Clinical Response to 7-Day Praziquantel Therapy in Fasciola Liver Abscess

Kim, Chan Gyoo; Kim, Seon Mie; Lee, Hyo Suk; Chai, Jong Yil; Kim, Chung Yong

Abstract

BACKGROUND: Fascioliasis is a zoonotic helminthiasis by fasciola species and is occasionally complicated by liver abscess, and the treatment of choice is oral bithionol, which is not available in Korea. Most clinical reports showed that praziquantel given at usual dosage (75 mg/kg for 1day) failed to cure Fasciola hepatica infections, however, it has not been investigated whether long-term praziquantel (70 mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. METHOD: Three patients who were diagnosed as liver abscess by F. hepatica were included in the current study. The diagnostic criteria for inclusion were 1) eosinophilia, 2) positive serologic test for F. hepatica antigen, 3) characteristic findings on CT scan and 4) demonstration of aggregates of eosinophils on ultrasonography-guided aspirates of the abscess. Praziquantel was given orally to patients at the daily dose of 70-84mg/kg for 7 days. The effectiveness was assessed by the normalization of eosinophil count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scan one year after treatment.
RESULTS
Blood eosinophil count decreased less than 500/mm3 in all patients within 2 to 3 months. The liver abscesses reduced in size by 90% in 5 months in one patient and disappeared within a year in two patients. No major adverse effects were observed.
CONCLUSION
We conclude that 7-day praziquantel therapy may be effective and safe in the treatment of liver abscess caused by F. hepatica.