Long-term mebendazole therapy may be parasitocidal in alveolar echinococcosis

Long-term chemotherapy of human alveolar echinococcosis with benzimidazole compounds (mebendazole, albendazole) has been shown to be primarily parasit ostatic, but its curative (parasitocidal) efficacy is debated. This article reports on a 117-year-old male patient with non-resectable alveolar echino coccosis of the liver who had been continuously treated for 13 years with m ebendazole (approximately 45-48 mg/kg body weight per day) and who tvas clo sely monitored according to a specific protocol, At the age of 80 years the patient died of oesophageal variceal bleeding, During treatment the hepati c lesion had decreased markedly in size in association with progression of perifocal calcification. At autopsy, a well-demarcated, necrotic, partially calcified, parasite-induced lesion of the right liver lobe and secondary b iliary cirrhosis mere found. Remnants of parasite tissue obtained from the periphery of the lesion showed a small-cystic structure, but it was not via ble, as evidenced by transplantation of tissue blocks to rodents. The case is suggestive fur a parasitocidal efficacy of mebendazole treatment carried out for 13 years, and is discussed in context with conflicting literature data.