[Human fascioliasis with atypical severe presentation. Treatment with triclabendazole].
BACKGROUND
Fascioliasis is a zoonosis mainly involving sheep but which occasionally may be found in man as an accidental host. It is acquired by the consumption of herbs (watercress, wild endive, and dandelion) contaminated with metacercarias. The adult phase is established in the biliary tree. Most of the human infections are asymptomatic or with unspecific self limited abdominal symptoms making diagnosis difficult.


METHODS
A case of human fascioliasis is of note because of two aspects: a) the infrequent, severe life threatening form of presentation: recurrent subcapsular hepatic hematomas, and b) favorable evolution of the patient on treatment with triclabendazol (to date its use is not approved in humans).


RESULTS
Resistance to treatment with praziquantel was observed at a dosis of 75 mg/day for 2 days, being repeated 15 days later with no response. The patient was posteriorly treated with 10 mg/kg of a single dosis of triclabendazol following approval as "compassive use" with a favorable clinical response.


CONCLUSIONS
This unusual disease requires a high index of suspicion to achieve diagnosis. Treatment with triclabendazol should be studied as a possible treatment of choice given is efficacy, absence of adverse effects and comfortable dosage.
Merino Alonso
J
J
Servicio de Farmacia, Hospital Nuestra Señora de la Candelaria.
Amérigo García
M J
MJ
Alvarez Rubio
L
L
Erdozaín Ruiz
I
I
D000368:Aged; D000871:Anthelmintics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D005211:Fascioliasis / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077682:Triclabendazole
D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole
Fascioliasis humana con presentación atípica y grave. Tratamiento con triclabendazol.