Thiabendazole Therapy in Visceral Larva Migrans

Report of a Case

Lorna G. MacdougallDepartment of Pediatrics, State University of New York at Buffalo, 219 Bryant Street, Buffalo, New York 14222

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The clinical and biochemical responses to thiabendazole therapy were noted in a 26-month-old child with visceral larva migrans. Thiabendazole, 25 mg per kg twice daily, was given orally for two 5-day periods. Serial estimations of the plasma concentration of thiabendazole and 5-hydroxythiabendazole were made during therapy; peak levels were recorded 3 hours after drug administration, and no drug was demonstrable in plasma 24 hours after the first test dose. No cumulative effect occurred after 5 days of continuous therapy, and no toxic side-effects were noted. The criteria selected for evaluation of clinical improvement were: defervescence, regression in liver size, resolution of pulmonary lesions, reduction in eosinophilia, and isohemagglutinin titers. No significant clinical improvement was noted on completion of therapy. Eight months later, isohemagglutinin titers had decreased, but hepatomegaly, pulmonary lesions, and eosinophilia persisted. It was concluded that thiabendazole in the regimen used yielded plasma levels comparable to those described in adults, but was ineffective in altering the natural course of the disease. Further clinical trials of more prolonged therapy may be justified.