Case 2 was a 36 years old female with right upper quadrant abdominal pain, jaundice, severe joint pain, fatigue, 8 kg weight loss, and hypereosinophilia. Her stool tests and Fas-2 ELISA were positive for Fasciola. After failing a treatment course with triclabendazole (2 doses of 10 mg/kg every 12 hours), she was referred to our center. Over 10 months she received 1 additional course of triclabendazole treatment (2 doses of 10 mg/kg every 12 hours), a course of 3 doses of triclabendazole 10 mg/kg every 12 hours, and a course of 2 doses of triclabendazole 10 mg/kg every 12 hours followed by nitazoxanide (500 mg every 12 hours for 7 days) with marked improvement of symptoms but persistence of Fasciola eggs in the stools.
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.