What parasites are associated with hepatosplenomegaly (enlargement of the liver and spleen)?

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Last updated: February 19, 2025 • View editorial policy

From the Guidelines

Parasites associated with hepatosplenomegaly include visceral leishmaniasis, schistosomiasis, and other parasitic infections that can cause enlargement of the liver and spleen due to infection and inflammation [ 1, 2 ].

Key Parasites

  • Visceral Leishmaniasis: caused by Leishmania parasites, can lead to hepatosplenomegaly, as well as other symptoms such as fever, weight loss, and pancytopenia [ 1 ]
  • Schistosomiasis: caused by Schistosoma parasites, can lead to hepatosplenomegaly, as well as other symptoms such as abdominal pain, diarrhea, and liver fibrosis [ 2 ] ### Diagnostic Tests In cases of suspected parasitic infection, it is essential to conduct diagnostic tests such as:
  • Blood smears
  • Serology
  • Imaging studies to confirm the diagnosis [ 1 ].

Treatment

Treatment depends on the specific parasite and may include medications such as:

  • Miltefosine for visceral leishmaniasis [ 1 ]
  • Praziquantel for schistosomiasis [ 2 ] It is crucial to consult a healthcare professional for proper diagnosis and treatment, as the management of these infections can be complex and requires careful consideration of the patient's overall health and medical history.

From the FDA Drug Label

Patients ≥ 12 years of age with clinical signs and symptoms compatible with visceral leishmaniasis (fever, splenomegaly, and cytopenia) confirmed by the presence of Leishmania amastigotes in aspirates of spleen or bone marrow The parasite associated with hepatosplenomegaly is Leishmania, specifically Leishmania donovani 3.

  • Key points:
    • Visceral leishmaniasis is characterized by fever, splenomegaly, and cytopenia
    • Leishmania amastigotes are found in spleen or bone marrow aspirates of infected patients
    • Hepatosplenomegaly is implied by the presence of splenomegaly, although liver enlargement is not explicitly mentioned in the text.

From the Research

Parasites Associated with Hepatosplenomegaly

The following parasites are associated with hepatosplenomegaly:

  • Schistosoma mansoni 4, 5, 6, 7
  • Plasmodium falciparum (malaria) 4, 5, 7
  • Fasciola 6
  • Toxocara 6
  • Toxoplasma 6
  • Leishmania (visceral leishmaniasis) 8
  • Echinococcus (hydatid disease) 6

Key Findings

  • Schistosoma mansoni and malaria infections can synergistically exacerbate hepatosplenomegaly 4, 5, 7
  • Chronic exposure to malaria can exacerbate hepatosplenomegaly even in the absence of S. mansoni infection 7
  • Hepatosplenomegaly associated with S. mansoni is exacerbated in children with relatively high exposure to malaria 4
  • Visceral leishmaniasis should be considered in the differential diagnosis of patients with hepatosplenomegaly or hypersplenism 8

Clinical Presentation

  • Hepatosplenomegaly can present with similar clinical symptoms regardless of the underlying parasitic cause 5, 6
  • Moderate or marked hepatomegaly is more commonly associated with schistosomiasis 6
  • Splenomegaly is more closely associated with dilation of the portal vein than hepatomegaly 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.