Fascioliasis is the parasitic infestation of the liver and biliary tract related to Fusciola hepatica. Bithionol is proposed as the treatment of choice for human fascioliasis without major side effects. However, the efficacy of bithionol has been evaluated in chronic but not in acute fascioliasis. In this study we report on the success of treatment with bithionol in 10 patients with fascioliasis, 8 having acute fascioliasis. The criteria for the diagnosis of fascioliasis were hypereosinophilia, positive immunoelectrophoresis and indirect hemagglutination. Bithionol was given orally to hospitalized patients at the daily dose of 25 mg/kg body wt for 10 days. Three patients with acute fascioliasis received a second course of bithionol2 or 3 mo after the first because of the recurrence of diarrhea and fatigue in one patient and persistent hypereosinophilia in two patients. AU patients were cured. The follow-up period after the first course of treatment was between 16 and 47 mo. No major side effects were observed. W e conclude that bithionol is the drug of choice for both acute and chronic fascioliasis. Moreover, its oral administration may allow treatment of fascioliasis in outpatients who do not have serious symptoms. (HEPATOLOGY 199 1; 14: 1066-1069.)
Fascioliasis is the parasitic infestation of the liver and biliary tract related to the trematode Fasciola hepatica that may be found in sheep and cattle in almost every country. Human beings may be accidentally infected by eating aquatic plants such as uncooked wild watercress contaminated with the encysted metacercariae (1). In acute invasive fascioliasis (i.e., the early phase), the parasites migrate through the liver. The main clinical features are fatigue, abdominal pains, diarrhea, hepatomegaly or fever. Blood hypereosinophilia is the most significant laboratory finding. At this phase no ova are found in the feces, and the serological tests are especially useful for the diagnosis. In chronic fascioliasis (i.e., the advanced phase), the adult liver flukes are in the biliary tract. The main clinical features are those of biliary