Case 1 was a 51 years old female farmer with 16 kg weight loss, right upper quadrant abdominal pain, night sweats, anorexia, malaise, fever, and hypereosinophilia. She was first treated with a single dose of 10 mg/kg triclabendazole with improvement of symptoms. However, after 8 months her symptoms returned and she was again noted to be shedding Fasciola eggs. The patient was treated 2 additional times with triclabendazole (each with 2 doses of 10 mg/kg every 12 hours) and then with 2 doses of triclabendazole 10 mg/kg every 12 hours followed by nitaxozanide 500 mg every 12 hours for 7 days with improvement of symptoms. However, continued to pass Fasciola eggs on stool tests.
Case 6 was a 12 years old male brother of case 5 diagnosed with asymptomatic F. hepatica infection. He failed the initial treatment with a single dose of triclabendazole. He was prescribed and failed 2 additional triclabendazole courses (2 doses of 10 mg/kg every 12 hours). He was subsequently treated with 2 doses of triclabendazole 10 mg/kg every 12 hours followed by nitaxozanide 500 mg every 12 hours for 7 days but his stool tests have remained positive for Fasciola eggs.