Severe spinal infections including vertebral osteomyelitis and spinal epidural abscess pose challenges in diagnosis and management. The evolution of epidemiologic risks for these processes includes the aging of the population, increase in spinal instrumentation procedures and health care-associated device utilization, and increased interconnection of the global community. Clinical presentation may be nonspecific, so clinicians must maintain a high index of suspicion to ensure prompt diagnosis and treatment to prevent progression to long-standing morbidity. Collaboration with specialists in surgical treatment and infectious disease guides the complex management of these cases.

To evaluate the long-term results of modified catheterization technique (Mo-CAT) for percutaneous treatment of liver CE2/CE3b hydatid disease in a large series.

A total of 119 patients (F/M:73/59) and 132 liver CE2 and CE3b cysts who underwent percutaneous treatment by Mo-CAT from 2009 to 2020 were included in the study. Patients' age ranges from 8 to 78 years (mean: 39 years). Volume changes of all cysts after the procedure, success and complication rates, duration of hospital stay, catheterization time and recurrence rates were recorded. Technical success was defined as successful catheter introduction into the CE. Clinical success was defined as cases with no mortality and no recurrence.

Among all patients, the mean reduction in the cyst volume was 65.84% (range 6.29-100%). The mean length of hospital stay was 3.88 ± 4.73 days (range 1-36 days). A total of 107 (89.9%) of 119 patients were discharged from the hospital in first the week after the procedure. Major complications were observed in 12 of 119 patients (10.08%) and 12 out of 132 cysts (9.09%). Recurrence was detected in 6 (4.5%) cysts in 6 patients (4.5%) who needed additional procedures. Among all 119 patients, the mean follow-up duration was 51.66 ± 35.56 months (median, 49.00 months; range 0-131 months).

Treatment of liver CE2/3b with Mo-CAT appears to be a safe, reliable and efficient technique which is associated with low recurrence and complication rates.

Hydatidosis, a major parasitic disease in Mediterranean countries, primarily affects the liver and lungs, but in rare cases, it may also affect the subcutaneous tissue. Subtle symptoms often delay diagnosis. This report presents a rare case of left flank hydatid cyst.

We report a 40-year-old man who had been suffering from a painless mass in the left flank for three months, which was recently painful, and was diagnosed with a subcutaneous hydatid cyst. Imaging and serology tests were inconclusive. The intact cyst was surgically removed, and histology confirmed hydatid cysts. Postoperative albendazole therapy was given for three months and resulted in complete recovery.

Hydatid cysts caused by Echinococcus granulosus primarily affect the liver and lungs, with subcutaneous cases being rare. This is the first reported case of a primary subcutaneous hydatid cyst in the left flank.

Hydatid disease should be considered in the differential diagnosis of soft tissue tumors, particularly in endemic areas. Outside of typical liver or lung involvement, diagnosis can be challenging and often delayed.

In rural communities of Mozambique, dogs are utilized not only as companion animals, but also for shepherding livestock, guarding, and hunting purposes, increasing exposure of humans to zoonotic parasites. Thus, we conducted a study to assess knowledge, attitudes, and perceptions of rural dog owners living in the districts of Gaza and Inhambane provinces, south of Mozambique, on cystic echinococcosis (CE) followed by a survey on the prevalence of gastrointestinal parasites with emphasis on Taeniidae infection in dogs from the same districts. A structured questionnaire was administered to 335 dog owners to assess their knowledge, attitudes and perceptions related to the risk factors for transmission, control, and prevention of CE. Responses were analyzed with SPSS software using the Chi-square test. To determine the prevalence of endoparasites, 723 dog fecal samples were collected and processed using a flotation technique to detect helminths/protozoa eggs/cysts/oocysts and modified Ziehl Neelsen staining to detect Cryptosporidium oocysts. Samples positive for taeniids were further processed to identify them to species level using molecular techniques. 3% (10/335) of respondents of the questionnaire were aware of CE which was higher in males (2.7%; 9/335) compared to females, in respondents aged 26-45 years old (2.1%; 7/335), and in agro-pastoralists (1.8%; 6/335). An overall prevalence of 93.7% (678/723) for at least one parasite species was found. Prevalence was 7.6% (55/723) for Spirocerca spp., 50.9% (368/723) for Ancylostoma spp., 4% (29/723) for Toxocara spp., 5.4% (39/723) for Trichuris spp., 8.7% (63/723) for Sarcocystis spp., 8.4% (61/723) for Dipylidium caninum, 8.7% (63/723) for Isospora spp., 2.2% (16/723) for Giardia spp. and 1.7% (12/723) for Cryptosporidium spp. Prevalence of taeniids was 2.4% (17/723) with six isolates identified as Taenia hydatigena and two as Taenia multiceps. Results of questionnaire survey showed that the Knowledge of cystic echinococcosis in districts of southern Mozambique was limited, and we recommend the development of targeted public health campaigns to raise awareness of local communities about transmission cycles and prevention CE. Future epidemiological studies should be conducted to investigate the potential source of CE infections in cattle by screening both wild and domestic canids.

Echinococcosis, also known as hydatid disease, is a zoonotic parasitic infection that poses a significant risk to human health. This article delineates the diagnostic and therapeutic course of a patient afflicted with pulmonary echinococcosis who was admitted to the Department of Thoracic Surgery II at Yunnan Cancer Hospital in April 2024. The patient exhibited a history of extensive exposure to livestock and a penchant for consuming undercooked meat. Prior to undergoing surgical intervention, the patient was initially diagnosed with bronchogenic pulmonary cyst. However, subsequent pathological examination revealed a diagnosis of pulmonary echinococcosis. The rarity of the disease and the paucity of experience in diagnosis and treatment rendered the patient's case a valuable opportunity to elucidate the diagnostic and therapeutic journey. This report aims to provide a comprehensive reference for the accurate identification and treatment of pulmonary echinococcosis in future clinical practice.

Background: Echinococcus granulosus is a zoonotic parasitic disease caused by the larval stage of the parasite Echinococcus, which has a long incubation period, expensive diagnosis and treatment, and long duration of medication, so it brings a great economic burden to patients and their families. Shangri-La City is one of the counties with a high prevalence of echinococcosis in Yunnan Province. The antigen-positive rate of Echinococcus feces is high and there is a potential risk of infecting people. Evaluation of comprehensive prevention and control intervention and different frequencies of dewormed dogs (EC-DD) are crucial. Methods: From 2022 to 2023, Jiefang, Nishi, and Jidi villages in Jiantang Town of Shangri-La City were selected as the intervention group (TIG) and Hongpo Village as the control group (TCG) for EC-DD. TIG took comprehensive intervention measures such as registration management of domestic dogs (RMDD), single tying of dogs alone (STDA), deworming of registered domestic dogs (DRDD), standardized disposal of feces after deworming (SDFD), and population health promotion and intervention (PHPI), while TCG did not do any prevention and control intervention. Results: The evaluation survey results show that the positive rate of Echinococcus antigen (PREA) of TIG decreased from 3.15% baseline to 1.94%. Compared with the baseline, it decreased 38.41%, and the PREA of TCG increased from 1.88% baseline to 4.17%. Compared with the baseline, it increased 56.35%. The knowledge awareness rate (TKAR) was increased from 56.56% baseline to 81.46%. Compared with the baseline, it increased by 30.57%. In the survey of dog keeping, the evaluation values of STDA, DRDD, SDFD, and the practice of not feeding dogs the diseased organs of animals were higher than the baseline values. In the survey of people's behavior habits, the evaluation values of people regularly washing hands, not drinking raw water, and not burning cow dung at home also improved compared with the baseline value. Conclusions: In areas with low prevalence of echinococcosis, the village with positive dogs shall take measures for the management of RMDD, STDA, and SDFD and perform deworming four times a year. In addition to these, the comprehensive prevention and control measures combined with PHPI can effectively control the PREA.

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.

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.

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.

Liver hydatid cysts remain a significant public health issue in Turkey, the Middle East, East Asia, and Russia. Surgical treatments are often employed for certain stages of this disease. However, the necessity of simultaneous cholecystectomy during these procedures remains unclear. Treating symptoms related to subsequent cholelithiasis can become more challenging. This study investigates the necessity of simultaneous cholecystectomy by following patients who underwent hydatid cyst surgery with or without concurrent cholecystectomy.

Patients who underwent surgery for hydatid cysts between 2019 and 2024 at the General Surgery Clinic of Ankara Bilkent City Hospital were retrospectively reviewed. A total of 97 patients were included, with 56 (54.32 %) undergoing cholecystectomy along with hydatid cyst surgery (Group 1) and 41 (45.68 %) not undergoing cholecystectomy (Group 2).Preoperative clinical, laboratory, and radiological findings, as well as intraoperative data, morbidity, mortality, and postoperative symptoms, were analyzed.

Patients in Group 1 had longer hospital stays, higher blood loss, and significantly higher Clavien-Dindo complication scores. In the postoperative follow-up of Group 2, 8 patients (19.51 %) developed stones or sludge, and 1 patient (2.4 %) developed polyps. Four patients (9.75 %) presented to the emergency department with cholecystitis symptoms. A total of 5 patients (12.19 %), including 4 with symptomatic cholelithiasis (9.7 %) and 1 with gallbladder polyps (2.4 %), underwent elective cholecystectomy. Two (40 %) of these cholecystectomies were performed laparoscopically, while three (60 %) were converted to open cholecystectomy.

Simultaneous cholecystectomy during liver hydatid cyst surgery may prevent difficulties associated with treating symptoms related to subsequent cholelithiasis.

Alveolar echinococcosis (AE) is caused by the chronic infection of E. multilocularis, whose tumor-like growth can lead to high fatality if improperly treated. The early diagnosis of infection and the treatment of advanced AE remain challenging. Herein, bulk RNA-seq, scRNA-seq, and spatial transcriptomics technologies are integrated, to reveal the host immune response mechanism against E. multilocularis both spatially and chronologically, collecting mouse liver samples at multiple timepoints up to 15 months post infection. These results unveil an unprecedented high-resolution spatial atlas of the E. multilocularis infection foci and the functional roles of neutrophils, Spp1+ macrophages, and fibroblasts during disease progression. The heterogeneity of neutrophil and macrophage subpopulations are critical in both parasite-killing and the occurrence of immunosuppression during AE progression. These findings indicate the transition of parasite control strategy from "active killing" to "negative segregation" by the host, providing instructive insights into the treatment strategy for echinococcosis.

This study aims to analyze changes in the disease burden of cystic echinococcosis in China from 1990 to 2019 and to predict trends from 2020 to 2044. Using the Global Burden of Disease 2019 (GBD 2019) database, we analyzed the trends in annual percentage change (APC) and average annual percentage change (AAPC) for incidence, prevalence, death, and disability-adjusted life years (DALY) rates of cystic echinococcosis in China via the Joinpoint Regression Program 4.8.0.1 software. Additionally, we applied Nordpred modeling to predict future trends in disease burden over the next 25 years. From 1990 to 2019, the incidence and prevalence of cystic echinococcosis in the Chinese population showed an overall increasing trend, whereas the death and DALY rates exhibited an overall decreasing trend. The disease burden of cystic echinococcosis was greater in males than in females, with significant differences across age groups. The highest incidence and prevalence rates were observed in the 10-24 years age group, whereas the lowest occurred in the 0-9 years age group. Fatalities and DALY rates increased with age, particularly in the 70 and older age groups. According to the Nordpred modeling results, the incidence, prevalence, and DALY rates of cystic echinococcosis in China are expected to rise slightly over the next 25 years. The overall disease burden of cystic echinococcosis is projected to increase gradually between 2020 and 2044, with men exhibiting higher incidence, prevalence, and DALY rates than women.

Echinococcosis, caused by the tapeworm Echinococcus, is rare in Korea and is primarily imported from endemic areas. We report a case of a 37-year-old Korean man with multiple large hepatic cysts, initially diagnosed as simple cysts at a local clinic in 2018. The patient had lived in Oman, an endemic area, for several months in 2016. Upon referral to a tertiary hospital in 2023, due to progressive cyst enlargement, liver magnetic resonance imaging revealed three large cysts with a water lily sign. Serum IgG against Echinococcus was positive by enzyme-linked immunosorbent assay. After diagnosis of echinococcosis, treatment with albendazole and puncture-aspiration-injection-reaspiration (PAIR) was performed. Microscopic and molecular analysis of cyst aspirates confirmed Echinococcus granulosus infection. Follow-up computed tomography demonstrated a reduction in cyst size, yet the emergence of a new right pleural effusion and consolidation in the left lower lobe of the lung necessitated the continuation of albendazole therapy. This case highlights the importance of thorough travel history, imaging findings, and the effectiveness of PAIR combined with albendazole in treating imported echinococcosis.

A young man presented with complaints of angina on exertion and dyspnoea on exertion for the last 3 months. On evaluation, he was found to have a cystic mass in the left ventricle with severe left ventricular systolic dysfunction. A cardiac MRI revealed a multiloculated mass in the left ventricle with multiple septa with internal enhancement and CT coronary angiography revealed compression of a coronary artery by the cystic mass. Serological tests for hydatid came out strongly positive, and subsequently, he underwent surgical excision under cardiopulmonary bypass. Postoperatively, he is doing well with no complaints.

Albendazole serves as a broad-spectrum anthelmintic medication for treating hydatid cysts and neurocysticercosis. However, its therapeutic effectiveness is limited by poor solubility. Nanocrystals offer a promising technology to address this limitation by enhancing drug solubility. The objective of this study is to evaluate an effective stabilizer for creating an albendazole nanocrystal formulation to improve oral absorption. Among different surfactants and polymers examined, tea saponins were used as the stabilizer to develop a nanosuspension with the particle size of 180 nm through a wet grinding approach. The physical characteristics of the nanocrystals were assessed using SEM, DSC, and XRPD. The nanocrystals significantly enhanced solubility by 2.9-2602 fold in different media and showed significant enhancement in dissolution rate compared to albendazole crystals in both pH 1.0 and pH 6.8 medium. Everted gut sacs experiments demonstrated that the nanocrystals increased Papp by 3.60-fold in duodenum, 3.76-fold in jejunum, 3.71-fold in ileum, and 5.26-fold in colon, respectively. Furthermore, pharmacokinetic studies revealed that the nanocrystals significantly enhanced oral bioavailability, resulting in a 4.65-fold increase in plasma AUC0-t value of albendazole sulfoxide (the primary active metabolite of albendazole) compared to the albendazole group. The present data indicates that tea saponins are potential natural stabilizers for preparing nanocrystals with enhanced oral bioavailability for insoluble drugs.

Cystic echinococcosis (CE) is a widespread neglected zoonotic disease caused by Echinococcus granulosus sensu lato (EG) with a global burden of control in the billions of dollars. E. granulosus' life cycle involves definitive, intermediate, and humans as dead-end hosts. Echinococcosis control programs use strategies that focus on any of these hosts. We aimed to provide a comprehensive and up-to-date overview of the EG control interventions worldwide.

We conducted a scoping review by mapping all studies on interventions for EG control following the Arksey and O'Malley Framework. We screened identified articles, and charted and coded selected papers. We classified the data based on target host, type of study, and control mechanism. We described the efficacy or safety outcomes, and the associated barriers/facilitators for the intervention. Critical appraisal was conducted.

From 7,853 screened studies, we analyzed 45: seven centered on human interventions, 21 on animals, and 17 on both. Studies on humans focused on educational strategies and human CE monitoring. The studies on animals were field trials and most were based on Praziquantel (PZQ) for dogs. Studies focused on both animals and humans had, in general, more participants, lasted longer, and covered larger geographical areas. Overall, the quality of studies was moderate to low.

Available evidence suggests that long-term interventions aimed at both animals and humans can achieve significant reduction in EG transmission, particularly when PZQ treatment for dogs is included. Higher quality evidence, standardization of methodologies, and better reporting on post-intervention outcomes are necessary for drawing stronger conclusions. Further evidence is needed to assess the sustainability and scalability of control measures. Nonetheless, an integrative One Health approach is essential for overcoming the multiple challenges associated with sustaining long-term control efforts for Echinococcosis.

RCN was supported by the National Institute of Allergy and Infectious Diseases (grant nos. K01AI139284 and R01AI168291). LOC, JAB, and RCN were supported by the Fogarty International Center (grant no. D43TW012741). TAD, CG and JAB were supported by the Fogarty International Center (grant no. D43TW001140).

Cystic echinococcosis is a disease caused by the parasite Echinococcus granulosus sensu lato . This parasite can be found in specific areas on all continents, especially in poverty-stricken regions, increasing costs and losses. Some countries have achieved control, but most are still in the process. Our review provides a clear picture of what we currently know about these control strategies and points out where more research is needed. It highlights how the findings can improve control practices by showing what works best and address practical challenges. The review also identifies gaps in current knowledge and suggests that comparing different control methods could help find the most effective and cost-efficient solutions. Key areas needing attention include increasing support and funding for echinococcosis, as the disease is often overlooked. More research from different fields is needed to better understand and manage the disease's complexities. Better and ongoing surveillance is crucial for maintaining effective control strategies. Finally, comprehensive reviews that bring together findings from different studies are needed to identify what works best and improve and combine future control efforts.

The present study aimed to evaluate the histologic, histochemical, and immunohistochemical changes in buffalo livers with cystic echinococcosis. Noninfected and infected livers were collected from the freshly slaughtered buffalo at the Aligarh abattoir. Small pieces of both infected and noninfected livers (n = 5) were cut and processed for histologic and histochemical studies. Immunohistochemistry was performed using rabbit anti-CD3, CD19, and CD117 antibodies. The results revealed the presence of brood capsules and germinal and laminated membranes surrounded by a fibrous adventitial layer, followed by moderate and diffused infiltration of eosinophils, monocytes, neutrophils, lymphocytes, and marked focal infiltration of mast cells. The infected livers also had mild dilation of central veins and sinusoids, mild and focal necrosis of hepatic tissue, and congestion of central and portal veins. Periodic acid-Schiff reaction revealed marked glycogen depletion in the infected liver. Masson's trichrome stain showed marked deposition of collagen fibers in the portal area, adventitial layer, and between the hepatocytes compared with the noninfected liver, where deposition was found only in the portal area. The T-cell response was more pronounced than the B-cell response in infected liver. Thus, it can be concluded that hydatid cyst infection causes several pathological and biochemical changes and increased infiltration of inflammatory cells in the infected livers, suggesting the involvement of nonspecific immune responses against hydatid cysts. The T-cell response was more pronounced than B-cells, indicating the involvement of cell-mediated immunity against cystic echinococcosis. These findings may help to understand the local immune responses to cystic echinococcosis.

Hydatidosis is an endemic parasitic disease that can occur in almost any part of the body. It presents in two different forms according to the type of tapeworm: Echinococcus granulosus (hydatid disease [HD]) and Echinococcus multilocularis (alveolar HD). Radiological imaging can reveal the type of cyst, disease activity and progression, and complications, with features depending on the HD stage, the organ involved, and complications. Radiological imaging is also used to plan treatment strategies and evaluate patients at follow-up. Here, we review the morphologies of different HD presentations and their radiological features, the diagnostic findings that suggest possible HD in rare sites, and the potential complications of HD. We also discuss the role of radiology in hydatidosis diagnosis and treatment.

Alveolar echinococcosis is a zoonosis caused by the larval stage of Echinococcus multilocularis. In previous studies, QTL analysis using C57BL/6 N (B6) and DBA/2 (D2) which differ in susceptibility suggested the presence of genes on chromosome 1 that control protoscolex development. In this study, we constructed several congenic mice with different chromosome 1 regions substituted to confirm the presence of responsible genes and to narrow down the regions where the responsible genes exist. Five lines of third-generation congenic strain were constructed and infection experiments were conducted. The results showed that the development of protoscolex was seen in the two lines, resulting to narrow-down the responsible region between 69.4 cM and 70.67 cM. There were 18 genes having different SNPs and 10 genes having amino acid substitutions between B6 and D2 within this region. Infection experiments with third-generation of congenic mice succeeded in narrowing down the chromosomal region determining protoscolex development, resulting to reduce the number of candidate genes. The identification of the gene responsible for protoscolex development will contribute to the control of E. multilocularis infection.

Pulmonary hydatid disease, caused by Echinococcus granulosus, presents significant clinical challenges, particularly in pediatric populations. Surgical intervention remains the gold standard for treatment, with various techniques employed, including capitonnage and non-capitonnage methods. This systematic review and meta-analysis evaluates the efficacy and safety of capitonnage compared to non-capitonnage techniques in children.

This systematic review and meta-analysis followed the PRISMA guidelines to ensure methodological rigor. A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases to identify relevant studies. To assess pooled event rates and corresponding 95% confidence intervals for both complications and cure rates, we employed a random-effects model, allowing for variability among study populations. All statistical analyses were conducted using Comprehensive Meta-Analysis software (version 3.7).

Thirteen studies met the established inclusion criteria for analysis. The overall complication rate was 46%, with significantly lower rates in the capitonnage group (24%) compared to the non-capitonnage group (58%). The cure rate was higher in the capitonnage group (83.5%) than in the non-capitonnage group (65.2%). Meta-regression analysis indicated that complication rates were influenced by cyst diameter, study publication date, mean age, and type of surgery.

The findings suggest that capitonnage is associated with better outcomes in terms of lower complication rates and higher cure rates. This evidence supports the use of capitonnage as a preferred surgical technique for managing pulmonary hydatid disease in children. Further research is recommended to explore the long-term outcomes and potential benefits of combining surgical and pharmacological treatments.

Lumbosacral hydatid disease (LHD), a rare skeletal parasitic disease that involves the lumbosacral region. In this study, we summarized the diagnostic and therapeutic procedures for patients with LHD to provide insights into managing this rare disease.

Between 2000 and 2023, 16 patients diagnosed with LHD were retrospectively analyzed. Each patient's medical records and follow-up details, were carefully assessed. The average follow-up period was 11.25 ± 6.41 years, providing valuable insights into treatment durability and effectiveness.

The diagnosis was confirmed via imaging, serological tests, and pathological examination. The clinical symptoms included lumbago with lower limb numbness (25 %) and urinary and fecal incontinence (25 %). All patients underwent surgery, with an average of 2.6 surgeries per patient. Thirteen (81.25 %) patients experienced recurrence postoperatively.

LHD is a severe and complex skeletal parasitic disease with significant diagnostic and therapeutic challenges. Effective management requires a comprehensive strategy involving surgery and additional therapies.

Cystic Echinococcosis (CE), caused by Echinococcus granulosus, primarily affects the liver and lungs, particularly in endemic regions. While commonly associated with gastrointestinal manifestations, CE can lead to severe complications that necessitate surgical intervention.

A 53-year-old female was referred due to a prolonged history of exertional dyspnea that recently worsened. Imaging studies indicated a large hydatid cyst in the right lobe of the liver and significant pleural effusion. Surgical management was conducted via thoracotomy, facilitating the excision of multiple cysts and drainage of the pleural fluid.

This case illustrates the potential for respiratory symptoms to emerge from hydatid cyst infections, which often present with digestive issues. Effective diagnostic techniques are crucial for identifying the cysts and assessing their impact on surrounding structures. The surgical intervention not only relieved the patient's symptoms but also mitigated the risk of further complications associated with untreated cysts.

The findings underscore the importance of recognizing atypical presentations of hepatic hydatid cysts. Timely surgical intervention was essential in managing the patient's condition, highlighting the critical role of prompt diagnosis and treatment in preventing serious complications.

Human alveolar echinococcosis caused by Echinococcus multilocularis is an important zoonotic disease in the northern hemisphere. The life cycle of E. multilocularis is maintained primarily in wild animals and requires an intermediate host (mainly small mammals). Human can become an intermediate host through accidental ingestion of E. multilocularis eggs. Hokkaido Prefecture is the only area of Japan in which human alveolar echinococcosis is endemic. The purposes of this study were to elucidate the land use ecological factors associated with the density of red fox feces along paved roads and the relationship between the distributions of red fox (Vulpes vulpes) populations and fox feces, which determine the level of hazard from eggs.

A series of surveys was conducted in the central part of the Nemuro Peninsula of Hokkaido, excluding urban areas, over a total of 4 years in May-June in 2014 and 2016-2018 when red foxes remain with their cubs around the dens. Transects of 500 m were set up on paved roads, and feces within the transects were counted. Univariable and multivariable analyses were performed to examine ecological factors including the principal components (PCs) of five land use-type occupancy proportions within 500 m and 1 km, respectively, as explanatory fixed-effect variables. The number of feces in each transect was examined as the response variable using integrated nested Laplace approximation with negative binomial errors with a spatio-temporal autocorrelations structure to separate the effects of similarities of neighboring locations and annual variation. The multivariable models with the lowest widely applicable information criterion values were selected.

The feces density was explained by the PC of the 500- m buffer (-0.27, 2.5th and 97.5th percentiles: -0.44, -0.10) characterized by mixed forests (-0.82) and scarcity of residential areas (0.29) and the proximity to the nearest livestock farm house (-0.35, 2.5th and 97.5th percentiles: -0.53, -0.17). This suggested that foxes defecate in the areas where prey is abundant, avoiding humans.

Policy discussions regarding bait distribution design targeting these conditions should be initiated.

A hydatid cyst is a parasitic disease caused by the development of the larval form of Echinococcus granulosus (1). The liver and lungs are the most frequent locations, while pancreatic involvement is unusual (<1 %), even in countries where hydatid disease is endemic (2). We report a rare case of a hydatid cyst of the pancreas, revealed by acute pancreatitis. Through this observation and a review of the literature, we discuss the diagnostic and therapeutic challenges of this rare localization of a hydatid cyst.

A 60-year-old man from rural southwestern Tunisia, with a medical history of cardiac conduction disorder such as atrioventricular block treated with a pacemaker and type II diabetes for 10 years, presented with epigastric pain and periodic episodes of vomiting for the past 2 years. The patient noticed a recent exacerbation of the pain over the last 3 months. On physical examination, there was no jaundice or fever. Mild tenderness of the entire supramesocolic region of the abdomen was revealed, and no palpable mass was evident. Biological tests showed an elevation of lipase to 5 times the normal level and an increased leukocyte count of 12,000/dL. Liver function tests were normal. The CT scan indicated pancreatitis, Balthazar grade E, with cystic formation in the tail of the pancreas extending into the dilated Wirsung duct. The echinococcal immunological test (ELISA) was positive, and tumor markers (CEA, CA 19-9) were negative. The diagnosis of a pancreatic hydatid cyst with pancreatitis was considered. The patient underwent surgery 2 months after the onset of pancreatitis. A left splenopancreatectomy was performed. Histopathological examination confirmed the presence of a hydatid cyst. Following an uneventful postoperative period, the patient was discharged on the 7th postoperative day. The patient was treated with Penicillin V (Oracillin®) 2 million IU per day for 2 years and Albendazole 800 mg per day for 2 months after surgery. At 1 year post-surgery, no hydatid recurrence was detected, and hydatid serology was negative.

Finally, We reported the case of a rare observation of hydatid cyst of the pancreas revealed by acute pancreatitis.

We highlighted the necessity to consider the hydatid origin when evaluating complicated cystic pancreatic tumors, especially in endemic regions.

Hydatid cyst contamination in food presents a persistent and pervasive threat to public health. Hence, several studies have been published on hydatid cysts in raw meat products. The current study aimed to meta-analyze the prevalence of hydatid cysts in meat. The search was performed in international databases, including PubMed, Web of Science, Scopus, and Google Scholar, from January 1, 2000, to February 10, 2024. A meta-analysis of prevalence was conducted using the metaprop command in the subgroups of countries, animals, and WHO regions. Meta-regression of the prevalence of hydatid cysts in meat over time and sanitation services ranking was conducted using a random effects model (restricted maximum--likelihood). Fifty-seven published references with 130 data reports were included in the study. The lowest and highest prevalence of hydatid cysts in raw meat was observed in Sudan at 0.01%, 95%CI (0.01-0.02) and Italy at 69.86%, 95%CI (68.14-71.55), respectively. The highest prevalence of hydatid cysts was observed in Sheep (12.32%), Cattle (11.85%), and Buffalo (10.65%). The lowest and highest prevalence of hydatid cysts was South-East Asian Reg (2.77%) and European Region (33.21%), respectively. Meta-regression showed that the prevalence of hydatid cysts has significantly decreased over time (p-value = 0.021) and insignificantly decreased with sanitation services ranking (p-value = 0.679). Therefore, in order to maintain the existing conditions and even reduce the burden of hydatidosis, public health education, promotion of hygienic practices, and investment need to be carried out continuously.

Cystic echinococcosis, although rare in Europe, presents a diagnostic challenge when encountered, especially in atypical locations such as the mesentery. This case report is significant because it highlights the unique presentation of mesenteric hydatid cysts, emphasizing the importance of considering uncommon etiologies in differential diagnosis, particularly in immigrant populations. The novelty of this case lies in its rarity and the diagnostic dilemma it posed, ultimately leading to successful management through prompt recognition and accurate diagnosis. A 33-year-old pregnant female from East Africa presented with intermittent abdominal pain during pregnancy. Imaging revealed a cystic mass adjacent to the mesentery, initially misdiagnosed as an ovarian cyst. Postpartum, she developed acute abdominal symptoms, leading to a revised diagnosis of a ruptured hydatid cyst. Antiparasitic treatment and surgical intervention were initiated, resulting in successful management. This case underscores the necessity of prompt recognition and accurate diagnosis of rare conditions such as mesenteric hydatid cysts, particularly in immigrant populations. A multidisciplinary approach is crucial for optimal patient care in such cases.

Parasites have attained a life-long stigma of being detrimental organisms with deleterious outcomes. Yet, recently, a creditable twist was verified that can dramatically change our perception of those parasites from being a source of misery to millions of people to a useful anti-cancerous tool. Various parasites have shown promise to combat cancer in different experimental models, including colorectal, lung, and breast cancers, among others. Helminths and protozoan parasites, as well as their derivatives such as Echinococcus granulosus protein KI-1, Toxoplasma gondii GRA15II, and Trypanosoma cruzi calreticulin, have demonstrated the ability to inhibit tumor growth, angiogenesis, and metastasis. This article provides an overview of the literature on various cancer types that have shown promising responses to parasite therapy in both in vitro and in vivo animal studies. Parasites have shown anti-neoplastic activity through a variety of mechanisms that collectively contribute to their anti-cancer properties. These include immunomodulation, inhibition of angiogenesis, and molecular mimicry with cancer cells. This review article sheds light on this intriguing emerging field and emphasizes the value of collaborative multidisciplinary research projects with funding agencies and pharmaceutical companies. Thus, these strategies would secure continuous exploration of this new avenue and accelerate the advancement of cancer therapy research. Although experimental studies are heavily conducted by leaps and bounds, further steps are definitely lagging. Upgrading research from the experimental level to the clinical trial would be a wise progression toward efficient exploitation of the anti-neoplastic capabilities of parasites, ultimately saving countless lives.

Echinococcus granulosus larvae can cause cystic echinococcosis (CE, also known as hydatid disease) in humans. The latent phase of hydatid disease lasts for years as a result of the slow growth of the cysts, which only become symptomatic when they are large. Therefore, CE is seldomly seen in very young children. Here we present a 4-year-old boy with two giant asymptomatic abdominal cysts. Ultrasound was inconclusive in regard to the nature of the cysts and serology for echinococcosis was negative, rendering CE improbable also in view of the young age. Nevertheless, in the absence of other conclusive explanations, the patient was started on albendazole. A subsequent diagnostic percutaneous puncture with direct microscopy of cyst fluid revealed parasitological evidence of echinococcosis. This case report shows that CE can present with giant cysts also at very young age and should be considered as a possible diagnosis in all children with giant abdominal cysts.

Cystic echinococcosis, resulting from infection with Echinococcus granulosus, poses a significant challenge as a neglected tropical disease owing to the lack of any known effective treatment. Primarily affecting under-resourced, remote, and conflict-ridden regions, the disease is compounded by the limitations of current detection techniques, such as microscopy, physical imaging, ELISA, and qPCR, which are unsuitable for application in these areas. The emergence of CRISPR/Cas12a as a promising tool for nucleic acid detection, characterized by its unparalleled specificity, heightened sensitivity, and rapid detection time, offers a potential solution. In this study, we present a one-pot CRISPR/Cas12a detection method for E. granulosus (genotype G1, sheep strain) integrating recombinase polymerase amplification (RPA) with suboptimal protospacer adjacent motif (PAM) and structured CRISPR RNA (crRNA) to enhance reaction efficiency. The evaluation of the assay's performance using hydatid cyst spiked dog feces and the examination of 62 dog fecal samples collected from various regions of Western China demonstrate its efficacy. The assay permits visual observation of test results about 15 minutes under blue light and displays superior portability and reaction speed relative to qPCR, achieving a sensitivity level of 10 copies of standard plasmids of the target gene. Analytic specificity was verified against four tapeworm species (E. multilocularis, H. taeniaeformis, M. benedeni, and D. caninum) and two other helminths (T. canis and F. hepatica), with negative results also noted for Mesocestoides sp. This study presents a rapid, sensitive, and time-efficient DNA detection method for E. granulosus of hydatid cyst spiked and clinical dog feces, potential serving as an alternative tool for field detection. This novel assay is primarily used to diagnose the definitive host of E. granulosus. Further validation using a larger set of clinical fecal samples is warranted, along with additional exploration of more effective approaches for nucleic acid release.

Hydatid disease, also known as echinococcosis, is a zoonotic parasitic infection caused by the larvae of the Echinococcus tapeworm. It is endemic in various regions worldwide, particularly in rural areas of countries in southern South America, Central Asia, China, parts of Africa, the Mediterranean, and parts of the Middle East. The disease primarily affects the liver (60-70% of cases) and the lungs (10-25% of cases), but it can involve any organ, including the brain, bones, and rarely the pelvic region, as seen in our case report. Hydatid disease typically follows an asymptomatic course in the early stages of the primary infection and may remain so potentially for years or even permanently. If symptoms occur, they depend on various factors, such as the number, size, and location among other factors. Typically, hydatid disease presents with nonspecific symptoms. Common symptoms include abdominal pain, hepatomegaly, as well as anaphylaxis in case of cyst rupture. Extrahepatic intra-abdominal isolated hydatic cyst is a rare finding (6-11%).

In our case, a 70 year-old Asian white male presented with right thigh pain radiating to the lower leg, which is an atypical presentation for an extrahepatic intraabdominal hydatid cyst. Primary intraabdominal hydatid cysts involving the pelvic region are relatively rare, and such cases pose diagnostic and management challenges.

This case report underscores the challenges in diagnosing and managing extrahepatic intraabdominal hydatid cysts, particularly in atypical presentations. A combination of clinical evaluation, serological studies, and imaging techniques facilitates accurate diagnosis.

Echinococcosis is a uncommon condition in pediatric patients, and encompasses alveolar and cystic forms, predominantly affecting the lungs and liver. Transmission occurs primarily through zoonotic means, such as the contamination of water and food by infected dog and other canid feces. Diagnosis can be challenging due to nonspecific symptoms that often mimic pneumonia.

A 6-year-old female patient from a rural area in Ecuador who initially presented with nonspecific symptoms indicative of pneumonia. However, further investigation into socio-environmental factors led to a diagnosis of pulmonary and hepatic hydatid disease.

The timely and accurate diagnosis of this infectious disease enabled the patient to receive appropriate treatment and surgical intervention, leading to her complete recovery.

Echinococcosis, one of the most serious and life-threatening parasitic forms of zoonosis worldwide, is caused by the larvae of Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis). Various drugs are being applied clinically to treat zoonosis; however, their therapeutic efficacy remains a great challenge, especially with albendazole as the preferred drug of choice. Receptor tyrosine kinase (RTK) signaling controls normal cellular proliferation, differentiation, and metabolism in humans and mammals, which are intermediate hosts of E. granulosus and E. multilocularis. Disruption of RTK signaling can cause various forms of carcinogenesis and exacerbate the progression of certain forms of parasitic disease. As a result, a significant number of studies on tyrosine kinase inhibitors (TKIs) have been conducted for the treatment of cancer and parasitic infection, with some TKIs already approved for clinical use for cancer. Notably, RTK signaling has been identified in the parasites E. granulosus and E. multilocularis; however, the mechanisms of RTK signaling response in Echinococcus-host intercommunication are not fully understood. Thus, understanding the RTK signaling response in Echinococcus-host intercommunication and the potential effect of RTK signaling is crucial for identifying new drug targets for echinococcosis. The present review illustrates that RTK signaling in the host is over-activated following infection by E. granulosus or E. multilocularis and can further facilitate the development of metacestodes in vitro. In addition, some TKIs exert strong parasitostatic effects on E. granulosus or E. multilocularis, both in vitro and/or in vivo, through downregulation of RTK signaling molecules. The summarized findings suggest that RTK signaling may be a promising drug target and that TKIs could be potential anti-Echinococcus drugs warranting further research.

Parasitic infections by Echinococcus granulosus are rare in Germany, and predominantly affect individuals with a migration background. Liver and lungs are the most commonly affected organs. Pulmonary cysts often remain asymptomatic until rupture, at which point symptoms may manifest. The diagnostic approach typically involves a combination of imaging modalities and serological tests, occasionally supplemented by molecular genetic methods. Given the global movements of migration, considerations of the epidemiology of common diseases in the country of origin should also be taken into account in the differential diagnosis. We present the unusual case of a pneumogenic sepsis in a young man from Syria, where the combination of medical history alongside radiological, serological, and molecular genetic investigations ultimately led to the diagnosis of a severe pulmonary echinococcosis with rupture.

Hydatid disease is an endemic parasitic infection caused by the larval stages of the tapeworm Echinococcus. It is highly endemic in Kazakhstan, with both Echinococcus granulosus and Echinococcus multilocularis widely distributed throughout the country. Hydatid disease can affect almost any organ in the body, with the liver and lung being the most common sites, while cardiac involvement is rare. We report a case of a young female presenting with a 1-year history of stabbing precordial pain, shortness of breath, and weakness. She had a hydatid cyst involving the myocardium of the left ventricle and the left lobe of the liver. The patient underwent surgical resection and received albendazole medication as part of the treatment regimen.

Albendazole (ABZ) is a highly effective yet poorly water-soluble antiparasitic drug known to form salts (ABZ-FMA, ABZ-DTA, and ABZ-HCl) with fumaric acid (FMA), D-tartaric acid (DTA), and hydrochloric acid (HCl). This research utilized a range of analytical techniques, including Fourier transform infrared spectroscopy (FT-IR), nuclear magnetic resonance hydrogen spectroscopy (1H NMR), powder X-ray diffraction (PXRD), dynamic vapor sorption (DVS), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM), to validate and characterize the solid-state properties of these drug salts. This study also assessed the solubility and intrinsic dissolution rate (IDR) of these salts under different pH conditions compared to the active pharmaceutical ingredient (API) and conducted stability studies. Moreover, the in vivo pharmacokinetic performance of ABZ salt was evaluated. The results of this study reveal that the new solid form of ABZ is primarily associated with amino acid esters and benzimidazole groups, forming intermolecular interactions. All three ABZ salts significantly improved the solubility and dissolution rate of ABZ, with ABZ-HCl demonstrating the optimal performance. Importantly, the drug salt exhibited robust physical stability when exposed to adverse conditions, including strong light irradiation (4500 ± 500 lux), high humidity (92.5 ± 5% relative humidity), elevated temperatures (50 ± 2 °C), and accelerated test conditions (40 °C/75 ± 5% relative humidity). Lastly, the in vivo pharmacokinetic analysis demonstrated that ABZ salt led to a substantial increase in AUC(0-24) and Cmax compared to ABZ. This elevation in solubility in aqueous solvents signifies that ABZ salt exhibits characteristics that can enhance oral bioavailability and pharmacokinetics. These findings provide potential solutions for the development of more effective and innovative drug formulations.

Cystic echinococcosis, also known as hydatid disease, is a chronic and endemic illness caused by infection with a parasite called Echinococcus granulosus. In Romania, this disease has an incidence rate of 5.6 per 100,000 individuals, which is the highest in the Dobrogea region. The liver is the most affected site, accounting for 68.8% of cases, followed by the lungs at 17.2%. While cases of hydatid disease in the genital organs are rare, occurring at an incidence rate of only 0.5%, it is worth noting that cases of this disease in pregnancy worldwide are also rare, occurring at an incidence rate of 1 in 20,000 to 1 in 30,000 pregnancies.

A 15-year-old Eastern-European woman who was 12 weeks pregnant presented to the emergency room with acute pelvic pain, dysuria, and frequent urination. Her laboratory tests showed that she had a urinary tract infection, and pelvic ultrasound revealed that she had a mass on her right adnexa. Despite receiving treatment, her symptoms did not improve, and she had to undergo surgery to remove the mass, which turned out to be a hydatic cyst. She also had to undergo a cesarean section to deliver her baby owing to fetal distress during labor.

This medical case report provides a detailed description of a pelvic hydatid cyst that was discovered during pregnancy. What makes this case particularly noteworthy is the cyst's unusual location-it was found at the level of the right broad ligament of the uterus. Despite the complexity of the situation, the patient was able to receive effective treatment and the cyst was successfully managed with great outcomes for both the patient and the newborn. We hope that this report serves as a valuable example of how medical professionals can navigate challenging cases and provide optimal care for their patients.

Alveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs.

We present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries.

The multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary.

Hydatidosis is a zoonotic parasitic disease caused by the cystic stage of Echinococcus species. Intrathoracic extrapulmonary hydatid cysts causing eventration are very rare. Here, we report a case of a 62-year-old female who presented with chest pain, intermittent coughing, general weakness, and fever. On auscultation, there were diminished respiratory sounds at the base of the left lung. A computed tomography scan showed a cystic formation with an ambiguous location involving the left lower thorax and the left hypochondrium. Complete surgical resection is the standard treatment for intrathoracic extrapulmonary hydatid cysts. Due to the direct bordering of the cyst with the pericardium in the left cadiophrenic angle, a cystotomy and evacuation of the cystic cavity were performed, followed by washing it with povidone and hyperosmolar saline. The location of the hydatid cyst has an important role in determining the surgical approach, as the unusual location could affect the possibility of radically removing the cyst.

Echinococcosis, a parasitic infection caused by Echinococcus tapeworms, can cause various symptoms depending on the location and size of the cysts. This article explores the complexities of echinococcosis, including its transmission cycle, clinical manifestations, diagnosis, and treatment approaches. The review highlights the challenges associated with diagnosing the different echinococcosis types, including cystic echinococcosis, alveolar echinococcosis, and polycystic echinococcosis. Each form of the disease necessitates a unique diagnostic approach that often combines serological tests, imaging techniques, and histological analysis. The article explores treatment options for each type of echinococcosis, including surgical resection, medication, and minimally invasive procedures such as puncture-aspiration-injection-reaspiration (PAIR). The article acknowledges current treatment methods' limitations and emphasises the need for further research into improved diagnostics, drug targets, and preventative measures. This review aims to provide a comprehensive overview of echinococcosis, encompassing its transmission, clinical presentation, diagnosis, and treatment modalities. By outlining the complexities of the disease and highlighting areas for future research, the article hopes to contribute to improved disease management and control. Key findings of the review include the identification of significant diagnostic challenges in differentiating between cystic, alveolar, and polycystic echinococcosis, the varying efficacy of treatment modalities such as surgical resection and PAIR, and the urgent need for further research into enhanced diagnostic methods, novel drug targets, and effective preventative strategies.

This report comprises the 14th assessment of the Echinococcus multilocularis surveillance scientific reports, provided by Finland, Ireland, United Kingdom (Northern Ireland) and Norway on their respective surveillance programmes. Every year since 2012, EFSA presents the assessment to the European Commission in which the sampling strategy, data collection and detection methods used by these countries are evaluated. More specifically, the surveillance programmes of these four countries are evaluated by checking the information submitted by each of them and verifying that the technical requirements are fulfilled as laid down in Commission Delegated Regulation (EU) 2018/772 of 21 November 2017 supplementing Regulation (EU) No 576/2013 of the European Parliament and of the Council with regard to preventive health measures for the control of Echinococcus multilocularis infection in dogs, and repealing Delegated Regulation (EU) No 1152/2011. The information is divided into four different categories for assessment: the type and sensitivity of the detection method, the selection of the target population, the sampling strategy and the methodology. For each category, the main aspects that need to be considered in order to accomplish the technical requirements of the legislation are checked against compliance of several criteria. The countries participating in this surveillance (Finland, Ireland, the United Kingdom (Northern Ireland) and Norway) succeeded in the fulfilment of the technical legal requirements foreseen in Commission Delegated Regulation (EU) 2018/772 concerning these four different categories. None of the four countries recorded positive samples in the 12-month reporting period.

Hydatid cyst disease, caused by the larval stage of Echinococcus granulosus, is a parasitic infection endemic in many regions, including South Asia. We present a case of a 36-year-old South Asian female with concurrent liver and peritoneal hydatid cysts, emphasizing the diagnostic challenges and management complexities associated with this condition. The patient presented with abdominal pain, nausea, and decreased appetite, and imaging studies revealed characteristic cystic lesions in the liver and peritoneum. Initial medical management with albendazole was followed by surgical excision due to inadequate response to therapy. Postoperative care included prophylactic albendazole to prevent recurrence. This case highlights the importance of a multidisciplinary approach involving medical therapy and surgical intervention tailored to the individual patient's needs and disease presentation.

This report describes a male in his late 20s who presented with a 2-month history of recurrent haemoptysis and chest pain. A chronic infection, such as tuberculosis, was suspected. He had undergone surgical resection of an intrapericardial hydatid cyst in the past. His blood investigations showed peripheral eosinophilia, and his chest X-ray showed a cystic oval lesion in the left upper zone. A CT pulmonary angiogram revealed filling defects in the bilateral segmental and subsegmental arteries with a cystic lesion in the left upper lobe. Further workup, including bronchoalveolar lavage culture and MRI of the thorax, confirmed the diagnosis of a hydatid cyst of pulmonary echinococcosis. This case illustrates the presentation of multisystemic echinococcosis in a young male with no other risk factors, initially treated with surgical resection and antihelminthic therapy. The disease later recurred, which required prolonged medications, which brought the patient into remission.