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Kenzaka T, Sato Y, Nishisaki H. Giant infected hepatic cyst causing exclusion pancreatitis: A case report. World J Clin Cases 2022; 10:2294-2300. [PMID: 35321169 PMCID: PMC8895190 DOI: 10.12998/wjcc.v10.i7.2294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/24/2021] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An infected hepatic cyst causes clinical symptoms, such as fever and abdominal pain. A cyst with a diameter > 10 cm increases the likelihood of exclusion symptoms in adjacent organs. Herein, we report a case of pancreatitis caused by an infected hepatic cyst.
CASE SUMMARY The patient was an 88-year-old woman with a history of polycystic liver disease and a cyst > 10 cm in diameter. She was referred to our hospital for upper abdominal pain that persisted for four days before consultation. She had a fever of 37.4ºC, and a blood test showed a C-reactive protein level of 23 mg/dL. An infected hepatic cyst was diagnosed by abdominal ultrasonography, computed tomography, and magnetic resonance imaging. Antibacterial therapy and percutaneous cyst puncture did not elicit sufficient therapeutic effects. As the cyst growth continued, laparoscopic hepatic cyst fenestration was performed on hospitalization day 20. Thereafter, symptoms improved, and she was discharged on hospital day 31.
CONCLUSION To our knowledge, this is the second case report of pancreatitis associated with hepatic cyst growth. Percutaneous cyst puncture and drainage or surgical therapy can be considered if a slight improvement with antibiotic therapy alone or exclusion of surrounding organs is observed. Further, attention is needed to avoid potential recurrence.
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Affiliation(s)
- Tsuneaki Kenzaka
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-cho, Tamba, Hyogo 669-3495, Japan
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo 652-0032, Japan
| | - Yu Sato
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-cho, Tamba, Hyogo 669-3495, Japan
| | - Hogara Nishisaki
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-cho, Tamba, Hyogo 669-3495, Japan
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2
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Manciulli T, Serraino R, D'Alessandro GL, Cattaneo L, Mariconti M, Vola A, Taccari F, Narra R, De Vito G, Trecarichi EM, Mazzitelli M, Matera G, Casulli A, Marascio N, Brunetti E, Tamarozzi F, Torti C. Evidence of Low Prevalence of Cystic Echinococcosis in the Catanzaro Province, Calabria Region, Italy. Am J Trop Med Hyg 2020; 103:1951-1954. [PMID: 32975181 DOI: 10.4269/ajtmh.20-0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cystic echinococcosis (CE) is one of the neglected tropical diseases recognized by the WHO. Echinococcus granulosus sensu lato affects more than 1 million people worldwide and is responsible for high costs in the healthcare system. A clear knowledge of the prevalence of CE and its clinical characteristics could have an important impact on the approach to its diagnosis and to the public health planning of treatment and control interventions. We performed a prevalence study in four municipalities of Catanzaro Province, South Italy. This area is considered to be at high risk of CE because of ovine breeding. We screened by abdominal ultrasound 2,426 volunteers, four of whom had abdominal CE. Given the need for prevention and control programs for CE in endemic areas of Italy, a detailed mapping of prevalence of CE, to complement data obtained through hospital discharge records, appears imperative.
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Affiliation(s)
- Tommaso Manciulli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,PhD School of Experimental Medicine, University of Pavia, Pavia, Italy.,Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Riccardo Serraino
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, Catanzaro, Italy
| | - Gian Luca D'Alessandro
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Letizia Cattaneo
- Unit of Infectious Diseases, University of Naples-Federico II, Napoli, Italy
| | - Mara Mariconti
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Ambra Vola
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Francesco Taccari
- Institute of Clinical Infectious Disease, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberta Narra
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Giuseppe De Vito
- Public Health Agency of the Catanzaro Province, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, Catanzaro, Italy
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, 'Magna Graecia' University, Catanzaro, Italy
| | - Adriano Casulli
- Department of Infectious Diseases, European Reference Laboratory for Parasites, Foodborne and Neglected Parasitic Diseases Unit, Istituto Superiore di Sanità, Rome, Italy.,Department of Infectious Diseases, WHO Collaborating Centre for Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Foodborne and Neglected Parasitic Diseases Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Nadia Marascio
- Department of Health Sciences, Unit of Clinical Microbiology, 'Magna Graecia' University, Catanzaro, Italy
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Francesca Tamarozzi
- Department of Infectious Diseases, WHO Collaborating Centre for Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Foodborne and Neglected Parasitic Diseases Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, Catanzaro, Italy
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3
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Thomas MN, Zwingelberg S, Angele M, Guba M, Werner J. [Diagnosis and treatment of cystic and alveolar echinococcosis]. MMW Fortschr Med 2019; 159:38-42. [PMID: 28924720 DOI: 10.1007/s15006-017-9948-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Michael N Thomas
- Klinikum der Universität München, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Marchioninistraße 15, D-81377, München, Deutschland.
| | - S Zwingelberg
- Klinikum der Universität München, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Marchioninistraße 15, D-81377, München, Deutschland
| | - Martin Angele
- Klinikum der Universität München, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Marchioninistraße 15, D-81377, München, Deutschland
| | - Markus Guba
- Klinikum der Universität München, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Marchioninistraße 15, D-81377, München, Deutschland
| | - Jens Werner
- Klinikum der Universität München, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Marchioninistraße 15, D-81377, München, Deutschland
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4
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Haji Mohammadi KH, Heidarpour M, Borji H. Allium Sativum Methanolic Extract (garlic) Improves Therapeutic Efficacy of Albendazole Against Hydatid Cyst: In Vivo Study. J INVEST SURG 2018; 32:723-730. [PMID: 29693456 DOI: 10.1080/08941939.2018.1459967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
After gas chromatography and mass spectrometry of prepared methanolic extract of Allium sativum, 40 laboratory BALB/c mice were infected intraperitoneally by injection of 1,500 viable protoscoleces. Five months after infection, the infected mice were allocated into four treatment groups, including 1- Albendazole (100 mg/kg); 2- Allium sativum methanolic extract (10 mL/L); 3- A. sativum methanolic extract (10 mL/L) + Albendazole (50 mg /kg); and 4- untreated control group. After 30 days of daily treatment, total number and weight of cysts and size of the largest cyst as well as blood serum bilirubin and liver enzymes were compared between the mice of different groups.The total number and weight of cysts and size of the largest cyst were significantly lower in treated groups A. sativum 10 mL/L + Albendazole 50 and Albendazole 100 in comparison to those of the control group (p < 0.05).The activity of alanine aminotransferase (ALT) enzyme and bilirubin concentration were significantly lower in the mice treated with A. sativum 10 mL/L and A. sativum 10 mL/L + Albendazole 50, when compared to the control group. In addition, bilirubin concentration revealed significant decrease in A. sativum 10 mL/L and A. sativum 10 mL/L + Albendazole 50 groups, when compared to the Albendazole group. In conclusion, administration of A. sativum 10 mL/L improved the anti-hydatidosis activity of Albendazole 50 mg /kg, due to parasitological effects similar to Albendazole 100 mg /kg but less hepatotoxic effects.
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Affiliation(s)
- K H Haji Mohammadi
- Department of Pathobiology, School of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - M Heidarpour
- Department of Clinical Sciences, School of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - H Borji
- Department of Pathobiology, School of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
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5
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Tamarozzi F, Rossi P, Galati F, Mariconti M, Nicoletti GJ, Rinaldi F, Casulli A, Pozio E, Brunetti E. The Italian registry of cystic echinococcosis (RIEC): the first prospective registry with a European future. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.18.21115] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cystic echinococcosis (CE), a worldwide zoonosis, is highly endemic in southern and eastern Europe. Its actual prevalence is unknown due to the lack of efficient reporting systems designed to take into account the particular features of the disease. Neglect of CE makes diagnosis and clinical management difficult outside referral centres, with inconsistencies in clinical practice and often unnecessary procedures carried out that have associated risks and costs. The Italian registry of CE (RIEC) is a prospective multicentre registry of CE patients seen from January 2012 in Italian health centres; data are voluntarily submitted to the registry. Its aims are to show the prevalence of CE in Italy, bring the importance of this infection to the attention of health authorities, encourage public health policies towards its control, and stimulate biological, epidemiological and clinical research on CE. From January 2012 to February 2014, a total 346 patients were enrolled in 11 centres, outnumbering national reports of many CE-endemic European countries. We discuss preliminary data and challenges of the RIEC, template for the European registry of CE, which has been implemented within the Seventh Framework Programme project HERACLES (Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies) since September 2014.
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Affiliation(s)
- F Tamarozzi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - P Rossi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - F Galati
- SIDBAE, Information Technology, Istituto Superiore di Sanità, Rome, Italy
| | - M Mariconti
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - G J Nicoletti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - F Rinaldi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - A Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Brunetti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
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6
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Ahn CS, Han X, Bae YA, Ma X, Kim JT, Cai H, Yang HJ, Kang I, Wang H, Kong Y. Alteration of immunoproteome profile of Echinococcus granulosus hydatid fluid with progression of cystic echinococcosis. Parasit Vectors 2015; 8:10. [PMID: 25566682 PMCID: PMC4311513 DOI: 10.1186/s13071-014-0610-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/17/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE), caused by Echinococcus granulosus metacestode, invokes a serious public health concern. Early diagnosis has great impacts on reduction of disability-adjusted life years. Several antigen B-related molecules (EgAgB; EgAgB1-5) are known to be immunopotent, but detection of EgAgB is variable in many patients and may not allow reliable interpretation of its immunological relevance. More importantly, the immunoproteome profile of hydatid fluid (HF) has not been addressed. METHODS We conducted a proteome analysis of the HF of a single fertile cyst of CE1 and CE2 stages through two-dimensional electrophoresis (2-DE). Each protein spot was analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). We subsequently determined the immunoproteome profile employing patient sera of entire disease spectrum from CE1 to CE5 stages. RESULTS We identified 40 parasite proteins, of which EgAgB (28 spots) and antigen 5 (EgAg5; 5 molecules) were abundant. EgAgB proteoforms constituted the majority, mostly EgAgB1 (24 spots), followed by EgAgB2 and EgAgB4 (2 spots each). EgAgB3 was detected only by liquid chromatography-MS/MS. EgAgB5 was not recognized. We also detected 38 host proteins, which were largely composed of serum components, antioxidant/xenobiotic enzymes, and enzymes involved in carbohydrate metabolism. CE1 and CE2 HF exhibited comparable spotting patterns, but CE2 HF harbored greater amounts of EgAgB and EgAg5 complexes. CE sera demonstrated complicated immune recognition patterns according to the disease progression; CE2 and CE3 stages exhibited strong antibody responses against diverse EgAgB and EgAg5 proteoforms, while CE1, CE4, and CE5 stages mainly reacted to EgAg5 and cathepsin B. Patient sera of alveolar echinococcosis (AE) cross-reacted with diverse EgAgB isoforms (36%). EgAg5 and cathepsin B also demonstrated cross-reactions with sera from neurocysticercosis and sparganosis. CONCLUSIONS Our results demonstrated that detection of a single defined molecule may not properly diagnose CE, since specific immunodominant epitopes changed as the disease progresses. Immunoproteome analysis combined with imaging studies may be practical in the differential diagnosis of CE from AE and other cystic lesions, as well as for staging CE, which are pertinent to establish appropriate patient management.
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Affiliation(s)
- Chun-Seob Ahn
- Department of Molecular Parasitology, Sungkyunkwan University School of Medicine and Center for Molecular Medicine, Samsung Biomedical Research Institute, Suwon, 440-746, Korea.
| | - Xiumin Han
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, Qinghai, China.
| | - Young-An Bae
- Department of Microbiology, Graduate School of Medicine, Gachon University, Incheon, Korea.
| | - Xiao Ma
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, Qinghai, China.
| | - Jin-Taek Kim
- Department of Molecular Parasitology, Sungkyunkwan University School of Medicine and Center for Molecular Medicine, Samsung Biomedical Research Institute, Suwon, 440-746, Korea.
| | - Huixia Cai
- Department of Molecular Parasitology, Sungkyunkwan University School of Medicine and Center for Molecular Medicine, Samsung Biomedical Research Institute, Suwon, 440-746, Korea.
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, Qinghai, China.
| | - Hyun-Jong Yang
- Department of Parasitology, Ewha Womans University, School of Medicine, Seoul, Korea.
| | - Insug Kang
- Department of Molecular Biology and Biochemistry, School of Medicine, Kyung Hee University, Seoul, Korea.
| | - Hu Wang
- Qinghai Province Institute for Endemic Diseases Prevention and Control, Xining, Qinghai, China.
| | - Yoon Kong
- Department of Molecular Parasitology, Sungkyunkwan University School of Medicine and Center for Molecular Medicine, Samsung Biomedical Research Institute, Suwon, 440-746, Korea.
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7
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Budke CM, Carabin H, Ndimubanzi PC, Nguyen H, Rainwater E, Dickey M, Bhattarai R, Zeziulin O, Qian MB. A systematic review of the literature on cystic echinococcosis frequency worldwide and its associated clinical manifestations. Am J Trop Med Hyg 2013; 88:1011-27. [PMID: 23546806 DOI: 10.4269/ajtmh.12-0692] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence Proportion Ratio: 1.35 [95% Bayesian Credible Interval: 1.16-1.53]) and increased with age. The most common manifestations of hepatic and pulmonary CE were abdominal pain (57.3% [95% confidence interval [CI]: 37.3-76.1%]) and cough (51.3% [95% CI: 35.7-66.7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.
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Affiliation(s)
- Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.
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8
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Abstract
Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and reaspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective.
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9
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Abstract
INTRODUCTION In this survey we evaluated the usefulness of ultrasonography (US) in the diagnosis, and in the treatment of complicated hydatid cysts. MATERIALS AND METHODS From June 1985 to June 2004, 221 patients with 294 hydatid cysts were examined. Twenty patients (9.0%) presented 22 complicated cysts (7.4%): 9 with infection, 5 ruptured into the bile ducts, 2 bilomas, 2 cysto-pleural fistulas, 2 allergic reactions, 1 rupture into the peritoneum and 1 intrasplenic hematoma. In all cases, US yielded a specific or suspected diagnosis, also in complications affecting non-hepatic sites, confirmed by computed tomography (CT), endoscopic papillotomy or percutaneous US-guided sampling. All patients with complicated cystic echinococcosis were treated with Albendazole 800 mg/day for at least 3 months. In addition to this therapy, 12 underwent US-guided drainage (9 infected cysts, 2 bilomas, 2 cysto-pleural fistulas, 1 intrasplenic hematoma); of these patients 3 subsequently underwent surgery because US-guided treatment was ineffective. Five patients were treated with perendoscopic sphincterotomy for obstruction of the bile passages, while 3 patients received only medical therapy. RESULTS Medical, echoguided and surgical treatments led to resolution of the complications and complete remission of the parasitic pathology in 19/20 patients (95%) and in 21/22 cysts (95.4%). There was partial remission in 1 case only. The therapy did not cause major complications and the results were confirmed during follow-up lasting from 5 months to 15 years (mean time 3 years). DISCUSSION AND CONCLUSION This study shows that the incidence of complications of hydatid cysts is low and that correct echographic management allows a rapid diagnosis and optimization of treatment in most cases.
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10
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Caremani M, Tacconi D, Lapini L, Benci A, Giaccherini R. Diagnosis of non-neoplastic cysts of the liver by percutaneous echoguided aspiration: Evaluation of electrolytes, metabolites, proteins and sediment. J Ultrasound 2007. [DOI: 10.1016/j.jus.2007.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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11
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Lahmar S, Sarciron ME, Chehida FB, Hammou A, Gharbi HA, Gherardi A, Lahmar J, Ghannay A, Pétavy AF. Cystic Hydatic Disease in Sheep: Treatment with Percutaneous Aspiration and Injection with Dipeptide Methyl Ester. Vet Res Commun 2006; 30:379-91. [PMID: 16502106 DOI: 10.1007/s11259-006-3186-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2004] [Indexed: 10/25/2022]
Abstract
An in vitro and in vivo study was conducted to show the effect of dipeptide methyl ester on the protoscolices of Echinococcus granulosus and in naturally infected sheep. Easily punctured cysts were located by ultrasonography. A PAIR and PAI method were performed by the injection of dipeptide methyl ester into these cysts at a final concentration of 110 mmol/L. Follow-up was conducted monthly by ultrasonography. After injection of the compound, the sheep were sacrificed at different times from 6 to 17 weeks. The size and the morphological aspect of treated cysts were noted. Samples were collected for histology and electron microscopy. In conclusion, these studies revealed significant and rapid detachment of the membrane of the treated cyst and alteration of the inner membrane in less than 5 min after injection of the drug, confirming the effect of the compound on the laminated layer of the parasite.
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Affiliation(s)
- S Lahmar
- Parasitology Laboratory, National Veterinary School, Sidi Thabet, Tunisia
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12
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Brunetti E, Gulizia R, Garlaschelli AL, Filice C. Cystic echinococcosis of the liver associated with repeated international travels to endemic areas. J Travel Med 2005; 12:225-8. [PMID: 16086899 DOI: 10.2310/7060.2005.12410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cystic echinococcosis (CE) is increasingly seen in immigrants from endemic areas to Western countries; however, it is rarely reported in short-term travels to endemic areas. This is partly because the echinococcal cyst typically grows slowly and may long remain clinically silent. We describe a case of cystic echinococcosis in a man born and living in a nonendemic urban area in North Italy that was acquired during a period of frequent travels in highly endemic countries.
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Affiliation(s)
- Enrico Brunetti
- Division of Infectious and Tropical Diseases, IRCCS S. Mateo, Pavia University, Pavia, Italy
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13
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Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev 2004; 17:107-35. [PMID: 14726458 PMCID: PMC321468 DOI: 10.1128/cmr.17.1.107-135.2004] [Citation(s) in RCA: 1078] [Impact Index Per Article: 53.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Echinococcosis in humans is a zoonotic infection caused by larval stages (metacestodes) of cestode species of the genus Echinococcus. Cystic echinococcosis (CE) is caused by Echinococcus granulosus, alveolar echinococcosis (AE) is caused by E. multilocularis, and polycystic forms are caused by either E. vogeli or E. oligarthrus. In untreated cases, AE has a high mortality rate. Although control is essentially feasible, CE remains a considerable health problem in many regions of the northern and southern hemispheres. AE is restricted to the northern hemisphere regions of North America and Eurasia. Recent studies have shown that E. multilocularis, the causative agent of AE, is more widely distributed than previously thought. There are also some hints of an increasing significance of polycystic forms of the disease, which are restricted to Central and South America. Various aspects of human echinococcosis are discussed in this review, including data on the infectivity of genetic variants of E. granulosus to humans, the increasing invasion of cities in Europe and Japan by red foxes, the main definitive hosts of E. multilocularis, and the first demonstration of urban cycles of the parasite. Examples of emergence or reemergence of CE are presented, and the question of potential spreading of E. multilocularis is critically assessed. Furthermore, information is presented on new and improved tools for diagnosing the infection in final hosts (dogs, foxes, and cats) by coproantigen or DNA detection and the application of molecular techniques to epidemiological studies. In the clinical field, the available methods for diagnosing human CE and AE are described and the treatment options are summarized. The development of new chemotherapeutic options for all forms of human echinococcosis remains an urgent requirement. A new option for the control of E. granulosus in the intermediate host population (mainly sheep and cattle) is vaccination. Attempts are made to reduce the prevalence of E. multilocualaris in fox populations by regular baiting with an anthelmintic (praziquantel). Recent data have shown that this control option may be used in restricted areas, for example in cities, with the aim of reducing the infection risk for humans.
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Affiliation(s)
- Johannes Eckert
- Institute of Parasitology, University of Zurich, CH-8057 Zurich, Switzerland.
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14
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Caremani M, Lapini L, Caremani D, Occhini U. Sonographic diagnosis of hydatidosis: the sign of the cyst wall. EUROPEAN JOURNAL OF ULTRASOUND : OFFICIAL JOURNAL OF THE EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY 2003; 16:217-23. [PMID: 12573791 DOI: 10.1016/s0929-8266(02)00076-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The Authors evaluate the diagnostic accuracy of echography in hepatic echinococcosis, particularly in the completely liquid types of cysts without septa or hydatid sand and in the solidified forms where the differential diagnosis with other hepatic pathologies can be difficult. The study was carried out with a 7.5 MHz probe and the results were compared with those from the use of a 3.5 MHz probe and from CT, serology for hydatidosis and echoguided sampling. Seventy one patients, 36 with liquid hepatic lesions and 35 with solid hepatic lesions (31 hydatid and 40 non-parasitic), were evaluated echographically, first with a 3.5 MHz probe and subsequently with a 7.5 MHz probe. All the patients underwent serology for hydatidosis. All the liquid lesions were subjected to percutaneous echoguided aspiration and all the solid lesions to CT; echoguided biopsy was performed in only 24 of the latter lesions. With the 7.5 MHz probe, a wall was revealed in 96.77% of parasitic cysts but in only 5% of non-hydatid ones. Moreover, using the 7.5 MHz probe, it was possible to see a triple-layered aspect of the wall in the hydatid cysts. The results obtained with the 7.5 MHz probe demonstrate a high diagnostic accuracy comparable to that of MR.
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Affiliation(s)
- Marcello Caremani
- Infectious Disease Department, Arezzo Hospital, 2 Nenni Street, 52100 Arezzo, Italy.
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Caremani M, Benci A, Maestrini R, Accorsi A, Caremani D, Lapini L. Ultrasound imaging in cystic echinococcosis. Proposal of a new sonographic classification. Acta Trop 1997; 67:91-105. [PMID: 9236941 DOI: 10.1016/s0001-706x(97)00057-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The ultrasonography permits the study of the natural history of cystic echinococcosis (CE) and evaluation of stages of the parasitic pathology. The evolution of abdominal CE was studied in 54 patients suffering from 97 abdominal cysts treated with albendazole, in 20 patients suffering from 20 hepatic cysts treated with echoguided percutaneous ethanol injection and in 39 patients suffering from 42 abdominal cysts, but left untreated. A new sonographic classification is suggested. Type I: Simple CE; (a) overall echofree; (b) with fine echos. Type II: Multiple CE; (a) multiple contiguous; (b) multiseptated with rosette, honeycomb and wheel-like pattern. Type III: With detachment of endocyst CE; (a) with double layer image; (b) with water-lily sign. Type IV: Mixed type CE; with fluid and solid aspect. Type V: Heterogeneous CE; (a) with ball of wool pattern; (b) with hypoechogenic image. Type VI: Hyperechoic CE; (a) with snow-storm pattern; (b) with dyshomogeneous aspect. Type VII: Calcified CE; (a) with advanced calcification of the layer only; (b) with calcification of overall cyst. This classification appears more appropriate to the natural history of CE and permits a better differential diagnosis and more suitable treatment.
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Affiliation(s)
- M Caremani
- Infectious Disease Division, Arezzo Hospital, Italy
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Caremani M, Benci A, Maestrini R, Rossi G, Menchetti D. Abdominal cystic hydatid disease (CHD): classification of sonographic appearance and response to treatment. JOURNAL OF CLINICAL ULTRASOUND : JCU 1996; 24:491-500. [PMID: 8906480 DOI: 10.1002/(sici)1097-0096(199611/12)24:9<491::aid-jcu1>3.0.co;2-i] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The natural history of cystic hydatid disease (CHD) can be divided into two stages. The first is characterized by the proliferation of the parasite; the second is marked by involution, ie, when the hydatid undergoes spontaneous distress or is subjected to pharmacological treatment. Echography makes it possible to study this evolution and to evaluate the stages of this parasitic pathology. This study of the evolution of abdominal CHD in 81 patients suffering from 127 cysts, with or without Albendazole treatment suggests a new sonographic classification: type I: simple CHD; type II: multiple CHD, type III: with detachment of membrane CHD; type IV: mixed CHD, type V: heterogeneous CHD; type VI: hyperechogenic CHD; type VII calcified CHD. Forty-seven patients suffering from 90 cysts of types I, II, III, IV, and V were treated with Albendazole; 31, suffering from 34 CHD of types VI and VII, were not treated, as they were considered involutional; 3 patients with 3 cysts refused therapy. Albendazole treatment resulted in the disappearance of 9 and in the solidification of 62 cysts. Of the remaining cases of CHD, 10 cysts showed sonographic alterations and 5 showed no modifications. Surgery was necessary for 2 patients (4 cysts). This new classification seems to be an aid in the recognition of the natural and therapy-induced involution of CHD and seems to improve the evaluation of the efficaciousness of the therapy.
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Affiliation(s)
- M Caremani
- Infectious Disease Division, Arezzo Hospital, Italy
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Craig PS, Rogan MT, Allan JC. Detection, screening and community epidemiology of taeniid cestode zoonoses: cystic echinococcosis, alveolar echinococcosis and neurocysticercosis. ADVANCES IN PARASITOLOGY 1996; 38:169-250. [PMID: 8701796 DOI: 10.1016/s0065-308x(08)60035-4] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- P S Craig
- Department of Biological Sciences, University of Salford, UK
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