Medical therapy with mebendazole in hydatid cyst disease. A follow-up of 40 cases
Bartoloni, C.; de Gaetano, A.M.; Magistrelli, P.; Danza, F.M.; Barone, C.; Nuzzo, G.; Gambassi, G.
Minerva Medica 80(3): 205-214
1989
ISSN/ISBN: 0026-4806 PMID: 2654757 Document Number: 326785
Mebendazole (50-60 mg/kg/day in 7-8 divided doses after fatty rich meals for at least 6 months) was given to 44 patients with cystic hydatid disease of the liver and other organs, about 1/3 having suffered from recurrences, even multiple, before beginning the pharmacological treatment. Fifteen patients underwent operation after a course of mebendazole, and macroscopic and histological degeneration of hydatid cysts was always documented; sixteen subjects were not operated due to their severe general and/or local conditions but ultrasound, radiologic (CT) and clinical evidence of cyst regression was obtained, and was closely comparable to that in the aforementioned group. Some of the patients (13) began the treatment only after conservative surgery. The mean real follow-up available at the moment is for 40 subjects because 2 patients did not show adequate compliance for the drug and in 2 additional cases it was withdrawn because of an increase in serum transaminases. The rate of recurrence was 7.5% and occurred in high-risk patients (multiple, bone, lung locations) who had, however, an additional and longer course of mebendazole with good results. The detachment of membranes and the increase of internal echoes, observed by means of ultrasonography, which was successfully applied to liver and soft tissue sites as well as the decrease in blood eosinophils when elevated before therapy, were observed to be the most sensitive indicators of early success in the medical treatment for hydatid disease, as far as the viability of parasite cysts was concerned.