Case report: nitazoxanide for treatment of refractory bony hydatid disease

Although nitazoxanide has been shown to have activity against Echinococcus multilocularis in animal studies and against E. granulosus in vitro, its use in treatment of human cystic echinococcosis has not been reported. We report a case of progressive bony hydatid disease treated with nitazoxanide that showed a clinical and radiologic response. The patient had a 40-year history of hydatid disease involving the left hip. Despite prolonged courses of albendazole and praziquantel, she had progressive disease with extensive involvement of the left hemipelvis and adjacent soft tissue cysts. She was treated with nitazoxanide, 500 mg twice a day for 3 months in combination with albendazole. The clinical response was supported by imaging showing marked improvement in the soft tissue cysts, with stable disease in the bony pelvis. Although further studies are required, this case suggests that nitazoxanide may be an effective treatment option in hydatid disease, particularly in patients with progressive disease who are receiving conventional therapy.