The metagenomic next-generation sequencing facilitates the diagnosis of fascioliasis without etiological evidence

Fascioliasis caused by Fasciola hepatica can be categorized into hepatic and biliary phases based on its pathogenesis. Clinical symptoms during the hepatic phase are often non-specific and may be easily overlooked. Serological and pathogenetic evidence are essential for diagnosis and for guiding subsequent antiparasitic therapy. Although serological tests demonstrate excellent sensitivity, the detection of adult Fasciola eggs relies on parasite maturation during the biliary phase. In cases where serological testing fails to provide diagnostic information during the hepatic phase, metagenomic next-generation sequencing (mNGS) can serve as a valuable adjunct. However, this increasingly utilized approach has not yet been incorporated into current guidelines or literature on fascioliasis. We report a case in which mNGS enabled timely detection of Fasciola hepatica , leading to effective treatment, and discuss the potential role of mNGS in the diagnosis of Fascioliasis.