Human fascioliasis in Egyptian children: successful treatment with triclabendazole

Human fascioliasis (HF) is an increasingly recognized public health problem in Egypt. During the past two years we diagnosed HF in 40 Egyptian children. Diagnosis was based on some or all of the following criteria: fever, tender hepatomegaly and high eosinophilia (febrile eosinophilic syndrome), presence of Fasciola hepatica eggs in stools, and/or serodiagnosis using the indirect haemagglutination test (IHAT). Eight of the 40 children had failed to respond to previous treatment with praziquantel. All children were treated with triclabendazole in a dose of 10 mg/kg as a single oral dose. Within 2 months, 31 children (78 per cent) were cured as evidenced by clinical well-being, normalization of eosinophil counts, Fasciola antibody titres, and absence of Fasciola hepatica eggs in stools. The remaining nine cases achieved clinical and laboratory cure after a second dose of triclabendazole. No side-effects were encountered in any of the cases. We conclude that triclabendazole is an effective, well-tolerated, easy to administer drug that should be considered in HF.