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October 3, 1966

Experimental Alveolar Hydatid DiseaseTreatment Failure With Thiabendazole

JAMA. 1966;198(1):75. doi:10.1001/jama.1966.03110140125034

Alveolar or malignant hydatid disease, caused by Echinococcus multilocularis, is endemic in Alaska, central and eastern Europe, and northern Asia. Effective treatment of its common hepatic form has been limited to a few cases in which hemihepatectomy has been successfully performed.1 Any drug which might be effective against this dangerous parasite therefore deserves consideration. Thiabendazole (2-(4′thiazolyl)-benzimidazole), useful in treatment of various adult and larval nematode infections,2-5 has also been reported to eliminate the rat tapeworm, Hymenolepis diminuta, although only when administered in large doses.2 This agent might be expected to have some activity against Echinococcus.

Sigmodon hispidus, the cotton rat, is highly susceptible to infection with eggs of E multilocularis. The larval hydatid cysts develop in the liver, mature in about six weeks, and produce many protoscoleces (the multiple small scoleces that bud from the germinal epithelium). If these protoscoleces are injected into other cotton rats, new