Treatment of Acute Fasciola Hepatica Infection in Children

摘要

During the summer of 1987, 15 children, 10 girls and 5 boys aged 5 to 10 years,were referred to hospital for investigation of prolonged fever and eosinophilia. All were acutely ill, complained of abdominal pain and diarrhea, and had enlarged tender livers. The admission sera in every child reacted positively to purified Fasciola antigen by counterimmuno-electrophoresis and enzyme-linked immunosorbent assay (ELISA) tests. Fasciola hepatica eggs were eventually found in the stools of every child. In acutely ill children, fever and toxemia were controlled with prednisone, 5 to 10 mg given daily, before starting antiparasitic therapy. Three children were treated with intramuscular dehydroemetine, 1.0 mg/kg body weight, given daily for 14 doses and 12 children were treated with oral bithionol, 40 mg/kg body weight, given on alternate days for 14 doses (table). Relapses were seen in 7 children but not in the other 8. Three weeks after completing therapy, 7 children, 2 treated with dehydroemetine and 5 with bithionol, had a recurrence of fever and passed F. hepatica eggs in the stools.