Challenges in diagnosis and treatment of fascioliasis in a non-endemic country

A returned traveller from Asia presented with prolonged fever, abdominal pain, and eosinophilia. Abdominal CT revealed hypodense lesions of the liver. Fascioliasis was clinically suspected. Serology and triclabendazole are unavailable in Israel; therefore, empiric treatment with nitazoxanide and transfer to Denmark for definitive serodiagnosis and triclabendazole treatment was necessary.