Human Fascioliasis in The Metropolitan Area of Curitiba, Brazil Evaluation of The Foci of Infection and Report of Nine Cases Treated With Triclabendazole.

In Brazil, only 35 cases of human fascioliasis have been reported. Several drugs have been used to treat Fasciola hepatica in humans, including praziquantel, and, more recently, triclabendazole. After three patients were diagnosed as having human fascioliasis by routine stool parasitological examinations done at Hospital de Clínicas UFPR, a study was done to determine the frequency of the infection in people and cattle from the surrounding area. Stool samples from 185 people and from 20 bovines were examined. Nine bovines' exams were positive for Fasciola hepatica and six new diagnoses of human fascioliasis were made. After taking a medical history, physical examination, routine blood examinations and biliary imaging in the 9 patients, therapy was given with praziquantel 75mg/Kg daily for 5 days. After 30 and 60 days stool examinations were made to evaluate the therapy's efficacy. All patients were asymptomatic. Hematological examinations were normal, and only one patient had an abnormal biliary system on the image study (echography). In the nine patients, praziquantel did not eliminate the fasciola eggs. Triclabendazole (a benzimidazole licensed for veterinary use) was therefore tested, 10mg/Kg one oral dose. Triclabendazole was effective and well tolerated in all patients. We conclude that fascioliasis is more common in some regions of Brazil than previously reported, and that single dose triclabendazole is effective and well tolerated in treating human fascioliasis.