Heart Worms

Heart Worms

Heartworm is an infection of the liver caused by parasites in the form of flatworms. Depending on the type of liver fluke that infects the body, people with liver fluke infection can experience a variety of complaints ranging from fever to jaundice.

A person can be infected with liver flukes if they eat food from aquatic plants or animal meat that is contaminated with liver fluke larvae. Therefore, this disease is also included in the zoonotic disease .

Causes of Heartworms

Liver worms are caused by parasites in the form of worms that infect the liver. Based on the species, liver flukes that can cause liver inflammation include:


A person can be infected with the liver fluke of the Clonorchis sinensis species , if they eat food such as fish, crabs and undercooked freshwater shrimp that are contaminated with the parasite larvae. This parasite, which is common in Asia, can survive in the human body for around 25-30 years if left untreated.


Infection with liver flukes of Opisthorchis species can also occur after consuming fish, crab and shrimp that are cooked undercooked or contaminated with liver worm larvae. If left untreated, this parasite can survive for up to 30 years and cause serious complications.

The opisthorchis parasite can be found in Thailand, Laos, Cambodia, Vietnam, Germany, Italy, and Russia.


A person can be infected with Fasciola liver flukes , especially Fasciola hepatica and Fasciola gigantica , if they consume aquatic plants, such as watercress , which are contaminated with liver fluke larvae from sheep or cow manure.

Symptoms of Heartworm

Early stages of heartworm infection usually do not cause symptoms until the sufferer's condition worsens. However, in some cases, inflammation due to heartworms can also cause the following symptoms:

  • Fever
  • Shivering
  • Stomach ache
  • The heart swells
  • Nausea and vomiting
  • Itchy skin
  • Jaundice
  • Diarrhea
  • No appetite
  • Weight loss

When to see a doctor

Early examination and treatment for heartworm infection is important to prevent complications. Therefore, if you experience the symptoms described above, immediately consult a doctor to get the right treatment.

Heartworm Diagnosis

To diagnose liver worms, the doctor will ask questions related to symptoms, medical history, sanitary conditions of residence, hand washing habits, and foods that are often consumed. After that, the doctor will perform additional examinations in the form of:

  • Blood test , to find out the type of liver worm parasite antibodies in the blood and check the white blood cell count
  • Scanning with CT scan, cholangiography , endoscopic retrograde cholangiopancreatography ( ERCP ), and MRI, to determine damage to the liver or bile that may be caused by liver worm infection
  • Stool examination , to ensure the presence of liverworm eggs in the feces

Heartworm Treatment

Heartworm treatment aims to prevent complications. Methods of treating heartworms that can be done by doctors include:


To treat infections in the liver, doctors can give worm medicines, such as nitazoxanide, triclabendazole , albendazole, and praziquantel.

Corticosteroids may also be given to treat acute liver fluke infections that cause severe symptoms.


Liver worm infection can spread to other organs, especially the bile ducts, and cause infection. To handle it, doctors can perform surgery to open blockages in the bile ducts.

Liver Worm Complications

Liver worms that are not treated can infect other organs and cause serious complications in the form of:

  • Gallstone disease
  • Infections of the ducts and gallbladder ( cholecystitis and cholangitis)
  • Bile duct cancer ( cholangiocarcinoma )

Heartworm Prevention

To prevent heartworm infection, there are several efforts that can be done, namely:

  • Avoid taking or picking vegetables that are in places suspected of being contaminated with parasites.
  • Wash hands with running water and soap before handling food, after using the toilet, and after contact with animals.
  • Wash food ingredients thoroughly before processing.
  • Make sure to cook vegetables, prawns, crabs and fish thoroughly before consuming.
  • Keep the food or water that will be consumed clean, especially if there are livestock around the house.
  • Check pets or farm animals regularly to the vet.
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