|
1
|
Kasat PR, Kashikar SV, Parihar P, Sachani P, Pradeep U. Hepatic and extra-hepatic hydatid cysts: A case series of radiological and clinical insights. Radiol Case Rep 2025; 20:2836-2844. [PMID: 40201055 PMCID: PMC11978297 DOI: 10.1016/j.radcr.2025.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 02/08/2025] [Accepted: 02/10/2025] [Indexed: 04/10/2025] Open
Abstract
Hydatid disease, caused by Echinococcus granulosus, is a parasitic infection that primarily affects the liver but can also involve other organs, including the spleen, kidney, and peritoneum. This case series examined 9 patients with hydatid cysts, highlighting their clinical presentations, radiological findings, and management strategies. This study analyzed 9 patients diagnosed with hepatic and extrahepatic hydatid cysts. Comprehensive evaluations were performed for all patients, including clinical history and contrast-enhanced computed tomography (CT) imaging. The cases included cystic lesions in the liver (7 patients), spleen (3 patients), kidney (2 patients), and peritoneum (1 patient). Typical radiological features, such as the "double-wall sign," daughter cysts, and peripheral calcifications, were observed. The management strategies varied from surgical excision to medical therapy with albendazole. Hydatid disease presents diverse clinical and radiological features. Early diagnosis using advanced imaging techniques and a multidisciplinary approach is critical for effective management and prevention of complications.
Collapse
Affiliation(s)
- Paschyanti R Kasat
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Shivali V Kashikar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Pratapsingh Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Pratiksha Sachani
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Utkarsh Pradeep
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| |
Collapse
|
|
2
|
Rafizadeh SM, Mousavi A, Rajabi MT, Aghajani A, Nozarian Z, Zand A. Orbital and medial rectus muscle involvement as initial presentations of hydatid disease. J Ophthalmic Inflamm Infect 2025; 15:21. [PMID: 40053189 DOI: 10.1186/s12348-025-00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Accepted: 02/20/2025] [Indexed: 03/10/2025] Open
Abstract
PURPOSE To report a rare case of orbital hydatid cyst involving the medial rectus muscle, which presented as progressive proptosis, with subsequent detection of liver involvement after further investigations. CASE PRESENTATION We present the case of a 12-year-old boy from a rural area with exposure to wildlife dogs. The patient had a two-month history of gradually progressive proptosis in the right eye, accompanied by periorbital swelling and limited medial ocular motility. Orbital magnetic resonance imaging (MRI) revealed a large mass within the medial rectus muscle, which showed peripheral enhancement with no central enhancement, consistent with a cystic lesion based on its imaging characteristics. The patient underwent orbitotomy, during which the lesion was aspirated, and its walls were resected. Pathological examination confirmed a structure of a hydatid cyst. Given the suggestive signs of a hydatid cyst as part of a systemic echinococcal infection, further investigations, including liver sonography, revealed a similar cystic lesion in the hepatic lobe. With the diagnosis of an orbital hydatid cyst and suspected echinococcal infection, the patient was treated with oral Albendazole for one month. His symptoms, including periorbital swelling, improved, and no recurrence was observed at a six-month follow-up. CONCLUSIONS Orbital hydatid cysts may present as inflammatory proptosis and should be considered in populations from endemic areas of human echinococcosis. Early diagnosis using orbital MRI, systemic investigations such as liver sonography, timely surgery for definitive diagnosis and treatment, and appropriate adjuvant antiparasitic medication are crucial for effective management.
Collapse
Affiliation(s)
- Seyed Mohsen Rafizadeh
- Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Mousavi
- Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Taher Rajabi
- Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Aghajani
- Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Nozarian
- Department of Pathology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Zand
- Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
3
|
Ku L, Ma X. Multimodality Imaging Assessment of a Multi-Organ Hydatid Cyst. Balkan Med J 2025; 42:164-165. [PMID: 39801152 PMCID: PMC11881522 DOI: 10.4274/balkanmedj.galenos.2024.2024-11-137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 12/16/2024] [Indexed: 03/05/2025] Open
Affiliation(s)
- Leizhi Ku
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Xiaojing Ma
- Department of Echocardiography, Wuhan Asia Heart Hospital, Wuhan University of Science and Technology, Wuhan, China
| |
Collapse
|
|
4
|
Attar A, Khademi B, Jalalpour MH. Isolated hydatid cyst in the medial rectus muscle: unveiling a rare orbital occurrence. J Ophthalmic Inflamm Infect 2024; 14:59. [PMID: 39532786 PMCID: PMC11557816 DOI: 10.1186/s12348-024-00436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 09/30/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Orbital hydatid disease, while rare, should be included in the differential diagnosis of unilateral proptosis, particularly in endemic areas. Accurate diagnosis and comprehensive management are essential for effective treatment and favorable long-term outcomes. CASE PRESENTATION A 12-year-old boy presented with a one-month history of diplopia and left-sided proptosis. A CT scan revealed a cystic mass within the left medial rectus muscle. Surgical intervention confirmed the presence of a hydatid cyst following cyst rupture and irrigation with hypertonic saline. The patient underwent a two-month course of albendazole therapy. Initially, the patient experienced persistent exotropia and diplopia, but at the three-year follow-up, he exhibited no diplopia or proptosis and only mild residual exotropia. CONCLUSION This case underscores the importance of considering orbital hydatid cysts in the differential diagnosis of unilateral proptosis in endemic regions. Heightened awareness, accurate diagnosis, and a tailored therapeutic approach, including surgical removal and antiparasitic treatment, are crucial for successful management and improved long-term outcomes.
Collapse
Affiliation(s)
- Alireza Attar
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behzad Khademi
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Hassan Jalalpour
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
|
5
|
Aldolly A, Alsaffaf Y, Karaja S, Arab H, Alshaikh N. Managing multiple hepatic hydatid cysts and a single cardiac hydatid cyst simultaneously through a single surgical entry via the abdomen: A case report. Int J Surg Case Rep 2024; 124:110342. [PMID: 39332222 PMCID: PMC11460513 DOI: 10.1016/j.ijscr.2024.110342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 09/18/2024] [Accepted: 09/21/2024] [Indexed: 09/29/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Hydatid Disease, primarily caused by the larval stage of the parasite Echinococcus granulosus, represents significant health challenges, particularly in endemic regions. Hepatic cysts are more common, while cardiac involvement is rare. CASE PRESENTATION This report presents the case of a 35-year-old woman with atypical abdominal pain persisting for several months. CT scan of the thorax and abdomen revealed multiple hydatid cysts in the liver and a single cyst in the apex of the heart. The intramyocardial cyst was asymptomatic. Albendazole was administered pre- and postoperatively. The surgical approach commenced with the hepatic cysts, accessing the area via a bilateral Kocher subcostal incision in the epigastric region. The second step involved an incision of the central diaphragm, providing clear visualization of the cardiac apex. The operation was successful and the patient was discharged without any complications. CLINICAL DISCUSSION There are many surgical techniques described in the literature. Recently, single-stage operations have been recommended to manage multiorgan hydatid cysts; however, having two surgical incisions in one operation can still be dangerous to the patient's health. CONCLUSION To our knowledge, this is the first case that describes a surgical technique that begins in the abdominal cavity and then progresses to the thoracic cavity through the diaphragm to manage both hepatic and cardiac hydatid cysts.
Collapse
Affiliation(s)
| | | | - Saja Karaja
- Faculty of Medicine, Hama University, Hama, Syria
| | - Hazem Arab
- Faculty of Medicine, Hama University, Hama, Syria
| | - Naser Alshaikh
- Professor in Thoracic Surgery, Damascus Hospital Al-Mujtahid, Damascus, Syria
| |
Collapse
|
|
6
|
Raheem A, Arsal SA, Ali SMS, Areeba S, Ahmed S, Kumar A. Proximity predicament: a rare case of hydatid cyst in the porta hepatis region. EGYPTIAN LIVER JOURNAL 2024; 14:71. [DOI: 10.1186/s43066-024-00379-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/30/2024] [Indexed: 01/05/2025] Open
Abstract
AbstractHydatid cysts near the porta hepatis present notable medical challenges due to their intricate positioning and potential influence on crucial structures within the liver and its vicinity. While relatively rare, their presence can lead to intricate medical scenarios because of their proximity to vital liver and bile duct structures, but their occurrence can present complex medical situations due to their proximity to critical structures in the liver and bile ducts. We present an unusual case of a 33-year-old male with no known comorbidities presented to the outpatient department of general surgery with pain, insidious in onset and gradually progressive, in the right hypochondrial region for the past 3 months, along with mild fever, reduced appetite, and weight loss of 3 kg. Managing hepatic cysts, especially when near the porta hepatis, poses significant diagnostic challenges. Imaging scans revealed multiple hypodense lesions suggestive of hepatic cysts, with the largest one measuring 5 cm × 8 cm in segment VI. Native post-contrast lesions were also observed in the right lower lobe. Although hepatic duct dilation was not observed, the presence of a cyst near the porta hepatis an atypical site for hydatid cyst, complicated potential PAIR procedures (puncture, aspirate, injection, re-aspirate), raising concerns about the risk of damaging vital structures like the hepatic artery or major bile duct. A multidisciplinary approach engaged interventional radiology to evaluate PAIRS feasibility. PAIRS was performed successfully, except for the cyst near the porta hepatis to avoid complications. Despite this, the patient continued to experience abdominal discomfort post-operation, although liver function tests improved in the postop period. This case underscores the uncommon occurrence of hydatid cysts near the porta hepatis and highlights the need for additional research to comprehend its prevalence and causes. Further investigation is crucial to enhance our understanding of the epidemiology and optimal management strategies involving PAIRS in such challenging cases.
Collapse
|
|
7
|
Pathak S, Shaik NM, Daniel B, Habieb M. A Hidden Threat: Hydatid Cyst Masked by Bacterial Infection. Cureus 2024; 16:e72045. [PMID: 39544559 PMCID: PMC11563447 DOI: 10.7759/cureus.72045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2024] [Indexed: 11/17/2024] Open
Abstract
Hydatid cysts are parasitic infections that primarily affect the liver, but complications like secondary bacterial infections can obscure the clinical presentation. Though infections are common in general practice, hepatic abscesses, particularly those associated with hydatid cysts, are rare and often manifest with non-specific symptoms, leading to delayed diagnosis. Given the risk of serious complications such as rupture and sepsis, maintaining a high index of suspicion is critical, especially in patients with risk factors like a history of travel to endemic regions, liver disease, or excessive alcohol consumption. This case report highlights the clinical challenge posed by a hydatid cyst complicated by bacterial infection. The patient's non-specific complaints initially masked the true pathology, resulting in a delayed recognition of the hepatic abscess. Prompt recognition of this condition, despite its rare presentation, is crucial for timely intervention and improved patient outcomes.
Collapse
Affiliation(s)
- Snehal Pathak
- Internal Medicine, Peterborough City Hospital, Peterborough, GBR
| | | | - Blessy Daniel
- Internal Medicine, Royal Devon University Healthcare NHS Foundation Trust, Exeter, GBR
| | - Mohamed Habieb
- Gastroenterology, Peterborough City Hospital, Peterborough, GBR
| |
Collapse
|
|
8
|
Alzoubi M, Daradkeh S, Daradka K, Shattarat LN, Al-Zyoud A, Al-Qalqili LA, Al-Warafi WA, Al-Nezaa I, ElMoubarek MN, Qtaishat L, Rawashdeh B, Alhajahjeh A. The recurrence rate after primary resection cystic echinococcosis: A meta-analysis and systematic literature review. Asian J Surg 2024:S1015-9584(24)02081-5. [PMID: 39343686 DOI: 10.1016/j.asjsur.2024.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 09/01/2024] [Accepted: 09/05/2024] [Indexed: 10/01/2024] Open
Abstract
Cystic echinococcosis (CE) is a chronic, complex, zoonotic disease caused by Echinococcus Granulose tapeworms. The disease may present with a variety of symptoms, ranging from asymptomatic to fatal. Surgical intervention is the primary treatment modality for CE. Despite advances in surgical techniques and chemotherapy, disease recurrence remains a major concern. Therefore, we aimed to determine the true rate of CE recurrence after primary resection and identify possible factors that increase the risk of recurrence. A systematic search of Medline, PubMed, Embase, and Cochran Library was conducted to identify studies reporting the incidence of CE recurrence after primary radical surgery. Data were pooled using random effect models. The disease prevalence was determined by calculating the ratio of CE recurrence and the total number of patients. A meta-regression was conducted to identify any potential factors linked to recurrence. A total of 38 eligible studies, with a total of 6,222 CE patients who underwent primary surgical removal, revealed a pooled recurrence rate of 8% (95% CI: 6%-10%). However, significant heterogeneity was observed (I2 p-value <0.001). Subgroup analysis by region showed the highest incidence of recurrence in European and Turkish studies, with rates of 11% (95% CI: 7%-17%) and 9% (95% CI: 5%-14%), respectively. The lowest recurrence rate was observed in Asian studies, with a rate of 4% (95% CI: 2%-7%). Moreover, the non-radical intervention has a recurrence of 5% (95%CI: 4%-7%), radical 7% (95%CI: 6%-9%), and studies that contained both interventions have 10% (95%CI: 6%-16%), P-value= 0.04. This is the first meta-analysis to evaluate the overall incidence of CE recurrence after primary surgical removal. The study also revealed a substantial degree of heterogeneity across the included studies and indicated possible risk factors for higher recurrence rates, such as the study's geographic area, type of surgery and the year it was published. These findings will help to guide future research in developing effective strategies to prevent or reduce CE recurrence and improve patient outcomes.
Collapse
Affiliation(s)
| | - Salam Daradkeh
- The University of Jordan, General Surgery Department, Jordan.
| | - Khaled Daradka
- The University of Jordan, General Surgery Department, Jordan.
| | | | - Asma Al-Zyoud
- The University of Jordan, School of Medicine, Jordan.
| | | | | | | | | | - Leen Qtaishat
- The University of Jordan, School of Medicine, Jordan.
| | | | - Abdulrahman Alhajahjeh
- The University of Jordan, School of Medicine, Jordan; King Hussein Cancer Center (KHCC), Internal Medicine Department, Jordan.
| |
Collapse
|
|
9
|
Ziad F, Zouaoui I, El Mamoune M, Aoufi S. Disseminated hydatidosis an unusual presentation: a case report. Access Microbiol 2024; 6:000803.v3. [PMID: 39314747 PMCID: PMC11418919 DOI: 10.1099/acmi.0.000803.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Hydatidosis, also known as cystic echinococcosis, is a widespread zoonosis, caused by a tapeworm of the genus Echinococcus. It presents a significant public health concern, particularly in endemic areas. The occurrence of disseminated hydatid disease is uncommon, even in regions where it is endemic, with an incidence ranging from 1-8%. The definitive diagnosis relies on a parasitological method. In this work, we present an unusual case of disseminated hydatid disease that was diagnosed in the central parasitology-mycology laboratory of 'The Ibn Sina University Hospital'. This is a 21-year-old patient residing in a rural area, who presented with heaviness-type pain in the right hypochondrium, accompanied with nausea and vomiting. During the examination, the patient mentioned the contact with dogs. Abdominal radiography (ultrasound and CT) revealed findings suggestive of multiple hydatid cysts located in the liver and peritoneum. This suspicion was confirmed by positive hydatid serology. After 9 months of treatment with albendazole, the patient underwent surgery for excision of the cysts shown on the x-ray, as well as other cysts incidentally discovered intraoperatively at the pelvic and rectal levels. All of the extracted specimens were sent to the parasitology laboratory. The direct examination, along with the viability test, revealed the presence of hooks and scolex of non-viable Echinococcus granulosus. Disseminated hydatidosis is a rare but serious presentation, and the positive diagnosis relies on several epidemiological, clinical, radiological and parasitological arguments. Medical and surgical treatments play a crucial role in determining the patient's prognosis.
Collapse
Affiliation(s)
- Fatima Ziad
- Central Laboratory of Parasitology-Mycology, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Imane Zouaoui
- Central Laboratory of Parasitology-Mycology, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Mostaine El Mamoune
- Central Laboratory of Parasitology-Mycology, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Sarra Aoufi
- Central Laboratory of Parasitology-Mycology, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| |
Collapse
|
|
10
|
Hassini L, Mhiri A, Aloui Y, Maitigue MB, Mtaoumi M, Bouattour K. Isolated Muscular Echinococcosis of the Hand and Forearm: A Case Report. J Orthop Case Rep 2024; 14:136-140. [PMID: 39253684 PMCID: PMC11381063 DOI: 10.13107/jocr.2024.v14.i09.4756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/24/2024] [Indexed: 09/11/2024] Open
Abstract
Introduction Hydatid diseases are a parasitic infestation of human and herbivorous animals caused by a cestode, Echinococcus granulosus. The liver and lung are commonly involved organs and the involvement of muscles and bones is very unusual, even in the countries where echinococcal infestation is endemic. Case Report We report a case of muscular hydatidosis of the hand and forearm in a 71-year-old male without particular histories, who consulted for tumefaction of the right hand and forearm evolving for 2 years. Biology and the standard radiographs were without anomalies. The diagnosis was evoked on magnetic resonance imaging (MRI) and confirmed by surgical biopsy and excision. The operative follow-up was simple with no recurrence after 3 years. Conclusion Muscular echinococcosis is an extremely rare disease. An MRI evaluation should be taken into account as the gold standard in the diagnosis. Surgical cystectomy is often indicated, and an excision with wide margins is mandatory to avoid the rupture of the cyst and anaphylaxis. Adjuvant pharmacological therapy is recommended to minimize the risk of recurrence.
Collapse
Affiliation(s)
- Lassaad Hassini
- Department of Orthopaedic Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Amir Mhiri
- Department of Orthopaedic Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Yahya Aloui
- Department of Orthopaedic Surgery, Sahloul Hospital, Sousse, Tunisia
| | | | - Mourad Mtaoumi
- Department of Orthopaedic Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Karim Bouattour
- Department of Orthopaedic Surgery, Sahloul Hospital, Sousse, Tunisia
| |
Collapse
|
|
11
|
Abbas I, Tamponi C, Madau G, Cavallo L, Varcasia A, Scala A. Treatment and management of coenurosis by Taenia multiceps: field data from outbreaks in endemic regions and literature review. Parasit Vectors 2024; 17:335. [PMID: 39123250 PMCID: PMC11312392 DOI: 10.1186/s13071-024-06430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Taenia multiceps coenurosis is endemic in sheep from various regions worldwide. Dogs, the key hosts, shed T. multiceps eggs in their feces contaminating the pasture, and lambs are mostly infected during their first turnout into pastures. The disease is manifested in two forms: acute (due to the migrating oncospheres in the CNS) or chronic (due to the developing coenuri in the brain or spinal cord). Both forms are frequently accompanied by neurological symptoms. METHODS Field trials conducted in an endemic region (Sardinia, Italy) to treat replacement lambs in six sheep flocks infected with acute coenurosis are summarized in this article. The article also reviews earlier reports on various approaches developed to treat and immunize sheep against coenurosis. RESULTS Accurate detection of the time in which lambs become infected is crucial in deciding which treatment approach should be used. Acute disease can be successfully treated via chemotherapy. Results of field trials conducted in Sardinia revealed the efficacy of three (1-week apart) oxfendazole doses (14.15 mg/kg) in protecting apparently healthy lambs in the infected flocks from developing neurological symptoms. A single praziquantel dose (18.75 mg/kg) worked well for the same purpose and was also found significant in treating 5 of 16 clinically ill lambs in one flock. Earlier reports documented high rates of recovery (up to 100%) in clinically diseased lambs that received much higher doses (50-100 mg/kg) of praziquantel. However, chemotherapy is not preferred in chronic coenurosis since it can lead to rupture of the coenuri, giving rise to serious inflammation in the CNS. Surgical intervention is highly recommended in this case, and the pooled success rates for surgery in chronic-infected cases was estimated at 82.1% (95% CI 73.1-91.0%). However, various trials have been conducted to immunize sheep against T. multiceps coenurosis, and the 18k (Tm18) family of oncosphere antigens was found promising as a vaccine candidate. CONCLUSIONS In acute coenurosis, selection of the proper anthelmintic should be done after consulting the owner for several reasons: (1) costs of the used anthelmintic: treating a small flock of 100 sheep costs around 1170 and 660 € for praziquantel and oxfendazole, respectively; (2) withdrawal time of the used anthelmintic: No time is required before consuming meat and milk from praziquantel-treated sheep, whereas meat and milk from oxfendazole-treated sheep should not be consumed for 44 and 9 days, respectively, causing additional costs for the farmers. Since no commercial vaccines have yet been developed against T. multiceps coenurosis in sheep, preventive measures remain the cornerstone of controlling this serious disease.
Collapse
Affiliation(s)
- I Abbas
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
- Parasitology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - C Tamponi
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - G Madau
- Veterinary Practitioner, Sardinia, Italy
| | - L Cavallo
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - A Varcasia
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy.
| | - A Scala
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| |
Collapse
|
|
12
|
Kuehn R, Uchiumi LJ, Tamarozzi F. Treatment of uncomplicated hepatic cystic echinococcosis (hydatid disease). Cochrane Database Syst Rev 2024; 7:CD015573. [PMID: 38994714 PMCID: PMC11240857 DOI: 10.1002/14651858.cd015573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Cystic echinococcosis is a parasitic infection mainly impacting people living in low- and middle-income countries. Infection may lead to cyst development within organs, pain, non-specific symptoms or complications including abscesses and cyst rupture. Treatment can be difficult and varies by country. Treatments include oral medication, percutaneous techniques and surgery. One Cochrane review previously assessed the benefits and harms of percutaneous treatment compared with other treatments. However, evidence for oral medication, percutaneous techniques and surgery in specific cyst stages has not been systematically investigated and the optimal choice remains uncertain. OBJECTIVES To assess the benefits and harms of medication, percutaneous and surgical interventions for treating uncomplicated hepatic cystic echinococcosis. SEARCH METHODS We searched CENTRAL, MEDLINE, two other databases and two trial registries to 4 May 2023. We searched the reference lists of included studies, and contacted experts and researchers in the field for relevant studies. SELECTION CRITERIA We included randomized controlled trials (RCTs) in people with a diagnosis of uncomplicated hepatic cystic echinococcosis of World Health Organization (WHO) cyst stage CE1, CE2, CE3a or CE3b comparing either oral medication (albendazole) to albendazole plus percutaneous interventions, or to surgery plus albendazole. Studies comparing praziquantel plus albendazole to albendazole alone prior to or following an invasive intervention (surgery or percutaneous treatment) were eligible for inclusion. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were symptom improvement, recurrence, inactive cyst at 12 months and all-cause mortality at 30 days. Our secondary outcomes were development of secondary echinococcosis, complications of treatment and duration of hospital stay. We used GRADE to assess the certainty of evidence. MAIN RESULTS We included three RCTs with 180 adults and children with hepatic cystic echinococcosis. Two studies enrolled people aged 5 to 72 years, and one study enrolled children aged 6 to 14 years. One study compared standard catheterization plus albendazole with puncture, aspiration, injection and re-aspiration (PAIR) plus albendazole, and two studies compared laparoscopic surgery plus albendazole with open surgery plus albendazole. The three RCTs were published between 2020 and 2022 and conducted in India, Pakistan and Turkey. There were no other comparisons. Standard catheterization plus albendazole versus PAIR plus albendazole The cyst stages were CE1 and CE3a. The evidence is very uncertain about the effect of standard catheterization plus albendazole compared with PAIR plus albendazole on cyst recurrence (risk ratio (RR) 3.67, 95% confidence interval (CI) 0.16 to 84.66; 1 study, 38 participants; very low-certainty evidence). The evidence is very uncertain about the effects of standard catheterization plus albendazole on 30-day all-cause mortality and development of secondary echinococcosis compared to open surgery plus albendazole. There were no cases of mortality at 30 days or secondary echinococcosis (1 study, 38 participants; very low-certainty evidence). Major complications were reported by cyst and not by participant. Standard catheterization plus albendazole may increase major cyst complications compared with PAIR plus albendazole, but the evidence is very uncertain (RR 10.74, 95% CI 1.39 to 82.67; 1 study, 53 cysts; very low-certainty evidence). Standard catheterization plus albendazole may make little to no difference on minor complications compared with PAIR plus albendazole, but the evidence is very uncertain (RR 1.03, 95% CI 0.60 to 1.77; 1 study, 38 participants; very low-certainty evidence). Standard catheterization plus albendazole may increase the median duration of hospital stay compared with PAIR plus albendazole, but the evidence is very uncertain (4 (range 1 to 52) days versus 1 (range 1 to 15) days; 1 study, 38 participants; very low-certainty evidence). Symptom improvement and inactive cysts at 12 months were not reported. Laparoscopic surgery plus albendazole versus open surgery plus albendazole The cyst stages were CE1, CE2, CE3a and CE3b. The evidence is very uncertain about the effect of laparoscopic surgery plus albendazole on cyst recurrence in participants with CE2 and CE3b cysts compared to open surgery plus albendazole (RR 3.00, 95% CI 0.13 to 71.56; 1 study, 82 participants; very low-certainty evidence). The second study involving 60 participants with CE1, CE2 or CE3a cysts reported no recurrence in either group. The evidence is very uncertain about the effect of laparoscopic surgery plus albendazole on 30-day all-cause mortality in participants with CE1, CE2, CE3a or CE3b cysts compared to open surgery plus albendazole. There was no mortality in either group (2 studies, 142 participants; very low-certainty evidence). The evidence is very uncertain about the effect of laparoscopic surgery plus albendazole on major complications in participants with CE1, CE2, CE3a or CE3b cysts compared to open surgery plus albendazole (RR 0.50, 95% CI 0.13 to 1.92; 2 studies, 142 participants; very low-certainty evidence). Laparoscopic surgery plus albendazole may lead to slightly fewer minor complications in participants with CE1, CE2, CE3a or CE3b cysts compared to open surgery plus albendazole (RR 0.13, 95% CI 0.02 to 0.98; 2 studies, 142 participants; low-certainty evidence). Laparoscopic surgery plus albendazole may reduce the duration of hospital stay compared with open surgery plus albendazole (mean difference (MD) -1.90 days, 95% CI -2.99 to -0.82; 2 studies, 142 participants; low-certainty evidence). Symptom improvement, inactive cyst at 12 months and development of secondary echinococcosis were not reported. AUTHORS' CONCLUSIONS Percutaneous and surgical interventions combined with albendazole can be used to treat uncomplicated hepatic cystic echinococcosis; however, there is a scarcity of randomised evidence directly comparing these interventions. There is very low-certainty evidence to indicate that standard catheterization plus albendazole may lead to fewer cases of recurrence, more major complications and similar complication rates compared to PAIR plus albendazole in adults and children with CE1 and CE3a cysts. There is very low-certainty evidence to indicate that laparoscopic surgery plus albendazole may result in fewer cases of recurrence or fewer major complications compared to open surgery plus albendazole in adults and children with CE1, CE2, CE3a and CE3b cysts. Laparoscopic surgery plus albendazole may lead to slightly fewer minor complications. Firm conclusions cannot be drawn due to the limited number of studies, small sample size and lack of events for some outcomes.
Collapse
Affiliation(s)
- Rebecca Kuehn
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Leonardo J Uchiumi
- Control Program of Cystic Echinococcosis, Ministry of Health, Río Negro Province, Viedma, Argentina
| | - Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| |
Collapse
|
|
13
|
Gurcan M, Ergul RB, Degirmenci E, Dursun M, Kadıoğlu A. A Rare Presentation of Hydatid Cyst: A Case Report of Uncommon Localization in the Pelvic Region and a Review of Current Literature. Cureus 2024; 16:e60312. [PMID: 38883115 PMCID: PMC11176713 DOI: 10.7759/cureus.60312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
Hydatid cyst disease, caused by the Echinococcus granulosus tapeworm larval form, typically affects the liver, lungs, and genitourinary tract. This case report details an unusual manifestation of hydatid cysts in a 62-year-old male with a history of retrovesical hydatid cyst surgery. The patient presented with pain at the root of the penis, and subsequent imaging revealed cysts in the suprapubic, pubic bone, and left pectineus muscle regions. Despite the challenges posed by the COVID-19 pandemic, the patient underwent surgical excision in 2023. The discussion emphasizes the rarity of such localized cysts, diagnostic imaging techniques, and the necessity of surgical intervention. The postoperative period involved a course of albendazole. While rectovesical hydatid cysts are uncommon, this case underscores the importance of considering them in the differential diagnosis of masses, particularly in endemic regions. Surgical excision remains the primary treatment for symptomatic hydatid cysts.
Collapse
Affiliation(s)
- Mehmet Gurcan
- Urology, Istanbul University School of Medicine, Istanbul, TUR
| | | | - Enes Degirmenci
- Urology, Istanbul University School of Medicine, Istanbul, TUR
| | - Murat Dursun
- Urology, Istanbul University School of Medicine, Istanbul, TUR
| | - Ateş Kadıoğlu
- Urology, Istanbul University School of Medicine, Istanbul, TUR
| |
Collapse
|
|
14
|
Ghanimatdan M, Sadjjadi SM, Mikaeili F, Teimouri A, Jafari SH, Derakhshanfar A, Hashemi-Hafshejani S. Therapeutic effect of curcumin nanoemulsion on cystic echinococcosis in BALB/c mice: a computerized tomography (CT) scan and histopathologic study evaluation. BMC Complement Med Ther 2024; 24:143. [PMID: 38575891 PMCID: PMC10993536 DOI: 10.1186/s12906-024-04451-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/21/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND This study aimed to determine the therapeutic efficacy of curcumin nanoemulsion (CUR-NE) in mice infected with Echinococcus granulosus sensu stricto protoscoleces. METHODS Forty-two inbred BALB/c mice were divided into seven groups of six animals each. Six groups were inoculated intra-peritoneally with 1500 viable E. granulosus protoscoleces, followed for six months and used as infected groups. The infected groups were named as: CEI1 to CEI6 accordingly. The 7th group was not inoculated and was named cystic echinococcosis noninfected group (CENI7). CEI1 and CEI2 groups received 40 mg/kg/day and 20 mg/kg/day curcumin nanoemulsion (CUR-NE), respectively. CEI3 received nanoemulsion without curcumin (NE-no CUR), CEI4 received curcumin suspension (CUR-S) 40 mg/kg/day, CEI5 received albendazole 150 mg/kg/day and CEI6 received sterile phosphate-buffered saline (PBS). CENI7 group received CUR-NE 40 mg/kg/day. Drugs administration was started after six months post-inoculations of protoscoleces and continued for 60 days in all groups. The secondary CE cyst area was evaluated by computed tomography (CT) scan for each mouse before treatment and on the days 30 and 60 post-treatment. The CT scan measurement results were compared before and after treatment. After the euthanasia of the mice on the 60th day, the cyst area was also measured after autopsy and, the histopathological changes of the secondary cysts for each group were observed. The therapeutic efficacy of CUR-NE in infected groups was evaluated by two methods: CT scan and autopsied cyst measurements. RESULTS Septal calcification in three groups of infected mice (CEI1, CEI2, and CEI4) was revealed by CT scan. The therapeutic efficacy of CUR-NE 40 mg/kg/day (CEI1 group) was 24.6 ± 26.89% by CT scan measurement and 55.16 ± 32.37% by autopsied cysts measurements. The extensive destructive effects of CUR-NE 40 mg/kg/day (CEI1 group) on the wall layers of secondary CE cysts were confirmed by histopathology. CONCLUSION The current study demonstrated a significant therapeutic effect of CUR-NE (40 mg/kg/day) on secondary CE cysts in BALB/c mice. An apparent septal calcification of several cysts revealed by CT scan and the destructive effect on CE cysts observed in histopathology are two critical key factors that suggest curcumin nanoemulsion could be a potential treatment for cystic echinococcosis.
Collapse
Affiliation(s)
- Mohamad Ghanimatdan
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fattaneh Mikaeili
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aref Teimouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamed Jafari
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Derakhshanfar
- Department of Comparative Biomedical Sciences, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeideh Hashemi-Hafshejani
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
15
|
Touati DM, Khefacha F, Ben Othmane MR, Khlifi N, Jaouad F, Idani M, Belhadj A, Saidani A, Chebbi F. Success in managing a giant hepatic hydatid cyst: a case report of successful conservative surgical intervention in an endemic setting. INTERNATIONAL JOURNAL OF SURGERY OPEN 2024; 62:38-42. [DOI: 10.1097/io9.0000000000000020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
Introduction and importance:
Echinococcosis, also known as a hydatid cyst, arises from a parasitic infection caused by the larval form of the tapeworm Echinococcus granulosus in humans. This endemic disease in Tunisia presents a significant public health challenge. The case highlights the enormous size of the liver hydatid cyst, emphasizing the importance and success of conservative surgical treatment.
Case Presentation:
A 45-year-old female shepherdess presented with abdominal pain and a mass, diagnosed as a giant hepatic hydatid cyst. A computed tomography scan revealed a dysmorphic liver with a large multivesicular cyst. Surgical intervention included the resection and closure of multiple cystic fistulas. Postoperative recovery was uneventful and at the 6-month follow-up, the patient displayed no indications of recurrence.
Clinical discussion:
Echinococcosis, prevalent in livestock-farming regions, primarily affects the liver and lungs. It often remains asymptomatic, detected incidentally. Diagnosis relies on imaging, with surgical excision as the primary treatment. Percutaneous options exist but are less effective. Serologies are underused. Management challenges include complications and recurrence. Conservative surgery is common but faces complications. Radical surgery is more effective, albeit complex. Albendazole preoperatively proves promising, reducing cyst viability. Regular follow-up is crucial for recurrence detection.
Conclusion:
Managing giant hepatic hydatid cysts requires tailored approaches, especially in endemic regions. Our success with conservative surgical treatment highlights its effectiveness in confronting formidable cyst sizes, informing clinical practice, and contributing to the medical literature.
Collapse
Affiliation(s)
- Dheker M. Touati
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Fahd Khefacha
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Mohamed R. Ben Othmane
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Nadhem Khlifi
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Firas Jaouad
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Marwa Idani
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Anis Belhadj
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Ahmed Saidani
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| | - Faouzi Chebbi
- General Surgery Department, Mahmoud El Matri Hospital, Ariana, Tunisia, Ariana, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, Tunis, Tunisia
| |
Collapse
|
|
16
|
Yadav SK, Ruchal A, Gaurav B, Bhattarai B, Khatiwada P, Shrestha A. Retroperitoneal hydatid cyst challenging the diagnosis: Case report with review of literature. Int J Surg Case Rep 2024; 114:109106. [PMID: 38134618 PMCID: PMC10800713 DOI: 10.1016/j.ijscr.2023.109106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/24/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Hydatid cyst is a zoonotic disease caused by a tapeworm, Echinococcus granulosus. A retroperitoneal hydatid cyst is extremely rare and its diagnosis can be challenging, particularly in the early stage as it can mimic several regional pathologies like pancreatic pseudocyst, pancreatic neoplasm, and other retroperitoneal cystic lesions. PRESENTATION OF CASE We report a rare case of 39-year-old Nepalese male with a left retroperitoneal hydatid cyst who presented with pain and feeling of mass in the left flank region for 6 months. Diagnosis was made by abdominal computed tomography and magnetic resonance imaging and management was done by partial cystectomy. DISCUSSION Retroperitoneal hydatid cysts can present with chronic pain, mass, and symptoms resulting from the mass effect which varies according to the different retroperitoneal locations. Diagnosis of the retroperitoneal cyst can be challenging clinically and radiologically in its early stages. Even in the late stage, ultrasonography may not suffice and additional imaging techniques such as computed tomography or magnetic resonance imaging are required for the diagnosis. CONCLUSION In endemic areas, hydatid cyst should be considered while dealing with a retroperitoneal swelling for early diagnosis and prevention of rupture. With a high level of clinical suspicion and radiological findings, retroperitoneal hydatid cyst can be diagnosed and surgery is the principal method of treatment.
Collapse
Affiliation(s)
- Sushil Kumar Yadav
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal.
| | - Anish Ruchal
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal
| | - Bishal Gaurav
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal
| | - Bhawesh Bhattarai
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal
| | - Prajwal Khatiwada
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal
| | - Aiska Shrestha
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal
| |
Collapse
|
|
17
|
Atay G, Erdogan S, Tugrul HC, Su Dur SM. Anaphylaxis during puncture of a hepatic hydatid cyst. North Clin Istanb 2023; 10:813-815. [PMID: 38328732 PMCID: PMC10846569 DOI: 10.14744/nci.2022.58260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022] Open
Abstract
Although hydatid cyst infects many organs, it most commonly involves liver, lungs, and central nervous system. The goal of hydatid cyst treatment is to completely eliminate the parasite and to prevent recurrences with minimal mortality and morbidity. The procedure of puncture, aspiration, injection of a scolicidal, and reaspiration (PAIR) of a cyst has been introduced as an alternative to surgical method since it is less invasive and less morbid and is associated with a shorter hospital stay and a lower cost. Herein, we report an 11-year-old girl who developed anaphylaxis during the puncture of a hepatic hydatid cyst. The patient who developed anaphylaxis during the PAIR procedure was administered intravenous adrenaline, methyl prednisolone, and antihistaminic medication. She was intubated and provided assisted ventilation using a mechanic ventilator. The child was extubated 4 h after her admission to the pediatric intensive care unit. During follow-up, the contents of her hepatic hydatid cysts were aspirated through a catheter, followed by their irrigation with 20% sodium chloride and re-aspiration. Then, 97% ethyl alcohol was injected into the cyst cavity to make it collapse. The goal of this report was to draw attention to the rare occurrence of anaphylaxis during the PAIR procedure and to stress that clini-cians should be vigilant for this complication.
Collapse
Affiliation(s)
- Gurkan Atay
- Department of Pediatric Intensive Care, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkiye
| | - Seher Erdogan
- Department of Pediatric Intensive Care, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkiye
| | - Hazal Ceren Tugrul
- Department of Pediatric Intensive Care, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkiye
| | - Seyma Melisa Su Dur
- Department of Interventional Radiology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkiye
| |
Collapse
|
|
18
|
Wazurkar AS, Lohiya S, Vagha KJ, Vagha J. A Rare Case of Isolated Hydatid Cyst in Right Lung in a Pediatric Patient. JOURNAL OF DATTA MEGHE INSTITUTE OF MEDICAL SCIENCES UNIVERSITY 2023; 18:780-782. [DOI: 10.4103/jdmimsu.jdmimsu_417_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 01/05/2025]
Abstract
Abstract
The parasite Echinococcus granulosus is the source of the disease hydatid cyst, which primarily affects the liver but can also affect other parts of the body. This case involves a seven-year-old boy who had fever and cough for 15 days which was identified as a case of isolated hydatid cyst of the right lung following examination and further testing. The child received albendazole preoperatively, then had the hydatid cyst removed with enucleation. After receiving advice to continue taking Praziquantel and Albendazole for another three months, the boy was discharged. If untreated, hydatid cysts of the lung can lead to serious problems like cyst rupture, pneumothorax, and infection and could pose a life-threatening risk. In order to identify hydatid cyst as early as possible, a comprehensive history and examination are crucial, and treatment should begin.
Collapse
Affiliation(s)
| | - Sham Lohiya
- Department of Pediatrics, Jawaharlal Nehru Medical College, DMIMS (DU), Wardha, Maharashtra, India
| | - Keta Jayant Vagha
- Department of Pediatrics, Jawaharlal Nehru Medical College, DMIMS (DU), Wardha, Maharashtra, India
| | - Jayant Vagha
- Department of Pediatrics, Jawaharlal Nehru Medical College, DMIMS (DU), Wardha, Maharashtra, India
| |
Collapse
|
|
19
|
Beacom S, Nand P, Singh P, Harrison A. Isolated pulmonary hydatid cyst. BMJ Case Rep 2023; 16:e254876. [PMID: 37541696 PMCID: PMC10407385 DOI: 10.1136/bcr-2023-254876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
Echinococcosis is primarily a disease of developing nations with poor medical infrastructure, where cohabitation with domesticated animals is common. These conditions, in conjunction with the inherent chronicity of the disease, lead to low rates of diagnosis and high morbidity. Robust surveillance is not readily available in communities with the highest disease burden.WHO classifications assist in diagnostic and treatment endeavours especially in countries where this disease is not commonly encountered. However, the understanding of the pathophysiology of echinococcosis and optimal treatment are still lacking in certain patient populations.We present the case of a female from Central Asia with an isolated pulmonary hydatid cyst. She was diagnosed several months after she had an uncomplicated pregnancy and gave birth to a healthy baby girl. Due to a delay in surgical intervention, our patient received a prolonged course of treatment which resulted in a significant reduction in the size of the cyst. Given her improvement, we questioned the current guidelines set by the WHO regarding surgical resection of pulmonary hydatid cysts, compared with an extended course with albendazole in patients with an unusual and protracted course of the disease. Furthermore, we discuss the possible role of pregnancy in exacerbating symptoms of underlying pulmonary hydatid disease.
Collapse
Affiliation(s)
- Sabrina Beacom
- Internal Medicine, St. Joseph Medical Center, Stockton, California, USA
| | - Priya Nand
- Infectious Diseases, Touro University, Stockton, California, USA
| | - Parampreet Singh
- Internal Medicine, St. Joseph Medical Center, Stockton, California, USA
| | - Anil Harrison
- Internal Medicine, West Florida Hospital, Pensacola, Florida, USA
| |
Collapse
|
|
20
|
Jahanshahi F, Parsaei AH, Naderi D, Davani SZN. Primary isolated extraluminal hydatid cyst of left pulmonary artery. Int J Surg Case Rep 2023; 106:108211. [PMID: 37113706 PMCID: PMC10105619 DOI: 10.1016/j.ijscr.2023.108211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Hydatid cyst of the pulmonary artery is scarce. There were few reports of intramural involvement of pulmonary artery secondary to cardiac or lung hydatic cyst in the literature. To our knowledge, there was no report of a primary isolated extraluminal hydatid cyst of the left pulmonary artery. CASE PRESENTATION A twenty-eight-year-old female presented to the hospital with a complaint of progressive dyspnea. The patients had no common COVID-19 infection symptoms. CLINICAL DISCUSSION The RT-PCR for COVID-19 RNA was negative. A spiral chest CT scan demonstrated a cystic mass sized 83 × 34 in the middle mediastinum. Intraoperatively, the intrapericardial mass arises from the left pulmonary artery and extends to the hilum of the left atrium. The mass was resected, and the pathology report noted a hydatid cyst. The postoperative course was uneventful, and the patient was discharged with the administration of albendazole for three months. CONCLUSION Although hydatid cyst primary isolated extraluminal hydatid cyst of the pulmonary artery is extremely rare, in cases with pulmonary artery stenos or hypertension manifestation, a probable differential diagnosis should be considered.
Collapse
Affiliation(s)
- Fatemeh Jahanshahi
- Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Delaram Naderi
- Student Research Committee, Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sam Zeraatian Nejad Davani
- Attending Professor of Cardiovascular Surgery and Dean of Faculty of Transplant and Organ Donation, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
21
|
Vangelakou K, M. Pitsilka M, Magouliotis D, Zacharoulis D. New Energy Devices in the Treatment of Cystic Echinococcosis. Infect Dis (Lond) 2023. [DOI: 10.5772/intechopen.109372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Treatment of cystic echinococcosis of the liver still remains a debatable subject. The method of choice should aim for the total elimination of the parasite with minimum morbidity and mortality. Different approaches have been proposed. Medical treatment as a monotherapy has been abandoned due to the high chances of recurrence and is mostly used as an adjuvant to surgery or minimally invasive methods. Surgical methods are divided into conservative ones, which include cystectomy and partial pericystectomy, and radical ones, total pericystectomy and hepatectomy. Radical procedures are correlated with lower complication and recurrence rates and, therefore, should be attempted when indications are present. On the other hand, conservative surgery can be the first option in endemic areas, performed by non-specialized general surgeons. The development of laparoscopic techniques made their use a possible alternative approach in selected cases. The use of percutaneous treatments is also quite widespread due to their minimally invasive nature. New energy devices seem to play a significant role in the treatment of cystic echinococcosis, although more studies are needed to establish their efficacy. Observation without intervention is an option for inactive uncomplicated cysts.
Collapse
|
|
22
|
Swiss Cheese Heart: Cardiac Hydatid Cysts. Can J Cardiol 2023; 39:87-88. [PMID: 36336306 DOI: 10.1016/j.cjca.2022.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
|
|
23
|
Mahmoodi S, Ebrahimian M, Mirhashemi SH, Soori M, Rashnoo F, Oshidari B, Shadidi Asil R, Zamani A, Hajinasrollah E. A 20 Years Retrospective Descriptive Study of Human Cystic Echinococcosis and the Role of Albendazole Concurrent with Surgical Treatment: 2001-2021. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:100-106. [PMID: 37197074 PMCID: PMC10183456 DOI: 10.18502/ijpa.v18i1.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 05/19/2023]
Abstract
Background Hydatid cyst, caused by the larvae of Echinococcus granulosus, is one of the most severe cestode infections occurring in Iran. The liver is the most commonly involved organ. The present study was carried out to review the demographic of 20 years surgically treated hydatic cysts. Methods Ninety-eight patients were enrolled in the study. Demographic features, time of surgery, cyst size, and albendazole usage have been reviewed from the medical records of patients in Loghman Hakim Hospital, Tehran, Iran, from 2001 to 2021. Statistical analysis was performed to find any correlation between the uses of concurrent albendazole with surgical procedure. Results Of 98 patients with hydatid cyst, 57 (58.2%) were female. The mean age of patients was 39.4 ±18.7 yrs, and the mean surgery time was 217.5 ± 81.4 minutes. Regarding the infection site, the liver (60.2%) and lungs (22.4%) were the most affected organs, respectively. 56.1% of patients had one cyst, and 42.9 % had two or more cysts. 20.4% of them had taken albendazole before surgery, but 86.7 % took it after the operation. No recurrent cysts were seen among 91.8% of them, but 8.2% mentioned suffering from a recurrent cyst. 85.7% of those recurrent cases did not receive albendazole before surgery, and 75% of recurrent cases after surgery did not take albendazole (P<0.05). Conclusion Administration of albendazole before and after the operation was significantly related to reduced recurrence, bleeding, morbidity, and even the time of surgery.
Collapse
Affiliation(s)
- Setareh Mahmoodi
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Manoochehr Ebrahimian
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hadi Mirhashemi
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Soori
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariborz Rashnoo
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahador Oshidari
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rouzbeh Shadidi Asil
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Zamani
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esmaeil Hajinasrollah
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
24
|
Vahidirad A, Mansouri M, Shamshirian A, Berenji F, Motie MR. Efficacy of Preoperative Albendazole on Protoscoleces Viability in Hydatid Cyst of the Liver. IRANIAN JOURNAL OF PARASITOLOGY 2022; 17:483-487. [PMID: 36694569 PMCID: PMC9825706 DOI: 10.18502/ijpa.v17i4.11274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/22/2022] [Indexed: 12/14/2022]
Abstract
Background Optimal duration for medical therapy of liver hydatid cysts before surgery in not certainly defined yet. In this study, we aimed to evaluate the effectiveness of 2 weeks preoperative albendazole in decreasing viable cysts. Methods Patients referring to Imam Reza Hospital, Mashhad, Iran with a diagnosis of hepatic hydatid cyst were randomly divided into intervention (44 patients) and control (46 patients) groups. The case group were treated with oral albendazole before surgery and the control group underwent surgery without albendazole therapy. Efficacy of albendazole on the reduction of prevalence and viability of the protoscoleces was finally evaluated. Results A number of 90 patients were included in the final analysis. Protoscoleces were reported alive in 10 (22.7%) and 17 (36.9%) of patients in the case and control group, respectively. The decrease of live protoscoleces in case group was not statistically significant (P=0.14). Conclusion Decrease in the viability of protoscoleces in hepatic hydatid cysts after 2 weeks administration of oral albendazole at a dose of 10 mg/kg/day preoperatively, is not significant. Optimal duration of medical treatment before surgery seems to be 4 weeks or more.
Collapse
Affiliation(s)
- Ali Vahidirad
- Department of Surgery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mostafa Mansouri
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Shamshirian
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Berenji
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Motie
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
|
25
|
Fourati K, Tlili A, Masmoudi A, Laabidi T, Ben Ameur H, Boujelben S. Primary retroperitoneal hydatid cyst with intraperitoneal rupture: a case report. J Med Case Rep 2022; 16:202. [PMID: 35610709 PMCID: PMC9131640 DOI: 10.1186/s13256-022-03415-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the liver followed by the lung. A primary localization in the retroperitoneum is extremely rare. Case presentation We report the case of a 29-year-old Tunisian patient presenting with progressive left flank pain and skin urticaria. On abdominal ultrasonography and computed tomography scan, a ruptured retroperitoneal hydatid cyst was diagnosed, which was confirmed by positive hydatid serology. The treatment consisted of resection of protruding dome. The evolution was favorable. No local recurrence was detected during postoperative follow-up. Conclusions Primary retroperitoneal hydatid cyst is extremely rare and has uncommon presentation, but we should learn the keys to its diagnosis. In endemic regions, high suspicion for this disease is justified regardless of localization.
Collapse
Affiliation(s)
- Kais Fourati
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ahmed Tlili
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.,Department of Surgery, Mohamed Ben Sassi Hospital, Gabes, Tunisia
| | - Abderrahmen Masmoudi
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia. .,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
| | - Taher Laabidi
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hazem Ben Ameur
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Salah Boujelben
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| |
Collapse
|
|
26
|
By Hook or by Crook. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
27
|
Abou-Bekr B, Riffi O, Klouche djedid S, emam hassen AK, ouadah A. Pericardial, pulmonary and hepatic hydatid cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
|
28
|
Aydin Y, Ulas AB, Ince I, Kalin A, Can FK, Gundogdu B, Kasali K, Kerget B, Ogul Y, Eroglu A. Evaluation of albendazole efficiency and complications in patients with pulmonary hydatid cyst. Interact Cardiovasc Thorac Surg 2022; 34:245-249. [PMID: 34587626 PMCID: PMC8766210 DOI: 10.1093/icvts/ivab259] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/16/2021] [Accepted: 08/13/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study investigated the efficacy and complications of albendazole use after surgery in patients with pulmonary hydatid cysts. METHODS One hundred fifty-three consecutive patients who met the study criteria out of 215 patients who received prophylaxis with albendazole after surgery for isolated pulmonary hydatid cysts in our clinic between January 2011 and December 2020 were analysed retrospectively. RESULTS Eighty-six out of 153 (56.2%) of cases were male and 67 (43.8%) were female. The average age was 24.6 ± 17.4 (between 3 and 71 years), 76 of them (49.7%) were 18 years old and younger, while 77 (50.3%) were adults. All cases were approached transthoracically and a total of 170 operations were performed on the 153 cases. Fever, weakness and dizziness were reported in only one patient who was given albendazole treatment. A partial increase in liver enzymes was observed in 16 cases (10.5%) after albendazole treatment. Mild leukopoenia and neutropenia were observed in only one of the cases. In 1 case, a second operation was performed 30 months later due to recurrence. Albendazole treatment was not required to be discontinued in any of the cases. Mortality was not observed in any of the cases. Factors such as mean age, cyst size and hospitalization period did not have a statistically significant effect on any changes in liver enzymes tests following albendazole therapy (P > 0.05). CONCLUSIONS Albendazole treatment can safely be used for postoperative prophylaxis in patients with pulmonary hydatid cysts in a controlled manner without causing serious complications. SUBJ COLLECTION 152.
Collapse
Affiliation(s)
- Yener Aydin
- Department of Thoracic Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
- Anesthesiology Clinical Research Office, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ali Bilal Ulas
- Department of Thoracic Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ilker Ince
- Anesthesiology Clinical Research Office, Faculty of Medicine, Ataturk University, Erzurum, Turkey
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Asli Kalin
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Fatma Kesmez Can
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Betul Gundogdu
- Department of Pathology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Kamber Kasali
- Department of Bioistatistics, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Bugra Kerget
- Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Yasemin Ogul
- Department of Medicinal Biochemistry, Regional Training and Research Hospital, Health Sciences University, Erzurum, Turkey
| | - Atilla Eroglu
- Department of Thoracic Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
|
29
|
Parlak E, Kerget F, Demirdal T, Şen P, Ulaş AB, Öztürk Durmaz Ş, Pekok U, Ertürk A, Akyol D, Kepenek Kurt E, Köksal Alay H, Pullukçu H, Taşbakan M, Erol S, Laloğlu E, Öztürk Engin D, Ağalar C, Parlak M. The Epidemiology, Clinical Manifestations, Radiology, Microbiology, Treatment, and Prognosis of Echinococcosis: Results of NENEHATUN Study. Vector Borne Zoonotic Dis 2021; 21:948-954. [PMID: 34647813 DOI: 10.1089/vbz.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: Echinococcosis, caused by Echinococcus species, is an important zoonotic disease causing major health problems in humans and animals. Herein, we aimed to evaluate the epidemiology, clinical and laboratory parameters, radiological, serological, pathological, and treatment protocols of followed-up cases of hydatidosis. Methods: A total of 550 patients diagnosed with hydatid cyst disease were included in this study. Patients who were positive for one or more of the enzyme-linked immunosorbent assay or indirect hemagglutination test, pathological results, or radiological findings were examined. The data analyzed were collected from nine centers between 2008 and 2020. Records were examined retrospectively. Results: Among the patients, 292 (53.1%) were women and 258 (46.9%) were men. The patients' mean age was 44.4 ± 17.4 years. A history of living in rural areas was recorded in 57.4% of the patients. A total of 435 (79.1%) patients were symptomatic. The most common symptoms were abdominal pain in 277 (50.4%), listlessness in 244 (44.4%), and cough in 140 (25.5%) patients. Hepatomegaly was found in 147 (26.7%), and decreased breath sounds were observed in 124 (22.5%) patients. Radiological examination was performed in all cases and serological methods were also applied to 428 (77.8%) patients. The most frequently applied serological test was IHA (37.8%). A single cyst has been found in 66% patients. Hepatic involvement occurred in 327 (59.4%), pulmonary involvement was found in 128 (23.3%), whereas both of them were recorded in 43 (7.8%) patients. Splenic involvement was only detected in nine (1.6%) patients. Echinococcus granulosus (72.5%) was most frequently detected. Cyst diameters of 56.9% of the patients were in the range of 5-10 cm. A total of 414 (75.2%) patients received albendazole as an antiparasitic. Mortality was noted in nine (1.6%) patients. Conclusion: Echinococcosis is an important public health problem in Turkey. It can affect the social, economic, and political structures of the community. Public education and awareness are extremely important.
Collapse
Affiliation(s)
- Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ferhan Kerget
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Tuna Demirdal
- Department of Infectious Diseases and Clinical Microbiology, Kâtip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Pınar Şen
- Department of Infectious Diseases and Clinical Microbiology, Saruhanlı State Hospital, Manisa, Turkey
| | - Ali Bilal Ulaş
- Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Şenay Öztürk Durmaz
- Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Pendik Hospital, İstanbul, Turkey
| | - Ayşe Ertürk
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | - Deniz Akyol
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Esma Kepenek Kurt
- Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Handan Köksal Alay
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Serpil Erol
- Infectious Diseases and Clinical Microbiology Clinic, Istanbul Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Laloğlu
- Department of Biochemistry, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Derya Öztürk Engin
- Infectious Diseases and Clinical Microbiology Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Ağalar
- Department of Infectious Diseases and Clinical Microbiology, Medıcana Ataşehir Hospital, İstanbul, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| |
Collapse
|
|
30
|
Abo-Aziza FAM, Zaki AKA, Alajaji AI, Al Barrak SM. Bone marrow mesenchymal stem cell co-adjuvant therapy with albendazole for managing Toxocara vitulorum-rat model. Vet World 2021; 14:347-363. [PMID: 33776300 PMCID: PMC7994112 DOI: 10.14202/vetworld.2021.347-363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/28/2020] [Indexed: 11/29/2022] Open
Abstract
Background and Aim: Toxocara vitulorum is a bovine intestinal nematode. Immune pictures following infection are conflicting and stopping anthelmintic albendazole treatment recording reversed liver abnormalities. The purpose of this work was to evaluate the therapeutic potential of bone marrow mesenchymal stem cells (BMMSCs) therapy, subsequent to albendazole administration in rats infected with T. vitulorum. Materials and Methods: The ultrasonographic and histopathological examinations as well as serum liver enzymes activity and the kinetics of recovery were investigated. The correlation of cell-mediated and humoral immune pictures was assessed by assaying immunoglobulins, splenocytes viability, phagocytic index, and Th1/Th2 cytokines. Results: The cultured BMMSCs counting were 4.21×104 cells/cm2 with 96.03% viability. Flow-cytometric analysis indicated positive CD90 (82%), CD105 (79%) and negative CD34 (0.37%), CD45 (0.42%), attesting to the suitability of the isolated BMMSCs for use in therapy. Transplantation of BMMSCs after albendazole administration significantly reduced the release of liver enzymes (p<0.05) indicating liver cellularity improvement. The ultrasonographic, macroscopic, and histopathological findings confirmed the biochemical results. Significant elevation in the levels of tumor necrosis factor (TNF)-α and interferon (INF)-γ with a decline in interleukin (IL)-4 was observed in the untreated model (p<0.05). However, albendazole treatment followed by BMMSCs therapy significantly lowered the release of TNF-α and INF-γ, associated with significant production of IL-4 and IL-10 (p<0.05). Conclusion: The final results indicated that the liver functions, histopathological findings, and immune parameters were aggravated after experimental T. vitulorum infection. Albendazole treatment followed by BMMSCs therapy was found to assist in regeneration of injured hepatic tissue. Besides, it appeared to modulate host defensive immune responses against T. vitulorum antigens. This work could define more clearly the events that manipulate the host immune, histopathological, and biochemical responses to minimize obstacles in using stem cell therapy in animal toxocariosis.
Collapse
Affiliation(s)
- Faten A M Abo-Aziza
- Department of Parasitology and Animal Diseases, Veterinary Research Division, National Research Centre, Cairo, Egypt
| | - Abdel Kader A Zaki
- Department of Physiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.,Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Ahmed I Alajaji
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Saleh M Al Barrak
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
| |
Collapse
|
|
31
|
Lane A, Wright H. Hydatid disease, hepatic injury and hypertonic saline: a clinical conundrum. BMJ Case Rep 2021; 14:14/1/e238390. [PMID: 33462022 PMCID: PMC7816914 DOI: 10.1136/bcr-2020-238390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Echinococcosis or human hydatid disease is a helminthic infection is caused by Echinococcus species. Classically, cystic echinococcosis is caused by Echinococcus granulosus sensu stricto, E. equinus, E. ortleppi and E. canadensis, though several other species have been implicated in hydatid disease. Echinococcus infection may lead to cystic disease of the liver, lungs and potentially other organs. Here we present a patient who had cystic disease of the lungs and liver. The patient initially experienced right upper quadrant pain and nausea, and later went on to develop a fever, cough and dyspnoea in the setting of hydropneumothorax. CT scan of the chest and abdomen revealed a large fluid collection at the left lung base and a large lobular complex fluid mass within the right lobe of the liver. Echinococcus titres were positive. The patient was commenced on albendazole; however, experienced significant derangement of liver enzymes within the following month. In light of this, the albendazole was ceased, and a hemi-hepatectomy was performed. During the hemi-hepatectomy there was some cyst content spillage, and subsequently a washout with hypertonic saline 3% was performed. This was followed by a course of praziquantel 1200 mg two times per day for 14 days. Repeat CT 6 months later demonstrated no evidence of recurrence.
Collapse
Affiliation(s)
- Angus Lane
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia,Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Hugh Wright
- Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| |
Collapse
|
|
32
|
Primary retroperitoneal hydatid cyst in pancreatic head region. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.680810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
|
33
|
Abetti A, Lyazidi S, Qechchar Z, Habbal R, Ettaoumi Y. Hepato-pericardial fistula revealed by a massive pericardial effusion: A case report of an exceptional complication of the hydatid liver cyst. Int J Surg Case Rep 2020; 73:199-202. [PMID: 32693235 PMCID: PMC7372154 DOI: 10.1016/j.ijscr.2020.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The rupture of the hydatid liver cyst in the pericardium is a very exceptional and serious complication that can cause sudden death following cardiac tamponade or anaphylactic shock. CASE PRESENTATION We report a case of a 25 years-old woman with a massive pericardial effusion due to fistulization of hepatic hydatid cyst. Surgical closure of the fistula and the resection of the tow hydatid cysts were successful in managing this rare case. DISCUSSION Hepato-pericardial fistula is an extremely rare complication of hydatid liver cyst. Only 6 similar cases were previously reported in the literature. The Hepato-pericardial fistula may result in an acute pericarditis that progress to either cardiac tamponade or constrictive pericarditis. Its diagnosis is based on ultrasound and CT imaging. The surgical treatment with supportive therapy seems to improve the outcomes. CONCLUSION Pericardial effusion secondary to rupture of hepatic hydatid cyst should always be suspected in endemic countries.
Collapse
Affiliation(s)
- Ayoub Abetti
- Department of Cardiovascular Surgery, Ibn Rochd University Hospital, Casablanca, Morocco; Department of Cardiovascular Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
| | - Selma Lyazidi
- Department of Cardiovascular Surgery, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Zakaria Qechchar
- Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Rachida Habbal
- Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Youssef Ettaoumi
- Department of Cardiovascular Surgery, Ibn Rochd University Hospital, Casablanca, Morocco
| |
Collapse
|
|
34
|
Nammour T, Barada K. Asymptomatic Liver Hydatid Cysts: Is There a Role for Nonoperative Management? THE SURGICAL MANAGEMENT OF PARASITIC DISEASES 2020:143-155. [DOI: 10.1007/978-3-030-47948-0_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
|
|
35
|
Abo-Aziza FA, Zaki AKA, Abo El-Maaty AM. Bone marrow-derived mesenchymal stem cell (BM-MSC): A tool of cell therapy in hydatid experimentally infected rats. CELL REGENERATION (LONDON, ENGLAND) 2019; 8:58-71. [PMID: 31844519 PMCID: PMC6895685 DOI: 10.1016/j.cr.2019.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 12/21/2022]
Abstract
This study aimed to clarify the potentiality of bone marrow mesenchymal stem cells (BM-MSC) transplantation with albendazole (ABZ) on the modulation of immune responses against hydatid cyst antigens and the regeneration of injured livers in experimentally infected rats. Three different antigens of hydatid cyst fluid (HCF), hydatid cyst protoscolex (HCP) and hydatid cyst germinal layer (HCG) were isolated and their antigenic potencies were determined. The ultrasound, immunological and pathological criteria were investigated. Counting of 80% confluence BM-MSC was 4.68 × 104 cells/cm2 with 92.24% viability. Final population doublings score was 65.31 that indicated proliferation and self-renewability. Phenotyping of BM-MSC showed expression of CD73 and CD29 without exhibition of CD34 and CD14. Ultrasound examination showed multiple hydatid cysts in liver with low blood flow and spleenomegaly 8 weeks' post infection. No significant differences were noted in cystic diameter in uni-cyst liver at 2nd and 4th weeks following ABZ treatment while it was significantly decreased (P < 0.05) following transplantation of BM-MSC + ABZ treatment comparing to experimentally infected untreated group. Igs and IgG responses to the three antigens were significantly elevated while elevation in IgM response was only to HCG (P < 0.05). ABZ treatment accompanied with significant decrease in Igs and IgG titers against HCF and HCG only at 4th week post treatment (P < 0.05). However, Igs titer against HCF, HCP and HCG was significantly decreased at the 4th week following transplantation of BM-MSC + ABZ. Interestingly, the combination of BM-MSC + ABZ treatment resulted in reduction of Igs response to HCP to normal level as that of healthy control. Experimental infection resulted in elevation of TNF-α and IL-6 (P < 0.05) while, IL-4 and IL-10 decreased (P < 0.01). After transplantation of BM-MSC + ABZ treatment, serum TNF-α and IL-6 concentrations were reduced (P < 0.05) at both the 2nd and 4th weeks. However, IL-4 and IL-10 concentrations were significantly elevated (P < 0.05) only at 4th week following transplantation of BM-MSC + ABZ treatment. In conclusion, BM-MSC transplantation following ABZ administration can regenerate injured liver tissue without complete disappearance of hydatid cyst. In addition, it can modulate host protective humeral and cell mediated immune responses against hydatid cyst antigens. Therefore, the current study encourages to move to the step of performing clinical trials in humans.
Collapse
Affiliation(s)
- Faten A.M. Abo-Aziza
- Department of Parasitology and Animal Diseases, Veterinary Research Division, National Research Centre, Cairo, Egypt
| | - Abdel Kader A. Zaki
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Amal M. Abo El-Maaty
- Department of Animal Reproduction and AI, Veterinary Research Division, National Research Centre, Cairo, Egypt
| |
Collapse
|
|
36
|
Kowalczyk M, Kurpiewski W, Zieliński E, Zadrożny D, Klepacki Ł, Juśkiewicz W, Lasocki J, Dyśko Ł, Batia K, Pesta W. A rare case of the simultaneous location of Echinococcus multilocularis in the liver and the head of the pancreas: case report analysis and review of literature. BMC Infect Dis 2019; 19:661. [PMID: 31340769 PMCID: PMC6657101 DOI: 10.1186/s12879-019-4274-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Background Echinococcosis multilocularis (Hydatid Disease - HD) is a zoonotic disease caused by the larval form of Echinococcus multilocularis (EM). The main sites for this zoonosis are the Middle East, China, India, Alaska, and Siberia. It is rather rare in Europe. In Poland, the Warmian-Masurian Province is the endemic region for Echinococcus multilocularis. The clinical manifestation of the disease is dependent on the location, the size of the cyst and the development stage of the parasite. Considering the uncommon character of echinococcosis in Central Europe, especially such located in the areas outside the liver and lungs, the authors would like to present a case of coexistence in one patient of two EM foci in the liver and the head of the pancreas. Case presentation We present a clinical case of a 32-year-old man who was diagnosed with a cystic lesion with septa and calcification in the sixth segment of the liver and a suspicious change in the head of the pancreas. ELISA Em 2 plus test was positive, Western Blot method - the P-5 pattern showed an image that is characteristic of an EM infection. The sixth liver segment with a tumour and a tumour from the head of pancreas were excised by means of laparotomy. On the 6th day after the surgery the patient was discharged from hospital without complications and in good condition. Currently, he is under the control of a parasitic and zoonotic clinic. He takes an 800 mg daily dosage of Albendazole. Conclusions The presented clinical case shows that if we have a patient with cystic / tumour change in the pancreas and positive immunological tests, CT and MRI of the abdominal cavity are usually sufficient in order to fully diagnose and to qualify such a person for surgery. The most effective treatment is surgical treatment supplemented with pre- and postsurgical treatment with Albendazole.
Collapse
Affiliation(s)
- Marek Kowalczyk
- Department of Laboratory Medicine Faculty of Health Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.,Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Waldemar Kurpiewski
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Ewa Zieliński
- Department of Emergency Medicine and Disaster Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.
| | - Dariusz Zadrożny
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Łukasz Klepacki
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Wit Juśkiewicz
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Jacek Lasocki
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Łukasz Dyśko
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Krzysztof Batia
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| | - Wiesław Pesta
- Clinic of Oncological and General Surgery, University Clinical Hospital in Olsztyn, Olsztyn, Poland
| |
Collapse
|
|
37
|
Scolicidal Effects of Chitosan-Curcumin Nanoparticles on the Hydatid Cyst Protoscolices. Acta Parasitol 2019; 64:367-375. [PMID: 31087261 DOI: 10.2478/s11686-019-00054-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 03/28/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE In the current era, cystic echinococcosis (CE), as larval stage of Echinococcus granulosus, is considered as a threat to human health. Scolicidal agents used in the surgery of cysts have different side effects. Therefore, the present study aimed to assess the effects of chitosan nanoparticles containing curcumin (Ch-Cu NPs) on the protoscolices of the hydatid cyst in vitro. METHODS Ch-Cu NPs were synthesized using a simple co-precipitation method and their structural and morphological properties were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), zeta analyzer, and Fourier transform infrared (FT-IR) spectroscopy. Then, the effects of different concentrations of Ch-Cu NPs (0.25, 0.05, 1, 2, and 4 mg/mL) on the fatality rate, and the length and width of protoscolices in different times (5, 10, 20, 30, and 60 min) were investigated. In addition, the SEM technique was used to evaluate the structure of the protoscolices after treatment. RESULTS Based on the results, the presence of curcumin on the chitosan nanoparticles was confirmed by FT-IR analysis. Further, XRD analysis approved the crystal structure of chitosan NPs. Furthermore, the highest fatality rate was 68% in 4 mg/mL concentration of Ch-Cu NPs. The length and width of protoscolices decreased based on the high concentrations of Ch-Cu NPs, compared to the control group. CONCLUSION Finally, Ch-Cu NPs expressed good scolicidal activities, which made them suitable to be considered as an anti-protoscolex agent.
Collapse
|
|
38
|
Fadel SA, Asmar K, Faraj W, Khalife M, Haddad M, El-Merhi F. Clinical review of liver hydatid disease and its unusual presentations in developing countries. Abdom Radiol (NY) 2019; 44:1331-1339. [PMID: 30306203 DOI: 10.1007/s00261-018-1794-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Human hydatid cyst disease is an international public health issue that particularly affects the developing countries. In this article, we discuss the epidemiology of hydatid disease in third world countries, the life cycle of echinococcus granulosus and how to make the clinical diagnosis of the disease, including laboratory tests and imaging modalities as well as uncommon presentation of this entity that we have encountered at the American University of Beirut Medical Center (AUBMC). We emphasize on the new World Health Organization classification of hepatic echinococcosis with examples from our clinical practice at AUBMC, and finally we describe the treatment, including medical and interventional therapies.
Collapse
Affiliation(s)
- Sandra Abi Fadel
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karl Asmar
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walid Faraj
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohammad Khalife
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maurice Haddad
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi El-Merhi
- Diagnostic Radiology Department, American University of Beirut Medical Center, Riad El Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
| |
Collapse
|
|
39
|
Ferhatoglu MF, Filiz AI. Intrapelvic Localised Hydatid Cyst. Cureus 2018; 10:e2956. [PMID: 30214844 PMCID: PMC6132802 DOI: 10.7759/cureus.2956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hydatid cysts, caused by Echinococcus granulosus, is an important health problem in endemic areas. The disease can localize most commonly in the liver and lungs. Primary pelvic involvement is a rare condition. In this case report, we aimed to present a 75-year-old male patient with a pelvic mass, which was diagnosed preoperatively as a hydatid cyst.
Collapse
Affiliation(s)
| | - Ali I Filiz
- General Surgery, Okan University Medical Faculty, Istanbul, TUR
| |
Collapse
|
|
40
|
Velasco-Tirado V, Alonso-Sardón M, Lopez-Bernus A, Romero-Alegría Á, Burguillo FJ, Muro A, Carpio-Pérez A, Muñoz Bellido JL, Pardo-Lledias J, Cordero M, Belhassen-García M. Medical treatment of cystic echinococcosis: systematic review and meta-analysis. BMC Infect Dis 2018; 18:306. [PMID: 29976137 PMCID: PMC6034244 DOI: 10.1186/s12879-018-3201-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 06/21/2018] [Indexed: 12/13/2022] Open
Abstract
Background Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions regarding medical treatment of CE. Methods A thorough electronic search of the relevant literature without language restrictions was carried out using PubMed (Medline), Cochrane Central Register of Controlled Trials, BioMed, Database of Abstracts of Reviews of Effects, and Cochrane Plus databases up to February 1, 2017. All descriptive studies reporting an assessment of CE treatment and published in a peer-reviewed journal with available full-text were considered for a qualitative analysis. Randomized controlled trials were included in a quantitative meta-analysis. We used the standard methodological procedures established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results We included 33 studies related to the pharmacological treatment of CE in humans. Of these, 22 studies with levels of evidence 2 to 4 were qualitatively analysed, and 11 randomized controlled trials were quantitatively analysed by meta-analysis. Conclusions Treatment outcomes are better when surgery or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Reaspiration) is combined with benzimidazole drugs given pre- and/or post-operation. Albendazole chemotherapy was found to be the primary pharmacological treatment to consider in the medical management of CE. Nevertheless, combined treatment with albendazole plus praziquantel resulted in higher scolicidal and anti-cyst activity and was more likely to result in cure or improvement relative to albendazole alone. Electronic supplementary material The online version of this article (10.1186/s12879-018-3201-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Virginia Velasco-Tirado
- Servicio de Dermatologia, Complejo Asistencial Universitario de Salamanca (CAUSA), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Montserrat Alonso-Sardón
- Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Área de Medicina Preventiva y Salud Pública, IBSAL, Universidad de Salamanca, C/Donantes de Sangre s/n. Campus Unamuno, 37007, Salamanca, Spain
| | - Amparo Lopez-Bernus
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Servicio de Medicina Interna, CAUSA, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,CIETUS, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Ángela Romero-Alegría
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Servicio de Medicina Interna, CAUSA, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Francisco Javier Burguillo
- Departamento Química-Física, Facultad de Farmacia, Universidad de Salamanca, C/Donantes de Sangre s/n. Campus Unamuno, 37007, Salamanca, Spain
| | - Antonio Muro
- Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, C/Donantes de Sangre s/n. Campus Unamuno, 37007, Salamanca, Spain
| | - Adela Carpio-Pérez
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Servicio de Medicina Interna, CAUSA, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,CIETUS, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Servicio de Microbiología, CAUSA, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Javier Pardo-Lledias
- Servicio de Medicina Interna, Hospital Marqués de Valdecilla, Avenida Valdecilla 25, 39008, Santander, Cantabria, Spain.
| | - Miguel Cordero
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.,Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain
| | - Moncef Belhassen-García
- Instituto de investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain. .,Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain. .,Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.
| |
Collapse
|
|
41
|
Malik AA, Nabi N, Bari SU, Beigh FA, A S, Hussain A. Recurrent primary intermuscular hydatid cyst of thigh - a case report. JOURNAL OF OTOLARYNGOLOGY-ENT RESEARCH 2018; 10. [DOI: 10.15406/joentr.2018.10.00386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
|
42
|
Malik AA, Ayoub I, Ahmad Wani M, Bari SU. Laparoscopic Versus Conventional Surgery for Hepatic Hydatid Disease: A Comparative Study. JOURNAL OF MINIMALLY INVASIVE SURGICAL SCIENCES 2017; 6. [DOI: 10.5812/minsurgery.57109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
|
43
|
Iqbal N, Hussain M, Idress R, Irfan M. Disseminated hydatid cyst of liver and lung. BMJ Case Rep 2017; 2017:bcr-2017-222808. [PMID: 29184009 DOI: 10.1136/bcr-2017-222808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hydatid cyst commonly affects liver followed by lung, but rarely affects both organs simultaneously. Here we presented a patient who presented with concurrent involvement of both lungs and liver. Patient presented with dyspnoea and generalised weakness with bilateral rounded opacities throughout the lung field of variable sizes. CT scan chest with contrast showed multiple rounded soft tissue density in both lungs and liver. Patient underwent mini thoracotomy which revealed multiple cystic lesions throughout lung. ELISA for anti-Echinococcus antibodies shows positive titres. Due to extensive involvement, patient was started on medical treatment albendazole. The patient showed significant improvement both clinically and radiographically on treatment. Thus long-term medical treatment helps in such cases where surgery is not possible.
Collapse
Affiliation(s)
- Nousheen Iqbal
- Department of Medicine, section of Pulmonology and critical care, Aga Khan Hospital, Karachi, Pakistan
| | | | - Romana Idress
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Medicine, Section of Pulmonology and Critical care, Aga Khan University and Hospital, Karachi, Pakistan
| |
Collapse
|
|
44
|
Keong B, Wilkie B, Sutherland T, Fox A. Hepatic cystic echinococcosis in Australia: an update on diagnosis and management. ANZ J Surg 2017; 88:26-31. [PMID: 29024292 DOI: 10.1111/ans.14117] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Ben Keong
- Department of Upper Gastrointestinal Surgery; St George Hospital; Sydney New South Wales Australia
| | - Bruce Wilkie
- Department of Surgery; Eastern Health; Melbourne Victoria Australia
| | - Tom Sutherland
- Medical Imaging Department; St Vincent's Hospital; Melbourne Victoria Australia
| | - Adrian Fox
- Department of Surgery; Eastern Health; Melbourne Victoria Australia
| |
Collapse
|
|
45
|
Saftawy EAE, El-Aal AAA, Badawi M, Attia SS, Abdelraouf A, Shoeib EY, Hassany M, Mohsen A, Afife AA, Gohar H, Badr MS. Research Note. One minute, intraoperative assessment of the viability of hydatid cysts using a simple reagent strip test. Helminthologia 2017; 54:157-164. [DOI: 10.1515/helm-2017-0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
SummaryThe aim of the current work was to evaluate the possibility of using a rapid and simple reagent strip test to investigate the viability of hydatid cysts intraoperatively, via testing certain biochemical parameters. Thirty eight HCF samples were processed and examined by different methods for determining the viability status. Using the reagent strip test in the current study, the highest significant level of glucose was detected in HCF samples with the highest viability % at pH 7.5 and the lowest significant level of glucose was detected in HCF samples with the lowest viability % at pH 8.5, indicating a likely correlation between glucose concentration and the viability of PSs. On the contrary, protein was not detected in HCF containing viable PSs and was found to be higher in HCF containing non-viable PSs, denoting the possible degenerative processes in such PSs. Haemoglobin was found in trace amounts in all of our samples. In addition, the strip test detected bacterial contamination in 8 samples and biliary leakage in 7 samples. Our results suggest that the simple reagent strip test can assist in providing fast, uncomplicated primary data regarding the viability status of the hydatid cysts. Thus, it may aid the surgeons to make informed decisions for further management and appropriate follow up to minimise the risk of post-operative recurrence.
Collapse
Affiliation(s)
- E. A. El Saftawy
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - A. A. Abd El-Aal
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - M. Badawi
- Department of Pathology, National Research Institute, Giza , Egypt
| | - S. S. Attia
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - A. Abdelraouf
- Department of Tropical Medicine, National Hepatology and Tropical Medicine Research Institute, Cairo , Egypt
| | - E. Y. Shoeib
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - M. Hassany
- Department of Tropical Medicine, National Hepatology and Tropical Medicine Research Institute, Cairo , Egypt
| | - A. Mohsen
- Department of Community Medicine, National Research Centre, Cairo , Egypt
| | - A. A. Afife
- Biomedical Sciences (BSc), The University of Manchester, Manchester , UK
| | - H. Gohar
- Department of Medical Microbiology, Faculty of Medicine, Cairo University, Cairo , Egypt
| | - M. S. Badr
- Department of Molecular Biology, Medical Research Centre, Faculty of Medicine, Ain Shams University, Cairo , Egypt
| |
Collapse
|
|
46
|
Patrono D, Tandoi F, Rizza G, Catalano G, Mirabella S, Celoria P, Corcione S, De Rosa FG, Salizzoni M, Romagnoli R. Liver transplantation with an uncommon full right hemiliver graft after hydatid cysts resection: Case report and review of the literature. Transpl Infect Dis 2017; 19. [PMID: 28244199 DOI: 10.1111/tid.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/23/2016] [Accepted: 12/04/2016] [Indexed: 11/28/2022]
Abstract
Because of widespread organ shortage, the transplant community has been exploiting more and more so-called "extended criteria" donors. In this scenario, liver grafts harboring benign tumors or large cysts represent an infrequent but potentially valuable source of viable grafts. We depict a challenging case of liver transplantation performed using a graft harboring two large Echinococcus granulosus hydatid cysts in close proximity with the hilar plate and complicated by cystobiliary communication. Although liver transplantation using grafts with hydatid cyst has been rarely reported (three published cases), our case was peculiar as one of the cysts was located close to the hilum and was ruptured into the left hepatic duct. The graft was finally accepted taking into account the low risk profile of the recipient, the good quality and size of the remnant liver parenchyma, and only after complete resection of the cysts was achieved. Although the recipient had a complication due to biliary confluence necrosis, at 10-months follow-up he is in good health with normal hepatic function, and a graft that could have been otherwise discarded was successfully used. The decision process along with technical and management issues are discussed.
Collapse
Affiliation(s)
- Damiano Patrono
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Francesco Tandoi
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giorgia Rizza
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giorgia Catalano
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Stefano Mirabella
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Piero Celoria
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Corcione
- Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Mauro Salizzoni
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Renato Romagnoli
- General Surgery 2U - Liver Transplantation Center, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
|
47
|
A Large Isolated Hydatid Cyst of the Adrenal Gland: A Case Report and Review of the Literature. Case Rep Endocrinol 2016; 2016:9237903. [PMID: 28018684 PMCID: PMC5149624 DOI: 10.1155/2016/9237903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/30/2016] [Accepted: 11/07/2016] [Indexed: 11/17/2022] Open
Abstract
A 44-year-old patient presented with two-year history of (R) lumbar pain. There was a strong history of childhood animals' contact, including dogs. A brother had multiple hydatid cysts requiring surgery. Initial ultrasound showed a large (R) adrenal mass measuring 10 × 9 × 8 cm. Subsequent CT scan confirmed a heavily calcified cyst in the (R) adrenal gland. Hormonal studies were normal. He had an uneventful course following a total adrenalectomy. Isolated adrenal hydatid is extremely rare with an incidence of less than 0.5%; however, the diagnosis should always be suspected in all patients from an endemic area presenting with an adrenal cystic mass.
Collapse
|
|
48
|
Aasen TD, Nasrollah L, Seetharam A. Drug-Induced Liver Failure Requiring Liver Transplant: Report and Review of the Role of Albendazole in Managing Echinococcal Infection. EXP CLIN TRANSPLANT 2016; 16:344-347. [PMID: 27228108 DOI: 10.6002/ect.2015.0313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Albendazole is often used as adjunctive therapy in the treatment of echinococcal infection to reduce cyst viability before and prevent recurrence after surgical treatment. In this report, we present a 38-year-old Iraqi woman with Echinococcus initiated on albendazole therapy who developed acute liver failure 6 weeks after treatment. Investigation for common viral and autoimmune causes of liver injury was unremarkable, and a liver biopsy revealed changes consistent with severe, drug-induced liver injury. Despite discontinuation of albendazole, liver function continued to deteriorate, prompting rescue with an orthotopic liver transplant. Often used perioperatively in the management of Echinococcus infection, albendazole can induce idiosyncratic severe liver injury, mandating close monitoring for hepatotoxicity.
Collapse
Affiliation(s)
- Tyler D Aasen
- >From the Department of Internal Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | | |
Collapse
|
|
49
|
Abdel-Baki AAS, Almalki E, Mansour L, Al-Quarishy S. In Vitro Scolicidal Effects of Salvadora persica Root Extract against Protoscolices of Echinococcus granulosus. THE KOREAN JOURNAL OF PARASITOLOGY 2016; 54:61-6. [PMID: 26951980 PMCID: PMC4792313 DOI: 10.3347/kjp.2016.54.1.61] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 09/30/2015] [Accepted: 11/01/2015] [Indexed: 11/23/2022]
Abstract
It has been known that Arak, Salvadora persica, has a number of medicinal properties. We tried to investigate in vitro scolicidal effect of root extracts of this plant against protoscolices from hydatid cysts of Echinococcus granulosus. Protoscolices were aseptically collected from sheep livers containing hydatid cysts. S. persica root extract was used in 10, 30, and 50 mg/ml concentration for 10, 20, and 30 min. The viability of protoscolices was ascertained by 0.1% eosin staining. Scolicidal activity of S. persica extract at a concentration of 10 mg/ml was 36.3%, 50.3%, and 70.8% after 10, 20, and 30 min of exposure, respectively. The scolicidal effect of this extract at a concentration of 30 mg/ml was 52.9%, 86.7%, and 100% after 10, 20, and 30 min of exposure, respectively. S. persica extract at a concentration of 50 mg/ml, meanwhile, killed 81.4%, 100%, and 100% of protoscolices after 10, 20, and 30 min, respectively. Also, the cytotoxic potential of S. persica was assessed on human liver cells (HepG2) using trypan blue exclusion test. No cytotoxic effect was observed on HepG2 cell line. The present study confirmed for the first time that the ethanolic extract of S. persica has high scolicidal power in vitro. However, in vivo effect of this material remains to be studied for treatment of echinococcosis in humans and herbivorous animals.
Collapse
Affiliation(s)
- Abdel-Azeem S. Abdel-Baki
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
- Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Esam Almalki
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
- Department of Medical Laboratory, College of Applied Medical Sciences, Majmaah University, Saudi Arabia
| | - Lamjed Mansour
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
- Unité de Recherche de Biologie intégrative et Ecologie évolutive et Fonctionnelle des Milieux Aquatiques, Département de Biologie, Faculté des Sciences de Tunis, Université De Tunis El Manar, Tunis, Tunisia
| | - Saleh Al-Quarishy
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
|
50
|
Chinya A, Khanolkar A, Kumar J, Sinha SK. Isolated hydatid cyst of the pancreas masquerading as pancreatic pseudocyst. BMJ Case Rep 2015; 2015:bcr-2015-211307. [PMID: 26264949 DOI: 10.1136/bcr-2015-211307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hydatid cyst of the pancreas is very rare and usually presents with obstructive jaundice. We report a case of a 7-year-old girl with cyst of the pancreas without any obstructive jaundice. The child was treated surgically and hydatid cyst of pancreas was found. Partial pericystectomy was performed. After 1 month on follow-up, the child developed pseudocyst of pancreas, which needed cystogastrostomy. Postoperatively, the child improved and is remaining well after 3 months of follow-up. Hydatid cysts of pancreas are very difficult to diagnose preoperatively and should be kept as a differential diagnosis of cystic intrapancreatic lesions. Serological tests can help in early diagnosis.
Collapse
Affiliation(s)
- Abhishek Chinya
- Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Ashwini Khanolkar
- Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Jyoti Kumar
- Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
| | - Shandip Kumar Sinha
- Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|