A case of unilocular hydatid disease imported from Saudi Arabia

An imported case of hepatic unilocular hydatid disease

A 38-year old man visited a private clinic complaining of epigastric discomfort for 2 months. A huge hepatic cyst was found by sonography and computerized tomography. An exploratory laparotomy was performed under the impression of hydatid disease. The cyst was successfully removed. A lot of living protoscolices of Echinococcus granulosus were found from the cystic fluid under light microscopy. During the operation, however, the cyst was accidentally ruptured and the cystic fluid spilled out. The patient was medicated with albendazole, and had been well without any signs of anaphylaxis or recurrence for 1 year follow-up period. He had been in Saudi Arabia for 3 years. This is the 16th case of hydatid disease reported in Korea and a case without immediate complication in spite of rupture of the cyst.

Immunoelectrophoretic analysis of major component proteins in cystic fluid of Taenia solium metacestodes

When cystic fluid of Taenia solium metacestodes (CF) was filtrated through Sephacryl S-300 Superfine, major proteins were in fractions III and IV. Major protein in fraction III was Band C protein of 150 kDa and that in fraction IV was Band N protein (Choi et al., 1990). When CF was electrophoresed in 0.9% agarose gel and reacted with anti-CF rabbit serum (RACF), two main bands, a long outer and a short inner band, were precipitated, together with 8 minor bands. RACF reacted with fraction III forming the long outer band whereas RACF formed the short inner band with fraction IV in immunoelectrophoresis (IEP). The long outer precipitin band of CF fraction III was similar to antigen B in hydatid fluid (HF) of Oriol et al. (1971), while the short inner band of CF fraction IV was similar to HF antigen 5 of Capron et al. (1967). When HF was reacted with RACF, the short inner band was immunoprecipitated without forming the long outer band. Common antigenicity between CF and HF seemed to exist in fraction IV rather than in fraction III of CF. Patient sera of neurocysticercosis reacted more frequently with fraction III than with fraction IV.

Cestode infections in Korea

Epidemiological surveys concerning cestodes of medical importance in Korea have been sporadically reported by many workers. Among various parasitic infections, cestode infections occur less frequently than other helminthiases, but they often cause serious clinical complications. Cestodes reported so far in Korea belong to the Order Pseudophyllidea or Cyclophyllidea (Subclass Cestoda), i.e., Diphyllobothrium latum, D. yonagoense, Spirometra erinacei, sparganum, Hymenolepis diminuta, H. nana, Mesocestoides lineatus, Taenia saginata, T. solium, metacestode of T. solium (cysticercus), and Echinococcus granulosus. The present paper is a brief review of the literature concerning these cestode infections in Korea. Taeniases by T. saginata or T. solium are prevalent cestode infections in Korea, and cysticercosis by T. solium often reveals serious clinical manifestations. H. nana infection is relatively rare, showing 0.22% egg positive rate in a nationwide survey in 1986. Sparganosis by the plerocercoid larva of Spirometra is not an uncommon cestode infection in man, and 16 kinds of animal hosts including the snakes and frogs have been reported. D. latum infection has been an uncommon intestinal parasitosis, but it tends to increase nowadays. Most of human hydatidosis cases have been recognized as imported ones from outside Korea, but one case was proven indigenous. Other 4 kinds of cestodiases are extremely rare in Korea and only a few cases have been recorded.

Cross-reacting and specific antigenic components in cystic fluid from metacestodes of Echinococcus granulosus and Taenia solium

Sera from confirmed patients of 5 hydatidosis, 67 neurocysticercosis and 89 other parasitic diseases were tested for specific antibody (IgG) levels by ELISA to cystic fluid antigens from metacestodes of Echinococcus granulosus (HF) and Taenia solium (CF). All hydatidosis sera reacted positively to both HF and CF while neurocysticercosis sera did in 49.3% to HF and 85.1% to CF. The frequencies of cross-reactions were lower in other parasitic diseases to both antigens. By SDS-PAGE, protein bands of 64, 35, 22 and 7 kilodaltons (kDa) were found common in HF and CF. SDS-PAGE/immunoblot exhibited that hydatidosis sera reacted crossly to CF at 135, 110, 100, 86, 64, 45, 39, 35 and 24 kDa bands while neurocysticercosis sera did to HF at 135, 100, 86, 64, 52, 39, 35, 29 and 24 kDa bands. These results indicated that protein bands of 135, 100, 86, 64, 39, 35 and 24 kDa were major common components in HF and CF. Protein bands of 7 kDa in HF and 15, 10 and 7 kDa in CF did not react crossly and were specific components in respective antigens.