Gallbladder infection by trematodes

A 34-year-old-man presented to the emergency department (ED) because of the persistence of remittent fever (average temperature 39 C), malaise, jaundice and intense epigastrium pain radiating to the back, lasting 2 weeks. He reported a history of alcoholic cirrhosis complicated by ascites and encephalopathy. At home, the patient was treated regularly with aldosterone antagonists (spironolactone, 100 mg/day) and loop diuretics (furosemide, 25 mg twice daily). The patient reported having recently made a journey to China, during which he had eaten typical local food, such as the ‘‘Yusheng’’, a Chinese raw fish salad.