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Fasciola hepatica — SCE Infectious Diseases MCQ

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HardParasitologyFasciola hepaticaSCE Infectious Diseases

A 52-year-old man presents after a 3-week trip to rural Thailand with daily fevers, eosinophilia (2.8 × 10⁹/L), right upper quadrant pain, and a CT showing multiple liver lesions. Serology for Fasciola hepatica is strongly positive. What is the recommended treatment?

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Correct answer: D — Triclabendazole 10 mg/kg as a single dose

Fasciola hepatica (liver fluke) infection presents with fever, eosinophilia, and hepatic lesions during the acute migration phase. Triclabendazole is the only drug with high efficacy against both immature and adult flukes and is the WHO-recommended treatment. Praziquantel is effective against many trematodes but has poor activity against Fasciola species. Albendazole has limited efficacy.

Reference: WHO 2023 – Guidelines for trematode infections; BNF 2024 – Triclabendazole