Laparoscopic appearance of fasciola hepatica infection.

Fasciola hepatica (FH) infection is endemic in South America, the Caribbean, Europe, and Asia. The population of southern Florida, with proximity to the Caribbean and South America, may be at risk. FH infection has acute and chronic stages. In the acute stage, the patient presents with fever, hepatomegaly, and abdominal pain. In the chronic stage, the trematode can invade the bile ducts resulting in biliary obstruction, hemobilia, and liver abscesses.1,2 A high index of suspicion must be maintained to make the diagnosis of FH infection. This is a case of FH infection in a patient from southern Florida who ingested watercress. The diagnosis was based on clinical suspicion, positive serology, laparoscopic appearance, and histologic features.