported barriers included lack of knowledge (76.2%), limited accessibility (44.4%), and reimbursement concerns (40.8%). Conclusion: Despite generally positive attitudes toward RSV vaccination, early recommendation of the newly introduced adult RSV vaccine by physicians was limited. Clearer clinical guidance and educational support may be necessary to improve its adoption in clinical practice in Türkiye.
Introduction: This study aimed to perform a bibliometric analysis of research addressing the risk and prevalence of perinatal transmission in maternal human immunodeficiency virus (HIV), Hepatitis B, and Hepatitis C infections. Materials and Methods: Using predefined keywords, we retrieved all articles published between 1982 and 2025. Only original research articles written in English and published after 1982 were included. A total of 1.058 records were identified, of which 1.016 were published in English. Data were exported, and duplicate records were removed using Mendeley. Quantitative analyses and visualizations were conducted using Microsoft Excel, VOSviewer, and the Bibliometrix package in R Studio. After duplicate removal, 1.015 articles were included in the final analysis. Results: The United States was the most productive country, contributing 457 articles (44.98%). Newell was the most prolific author, with 32 publications. The most highly cited article was “Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission,” which received 738 citations. Overall, research output addressing perinatal transmission risk and prevalence in maternal HIV, Hepatitis B, and Hepatitis C infections has increased markedly over the past three decades. Conclusion: The increasing volume of publications reflects growing international interest and an expanding research scope in this field. Over the past three decades, a substantial rise has been observed in studies examining perinatal transmission risk and prevalence in maternal HIV, Hepatitis B virus, and Hepatit C infections.
Mucormycosis is a rare and rapidly progressive fungal infection associated with high mortality, particularly among immunocompromised individuals. Solid organ transplant recipients remain at risk not only during the early posttransplant period but also during episodes of intensified immunosuppression for rejection. We report the case of a 14-year-old female liver transplant recipient who developed rhino-orbitocerebral mucormycosis that was initially misdiagnosed as a dental abscess and orbital cellulitis. Early clinical suspicion, prompt histopathological confirmation, aggressive surgical management—including enucleation and partial maxillectomy—and prolonged antifungal therapy (liposomal amphotericin B followed by posaconazole) resulted in survival despite cerebral involvement. At 18 months posttransplantation, the patient remains alive and continues antifungal therapy, with radiologically stable residual lesions. This case highlights the importance of maintaining a high index of suspicion, ensuring early diagnostic confirmation, and implementing prolonged, individualized antifungal therapy to achieve favorable outcomes in liver transplant recipients with cerebral mucormycosis.
Introduction: Corynebacterium striatum has emerged as a significant nosocomial pathogen, particularly among intensive care unit (ICU) patients. This study aimed to determine whether Corynebacterium striatum isolated from respiratory samples represents true infection or colonization and to identify risk factors distinguishing these conditions. Materials and Methods: We conducted a retrospective cohort study from June 2015 to June 2025, including adult ICU patients with Corynebacterium striatum isolated from respiratory specimens. Patients were classified into pneumonia or colonization/contamination (CC) groups. Risk factors were analyzed using descriptive statistics, univariate comparisons, and multivariate binary logistic regression to identify independent predictors of pneumonia. Results: Among 396 patients, 126 (31.8%) were classified in the pneumonia group and 270 (68.2%) in the CC group. Chronic obstructive pulmonary disease (COPD; 31% vs. 2.2%, p < 0.001) and cardiovascular disease (22.2% vs. 11.5%, p = 0.005) were more prevalent in the pneumonia group. Multivariate analysis identified COPD (adjusted odds ratio [OR] = 26.67; 95% confidence interval [CI] = 5.05-140.91; p < 0.001) and Bartlett score (adjusted OR = 20.61; 95% CI = 10.99-38.61; p < 0.001) as independent predictors of pneumonia. The area under the Receiver Operating Characteristic curve for the Bartlett score was 0.941 (95% CI = 0.914-0.968); a score >= 1 had 92% sensitivity and 93% specificity for predicting pneumonia. Conclusion: Isolation of Corynebacterium striatum from respiratory samples in ICU patients should not be automatically dismissed as contamination, particularly in patients with COPD or specimens with higher Bartlett scores. Assessment of specimen quality provides valuable diagnostic insight, and ongoing surveillance of antimicrobial resistance remains essential.
Introduction: Staphylococcus aureus is a major pathogen causing infections in both community and hospital settings. Surveillance of this organism is essential for effective planning of preventive strategies. This study aimed to evaluate changes in the isolation frequency and antimicrobial resistance patterns of Staphylococcus aureus strains in a university hospital over recent years. Materials and Methods: in this retrospective cross-sectional study, data on Staphylococcus aureus strains isolated at & Idot;n & ouml;n & uuml; University Faculty of Medicine Hospital between january 2019 and June 2025 were collected. Demographic information of patients and antimicrobial resistance profiles of the isolates were analyzed. Changes in strain prevalence and resistance rates over the years were assessed using linear regression analysis. Results: A total of 3,514 Staphylococcus aureus strains were examined, including 861 (24.5%) community-acquired and 2653 (75.5%) hospital-acquired. The median prevalence of Staphylococcus aureus among all cultures was 9.96%, showing a nonsignificant variation from 9.2% to 11.57% over the study period. Comparison of pre-and post-pandemic periods revealed a significant increase in hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) (p < 0.05) whereas changes in community-acquired MRSA were not significant. Among hospital isolates, methicillin resistance approximately doubled, whereas no significant change was observed in community-acquired strains. Methicillin-resistant strains exhibited two-to seven-fold higher resistance to several antimicrobials, including quinolones, aminoglycosides, macrolides, and co-trimoxazole, compared to methicillin-susceptible strains. During the study period, resistance to amikacin, gentamicin, and erythromycin significantly decreased, while resistance to tetracycline and clindamycin increased. Conclusion: Although the overall prevalence of Staphylococcus aureus remained stable, methicillin resistance increased steadily, particularly in hospital-acquired strains. Targeted strategies to control these highly resistant strains should be a priority.
Introduction: Human papillomavirus (HPV) vaccination has not yet been included in national immunization programs in many low- and middleincome countries, including T & uuml;rkiye. People living with human immunodeficiency virus (PLWH) are a priority group for vaccination due to their heightened susceptibility to persistent HPV infection and HPV-related cancers. Identifying barriers to vaccination is essential for developing effective prevention strategies. Materials and Methods: We conducted a cross-sectional study between April and July 2024 among PLWH receiving care at a tertiary training and research hospital. Data were collected using a structured questionnaire covering sociodemographic characteristics, HPV knowledge, vaccination history, and attitudes. Statistical analyses were performed to identify factors associated with HPV knowledge and vaccine uptake. Results: A total of 120 individuals participated: 92.5% (n = 111) were male, 6.7% (n = 8) female, and 0.8% (n = 1) transgender. The mean age was 34.6 years. Overall, 60.0% (n = 72) reported awareness of HPV, but only 12.5% (n = 15) had received at least one vaccine dose. Among those aware of HPV, uptake was 18.1%. Vaccination was significantly higher among participants with a previous HPV infection (25.0%, p < 0.05) and those informed by physicians (45.8%, p < 0.001). Among unvaccinated participants, 48.8% (n = 51) indicated they would accept the vaccine only if it were provided free of charge. Higher education level, younger age, and non-heterosexual orientation were significantly associated with greater HPV knowledge. Conclusion: Despite moderate awareness, HPV vaccination coverage among PLWH in T & uuml;rkiye remains unacceptably low, primarily due to economic and informational barriers. Expanding cost-free vaccination programs and reinforcing physician recommendations are critical to improving vaccine uptake and reducing the burden of HPV-related diseases in this high-risk population.
Direct-acting antivirals have achieved high sustained virologic response (SVR) rates in the treatment of chronic hepatitis C virus (HCV) infection. However, data on retreatment strategies following failure of glecaprevir/pibrentasvir (G/P) therapy remain limited. We report the case of a 48-year-old man with genotype 3 chronic HCV infection who experienced virologic failure despite full adherence to an 8-week G/P regimen. The patient was subsequently treated with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for 12 weeks, resulting in normalization of liver enzyme levels and undetectable HCV ribonucleic acid at the end of treatment and 12 weeks after treatment, confirming achievement of SVR12. This case demonstrates that SOF/VEL/VOX may represent an effective and safe salvage therapy for patients with genotype 3 HCV infection who fail prior G/P treatment and provides clinical insight to guide retreatment decisions.
A 78-year-old male presented to the emergency department with a two-day history of high-grade fever and confusion. Cerebrospinal fluid analysis was positive for Herpes simplex virus type 1 (HSV-1) via polymerase chain reaction, and intravenous acyclovir therapy was initiated. During hospitalization, the patient developed hyponatremia, which was attributed to cerebral salt wasting syndrome based on elevated urinary sodium levels and clinical hypovolemia. Hyponatremia and consciousness improved following acyclovir therapy and aggressive isotonic fluid replacement. After being discharged, the patient experienced recurrent cognitive decline, leading to a second hospitalization. Further evaluation resulted in a diagnosis of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Treatment with intravenous immunoglobulin resulted in gradual improvement in consciousness. This case highlights the coexistence of HSV encephalitis-associated cerebral salt wasting syndrome and subsequent anti-NMDAR encephalitis.
Fascioliasis is a parasitic zoonotic infection caused by the liver flukes Fasciola hepatica and Fasciola gigantica. Although herbivorous mammals such as cattle, sheep, horses, and buffalo serve as primary hosts, humans can act as accidental hosts. Human infection typically occurs through ingestion of watercress or other aquatic plants contaminated with larvae from water sources in areas where these animals graze. Clinical manifestations include fever, right upper-quadrant abdominal pain, nausea, fatigue, and eosinophilia. Diagnosis relies on a combination of parasitological, laboratory, and imaging investigations, which can be challenging. Nevertheless, treatment with the antihelminthic drug triclabendazole is effective and straightforward. Here, we report two cases of human fascioliasis identified during the evaluation of abdominal pain, highlighting the importance of considering parasitic infections in the differential diagnosis of liver lesions accompanied by eosinophilia in endemic regions.
Introduction: Fasciola hepatica infection (fascioliasis) is an uncommon zoonotic parasitic disease in humans that primarily involves the hepatobiliary system. It may present with a broad spectrum of clinical manifestations, ranging from obstructive jaundice and cholangitis to chronic biliary inflammation and cirrhosis. This study aimed to describe the clinical, laboratory, and radiological characteristics of fascioliasis cases diagnosed over a five-year period between 01.01.2020 and 01.01.2025 in a tertiary care center and to highlight its relevance in differential diagnosis. Materials and Methods: We conducted a retrospective review of adult patients diagnosed with Fasciola hepatica infection between 2020 and 2025 at Elaz & imath;& gbreve; Fethi Sekin City Hospital. Hospital records, electronic files, and discharge summaries were examined. Clinical presentations, laboratory parameters, and radiological findings at initial admission and at one-month follow-up were evaluated. Analyses were performed using SPSS version 20.0, and appropriate statistical tests were applied according to data distribution. Results: Twenty-six patients met the inclusion criteria (mean age: 51 +/- 10.93 years; 73% female). Most patients lived in rural areas (61.5%). Abdominal pain was reported in 50% of cases, and peripheral eosinophilia was documented in all patients. Ultrasonography, computed tomography, and magnetic resonance imaging frequently suggested malignancy (69.2%); however, these lesions regressed after treatment with triclabendazole. Significant reductions were observed in alkaline phosphatase (ALP), lactate dehydrogenase (LDH), eosinophil count, and leukocyte count, while serum albumin levels increased after treatment (p < 0.001). Stool microscopy was performed in two patients but failed to detect parasitic eggs. Conclusion: Fascioliasis should be considered in the differential diagnosis of hepatic lesions, particularly in patients from rural settings who present with eosinophilia and abdominal pain. Early diagnosis can be achieved through a combination of serology, imaging modalities, and strong clinical suspicion. ALP, LDH, and eosinophil levels are valuable, non-invasive indicators for monitoring treatment response.
