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Giorgio A, Ciracì E, De Luca M, Stella G, Giorgio V. Hepatic abscess and hydatid liver cyst: European infectious disease point of view. World J Hepatol 2025; 17:103325. [PMID: 40027570 PMCID: PMC11866163 DOI: 10.4254/wjh.v17.i2.103325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 12/25/2024] [Accepted: 01/21/2025] [Indexed: 02/20/2025] Open
Abstract
This manuscript is based on a recent study by Pillay et al that was published in recently. Liver abscesses can be caused by rare potentially life-threatening infections of either bacterial or parasitic origin. The incidence rate in Europe is lower than in developing countries, but it is a major complication with high morbidity, particularly in immunocompromised patients. They are most frequently caused by Enterobacterales infections, but hypervirulent Klebsiella strains are an emerging problem in Western countries. Amoebiasis has been a public health problem in Europe, primarily imported from other endemic foci. At the same time, this infection is becoming an emerging disease, as the number of infected patients who have not traveled to endemic areas is rising. Treatment options for hydatid liver cyst include chemotherapy, open or laparoscopic surgery, percutaneous treatment (percutaneous aspiration, re-aspiration and injection and its modification) and ''wait and watch'' strategy. Most hydatid liver cyst patients in Pillay et al's study received surgical treatment, but several studies have confirmed the safety and efficacy of percutaneous aspiration, re-aspiration and injection.
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Affiliation(s)
- Antonio Giorgio
- Liver Unit, Athena Clinical Center, Piedimonte 81016, Caserta, Italy.
| | - Emanuela Ciracì
- Ospedale Civile di Ostuni (BR), Medicina Interna, Ostuni 72017, Brindisi, Italy
| | | | - Giuseppe Stella
- Department of Pediatric and Women, Children and Public Health Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica Del Sacro Cuore, Rome 00168, Italy
| | - Valentina Giorgio
- Department of Pediatric and Women, Children and Public Health Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica Del Sacro Cuore, Rome 00168, Italy
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Qin M, Yang G, Yan J, Wang L, Feng Y, Wang D, Wang Q, Hou Y, Zhao J, Lei J, Wang Z, Jiang M, Yu C, Gavotte L, Frutos R. Assessment of compliance and therapeutic efficacy of albendazole treatment in Chinese patients with echinococcosis. Infect Dis Poverty 2024; 13:98. [PMID: 39707489 DOI: 10.1186/s40249-024-01268-3] [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: 07/23/2024] [Accepted: 12/04/2024] [Indexed: 12/23/2024] Open
Abstract
BACKGROUND Echinococcosis is an infectious parasitic disease that is extremely harmful to human health. Albendazole is provided free of charge to patients requiring medication under the central government finance transfer payment scheme for echinococcosis control and prevention in China. Our aim is to monitor the state of patient medication and its therapeutic impact, which will help improve medication compliance and the therapeutic effect. METHODS Random cluster sampling was used to select 10 echinococcosis-endemic counties in China, and all albendazole-treated patients in these counties were investigated. The chi-square and Kruskal-Wallis tests were used to compare two or more rates or constituent ratios, and multiple logistic regression analysis was used to identify the influencing factors. The records of patients were reviewed to obtain the initial diagnosis results as well as the most recent follow-up results and time, and efficacy was assessed. RESULTS We examined 899 patient files treated with albendazole in 10 endemic counties. Of the 582 evaluable files, 7.9% did not take albendazole, and 69.2% did not take albendazole regularly. Only 22.9% took albendazole regularly. Of the 536 patients who took albendazole, 242 exhibited adverse reactions. Patients who were Tibetan, herdsmen, received no formal education, used emulsion, and exhibited adverse reactions demonstrated poor compliance. A total of 174 patients with cystic echinococcosis received their most recent imaging follow-up results within one year of the investigation date. Among them, 9 patients met the criteria for cure, accounting for 5.2%; 56 patients showed effectiveness, accounting for 32.2%; 105 patients were deemed ineffective, accounting for 59.8%; 5 patients experienced recurrence, accounting for 2.9%. CONCLUSIONS Albendazole medication compliance in patients with echinococcosis is not ideal. We must prioritize health education and promotion for Tibetans, herdsmen, and those without formal education. Patients who adhered to their medication regimen achieved higher rates of cure and effectiveness. To improve medication compliance and efficacy, it is particularly important to improve communication and medication guidance for patients receiving emulsions and those with adverse reactions after taking albendazole. Simultaneously strengthen patients' attention to follow-up and re-examination.
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Affiliation(s)
- Min Qin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China
- Chaoyang District Center for Diseases Prevention and Control of Beijing, Beijing, China
| | - Guobing Yang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jun Yan
- Chinese Centre for Disease Control and Prevention, Beijing, China.
| | - Liying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China.
| | - Yu Feng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Dong Wang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Qian Wang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Yanyan Hou
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Jiangshan Zhao
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Jiaxi Lei
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China
| | - Zhiyi Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China
| | - Mingzhe Jiang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China
| | - Chenghang Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Centre for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases, National Centre for International Research On Tropical Diseases, Shanghai, China
| | - Laurent Gavotte
- Espace-Dev, UMR 228, Université de Montpellier, Montpellier, France
| | - Roger Frutos
- Centre de Cooperation International en Recherche Agronomique Pour Le Développement, UMR 17, Intertryp, Campus International de Baillarguet, Montpellier, France
- Faculty of Medicine-Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Warasna HJM, Abuzaina KN, Fakhouri SN, Shahin FBY, Awad BYH, Awad MYH, Banat MA, Smerat MI. Resolution of infertility following hydatid cyst removal: a case report. Ann Med Surg (Lond) 2024; 86:6835-6842. [PMID: 39525722 PMCID: PMC11543199 DOI: 10.1097/ms9.0000000000002602] [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: 07/09/2024] [Accepted: 09/17/2024] [Indexed: 11/16/2024] Open
Abstract
Introduction and importance Human echinococcosis, also known as 'hydatid cyst,' constitutes a zoonotic parasitic disease attributed to Echinococcus granulosus or Echinococcus multilocularis. Primary afflictions occur in the liver and lungs, whilst the implication of alternative organs remains infrequent. The clinical presentation can vary, and large cysts may cause compression symptoms and complications. This case involved a 21-year-old Palestinian female with three large hydatid cysts in the liver, causing compression of adjacent structures and unique clinical manifestations. Case presentation A female aged 21 arrived with signs of heart palpitations, shortness of breath, tiredness, and pain in the right upper abdomen, alongside a background of infertility. During routine pre-IVF ultrasound, three liver hydatid cysts were unexpectedly found, leading to a referral to the surgical department. Laboratory tests and imaging confirmed this diagnosis. The surgery involved cyst aspiration, hypertonic saline injection, and marsupialization. Post-surgical complications were managed as they occurred. The symptoms lessened afterward, and a successful pregnancy was achieved 9 months post-surgery. Clinical discussion Zoonotic infection by cystic echinococcosis (CE) primarily engages the liver and lungs. The progression of symptoms is contingent upon cyst placement and resultant pressure on adjacent tissues. Diagnosis requires imaging alongside serological assays, while large cysts necessitate surgical intervention. Conclusion The presented case underscores the complexity of managing multiple extensive liver hydatid cysts, highlighting the necessity to consider hydatid disease amidst patients presenting with indeterminate symptoms, particularly within endemic zones. An extensive surgical strategy produced positive outcomes, illustrating the significance of prompt intervention for symptom alleviation and sustained patient health.
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Affiliation(s)
| | | | | | | | | | | | - Mohamad A. Banat
- Faculty of Medicine, Palestine Polytechnic University, Hebron, State of Palestine
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Bold B, Schindler C, Narankhuu U, Shagj A, Bavuujav E, Sodov S, Nyamdorj T, Zinsstag J. The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia. Trop Med Infect Dis 2024; 9:163. [PMID: 39058205 PMCID: PMC11281321 DOI: 10.3390/tropicalmed9070163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, is significantly underreported in Mongolia due to geographical remoteness, a lack of early diagnostics, and poor clinical management. This study aimed to provide a more accurate estimate of CE in Mongolia by comparing data from surgical (reported) and diagnosed (unreported) cases and assessing the challenges faced by rural doctors in disease management and surveillance. We collected data on surgical cases hospitalized between 2006 and 2016 and newly diagnosed CE cases in 2016 from eight provinces. Using a quasi-Poisson regression model, we extrapolated the collected data to estimate the number of diagnosed cases for the entire country. Additionally, forty health professionals from all 21 provinces rated local clinical management for CE through a questionnaire. The results reveal that surgical cases (2.2 per year) represent only one-eighth of diagnosed cases (15.9 per year). The laboratory facilities, disease reporting, and cyst classification usage scored below 2. These results highlight the significant underreporting of CE in Mongolia and urge human and animal health experts, along with policymakers, to invest in combating CE, particularly in remote provincial areas. This study also emphasizes the need for standard clinical management involving cyst classification according to the WHO-IWGE and seamless integration of CE reporting and monitoring mechanisms, which can significantly contribute to the national and global burden estimation of CE.
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Affiliation(s)
- Bolor Bold
- National Center for Zoonotic Disease, Ulaanbaatar 18131, Mongolia; (U.N.); (A.S.); (T.N.)
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (C.S.); (J.Z.)
- Department of Public Health, Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
- School of Global Health, Chinese Centre for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (C.S.); (J.Z.)
- Department of Public Health, Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Uranshagai Narankhuu
- National Center for Zoonotic Disease, Ulaanbaatar 18131, Mongolia; (U.N.); (A.S.); (T.N.)
| | - Agiimaa Shagj
- National Center for Zoonotic Disease, Ulaanbaatar 18131, Mongolia; (U.N.); (A.S.); (T.N.)
| | - Erdenebileg Bavuujav
- Mongolian Society of Diagnostic Ultrasound, Ulaanbaatar 210648, Mongolia; (E.B.); (S.S.)
| | - Sonin Sodov
- Mongolian Society of Diagnostic Ultrasound, Ulaanbaatar 210648, Mongolia; (E.B.); (S.S.)
| | - Tsogbadrakh Nyamdorj
- National Center for Zoonotic Disease, Ulaanbaatar 18131, Mongolia; (U.N.); (A.S.); (T.N.)
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland; (C.S.); (J.Z.)
- Department of Public Health, Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
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Luo X, Jiang P, Ma J, Li Z, Zhou J, Wei X, A J, Chai J, Lv Y, Cheng P, Cao C, A X. Circulating free DNA as a diagnostic marker for echinococcosis: a systematic review and meta-analysis. Front Microbiol 2024; 15:1413532. [PMID: 39021627 PMCID: PMC11251952 DOI: 10.3389/fmicb.2024.1413532] [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: 04/07/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Echinococcosis is a chronic zoonotic disease caused by tapeworms of the genus Echinococcus. The World Health Organization (WHO) has identified encapsulated disease as one of 17 neglected diseases to be controlled or eliminated by 2050. There is no accurate, early, non-invasive molecular diagnostic method to detect echinococcosis. The feasibility of circulating free DNA as a diagnostic method for echinococcosis has yielded inconclusive results in a number of published studies. However, there has been no systematic evaluation to date assessing the overall performance of these assays. We report here the first meta-analysis assessing the diagnostic accuracy of cfDNA in plasma, serum, and urine for echinococcosis. Methods We systematically searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WeiPu databases up to 17 January 2024, for relevant studies. All analyses were performed using RevMan 5.3, Meta-DiSc 1.4, Stata 17.0, and R 4.3.1 software. The sensitivity, specificity, and other accuracy indicators of circulating free DNA for the diagnosis of echinococcosis were summarized. Subgroup analyses and meta-regression were performed to identify sources of heterogeneity. Results A total of 7 studies included 218 patients with echinococcosis and 214 controls (156 healthy controls, 32 other disease controls (non-hydatid patients), and 26 non-study-targeted echinococcosis controls were included). Summary estimates of the diagnostic accuracy of cfDNA in the diagnosis of echinococcosis were as follows: sensitivity (SEN) of 0.51 (95% CI: 0.45-0.56); specificity (SPE) of 0.99 (95% CI: 0.97-0.99); positive likelihood ratio (PLR) of 11.82 (95% CI: 6.74-20.74); negative likelihood ratio (NLR) of 0.57 (95% CI: 0.41-0.80); diagnostic ratio (DOR) of 36.63 (95% CI: 13.75-97.59); and area under the curve (AUC) value of 0.98 (95% CI: 0.96-1.00). Conclusion Existing evidence indicates that the combined specificity of circulating cfDNA for echinococcosis is high. However, the combined sensitivity performance is unsatisfactory due to significant inter-study heterogeneity. To strengthen the validity and accuracy of our findings, further large-scale prospective studies are required.Systematic review registrationThe systematic review was registered in the International Prospective Register of Systematic Reviews PROSPERO [CRD42023454158]. https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Xiaoqin Luo
- Qinghai University, Xining, China
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | | | | | - Zian Li
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Jianwu Zhou
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | | | - Jide A
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Jinping Chai
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
| | - Yanke Lv
- Qinghai University, Xining, China
| | | | | | - Xiangren A
- Qinghai University, Xining, China
- Department of Clinical Laboratory, Qinghai Provincial People’s Hospital, Xining, China
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Habibi B, Gholami S, Bagheri A, Fakhar M, Torabi M, Tabaripour R, Moradi A. Detection of circulatory E. granulosus-derived cell-free DNA in the plasma and urine of human cystic echinococcosis using an in-house PCR: a potential promising diagnostic biomarker. Mol Biol Rep 2024; 51:452. [PMID: 38536533 DOI: 10.1007/s11033-024-09385-w] [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: 10/30/2023] [Accepted: 02/26/2024] [Indexed: 02/06/2025]
Abstract
BACKGROUND The diagnostic tool for identifying cystic echinococcosis (CE) patients at an early stage is currently lacking. However, circulatory cell-free DNA (cfDNA) has shown potential as a biomarker for parasitic infections and could be used for diagnosing CE. RESEARCH DESIGN AND METHODS The plasma and urine samples were collected from 39 patients with confirmed CE through imaging and histopathological techniques. All plasma samples were tested for anti-echinococcal antibodies using a commercial ELISA test. Total plasma and urine cfDNA were extracted and an in-house PCR assay was developed to detect E. granulosus specific cfDNA in the samples of CE patients. RESULTS Out of the 39 patients, 30 tested positive for E. granulosus using serology, with a sensitivity of 76.9%. Moreover, the detection rates for the cfDNA were 79.5% in plasma samples and 58.97% in urine samples using the 80 bp COX1 gene. The plasma-based PCR and serology test showed the highest agreement (Kappa = 0.53). CONCLUSIONS Plasma-based PCR has been found to be a reliable diagnostic tool for identifying CE patients at different cyst stages. It offers validity, speed, and sufficient sensitivity, making it an alternative to serology in diagnosing CE in endemic areas.
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Affiliation(s)
- Bentolhoda Habibi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shirzad Gholami
- Toxoplasmosis Research Center, Communicable Diseases Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Mazandaran Registry Center for Hydatid Cyst, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abouzar Bagheri
- Department of Clinical Biochemistry-Biophysics and Genetics, Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
- Mazandaran Registry Center for Hydatid Cyst, Mazandaran University of Medical Sciences, Sari, Iran.
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P. O Box: 48166-33131, Sari, Iran.
| | - Mahdi Torabi
- Baghiatallah Hospital, Baghiatallah University of Medical Sciences, Tehran, Iran
| | - Rabeeh Tabaripour
- Toxoplasmosis Research Center, Communicable Diseases Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alimohammad Moradi
- Department of General surgery Division of HPB and transplantation surgery, Tehran University of Medical Sciences, Tehran, Iran
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文 家, 王 奇, 费 帆, 廖 晓, 陈 勇, 袁 莉, 陈 增, 陈 隆, 徐 如, 刘 进. [Clinical Features and Surgical Outcomes of 15 Cases of Intracranial Alveolar Echinococcosis]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1250-1255. [PMID: 38162060 PMCID: PMC10752774 DOI: 10.12182/20231160603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Indexed: 01/03/2024]
Abstract
Objective To investigate the surgical treatment strategy of intracranial alveolar echinococcosis (AE) and the clinical outcomes. Methods The clinical and follow-up data of 15 intracranial AE patients who underwent surgical treatment in the Departments of Neurosurgery of Sichuan Provincial People's Hospital (SPPH) and People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture (a branch hospital of SPPH) between March 2017 and January 2021 were retrospectively analyzed. Full follow-up data were available for each of the 15 cases. The clinical and imaging characteristics, general surgical information, and surgical outcomes were analyzed. Results In the 15 patients, there were a total of 50 intracranial lesions, with an average of (3.3±3.1)/case. Four cases had solitary intracranial lesions, while 11 cases had multiple lesions, with the number of intracranial lesions per case ranging from 2 to 13. All patients with solitary intracranial lesions received total resection. In 6 patients with multiple intracranial lesions, only the largest lesion was surgically removed, and in 5 patients, 2 to 3 adjacent lesions were surgically removed. All but one patient had extracranial lesions in their liver, lungs, kidneys, adrenal glands, and thoracic vertebrae. The patients were followed up for 12 to 58 months after surgery, with the mean follow-up time being (28.1±13.4) months. Among the 15 cases, 13 showed stable intracranial condition during postoperative follow-up. Intracranial lesions recurred in 2 patients who had deep lesions accompanied by dissemination to the subarachnoid space. Two patients died during follow-up. Conclusion Microsurgical treatment of intracranial AE is effective, but total surgical resection is difficult to accomplish when patients have echinococcosis lesions located at a depth, especially when the lesions are spreading to the subarachnoid space. The prognosis of patients is closely associated with the extent of lesion invasion and the control of systemic hydatid lesions, especially those in the liver.
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Affiliation(s)
- 家智 文
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 奇 王
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 帆 费
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 晓灵 廖
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 勇 陈
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 莉 袁
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 增雄 陈
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 隆益 陈
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 如祥 徐
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
| | - 进平 刘
- 阿坝藏族羌族自治州人民医院 神经外科 （马尔康 624000）Department of Neurosurgery, People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Maerkang 624000, China
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Hadipour M, Darani HY, Talebzadeh H, Eslamian M, Aboutalebian S, Harandi MF, Mirhendi H. Sensitive detection of specific cell-free DNA in serum samples from sheep with cystic echinococcosis. PLoS Negl Trop Dis 2023; 17:e0011715. [PMID: 37856565 PMCID: PMC10617735 DOI: 10.1371/journal.pntd.0011715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/31/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Developing more sensitive methods for the diagnosis of echinococcosis is essential. In this study PCR assay for sensitive detection of specific cell-free DNA (cfDNA) of Echinococcus granulosus sensu lato in the sera of the sheep naturally infected with echinococcosis was investigated. METHODS To extract cfDNA from 35 infected sheep, the modified phenol-chloroform method was used for two different volumes (0.5 and 2 ml) of serum samples. From each extracted sample, two DNA volumes (5 and 10 μl) were amplified using both standard PCR and semi-nested PCR targeting NADH dehydrogenase subunit I. RESULTS Standard and semi-nested PCR on 0.5 ml of serum samples detected Echinococcus DNA in 8 and 12 out of 35 sheep, respectively; however, using 2 ml of serum samples, they detected 24 and 27 samples. By increasing the volume of template DNA, the PCRs could detect 29 and 33 out of 35 samples. The results were confirmed by sequencing of randomly selected PCR amplicons and comparing them with GenBank databases. CONCLUSIONS Larger volumes of serum for DNA extraction, greater volumes of DNA template for PCR, and employing a semi-nested PCR protocol, increased the sensitivity of PCR to 95%. This approach can also be applied to the diagnosis of echinococcosis in humans.
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Affiliation(s)
- Mahboubeh Hadipour
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Yousofi Darani
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Talebzadeh
- Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Eslamian
- Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Aboutalebian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran; Dept. of Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Shahriarirad R, Shekouhi R, Erfani A, Rastegarian M, Eskandarisani M, Motamedi M, Sarkari B. Evaluation of the features of cystic echinococcosis with concurrent super-infection: a retrospective study in Southern Iran. BMC Infect Dis 2023; 23:525. [PMID: 37563707 PMCID: PMC10413494 DOI: 10.1186/s12879-023-08520-5] [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: 03/24/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE Superinfection of cystic echinococcosis (CE) is a life-threatening complication with significant morbidities, which can be prevented with early diagnosis and treatment. This study aims to examine the clinical characteristics, diagnostic methods, and treatment options for superinfected CE, as there is currently limited information available on the differences between superinfected and non-infected CE in terms of clinical features, serological and radiologic findings. METHODS This cross-sectional study was conducted on hospital records of patients who were diagnosed with hydatid cysts in a 15-year period (2004 to 2018) in two main university-affiliated referral centers in Fars province, southern Iran. Patients' information regarding the demographical and clinical features related to CE, age, sex, previous history of CE or recurrence, size and location of CE, and length of hospital stay were collected. Moreover, the characteristics of concurrent infections with hydatid cysts were recorded. RESULTS A total of 586 surgeries due to CE were performed on 501 patients, of which 67 (11.43%) had reoperations due to the recurrence of the disease. A total of 30 (5.99%) incidences of superinfection were observed. There were no statistically significant differences in terms of laboratory and imaging findings between CE patients with concurrent infections and other CE patients (p-value > 0.05). Among the patients with super-infection, four had fungal infections of the lungs. Aspergillus fumigatus was the causative pathogen in all four patients that were diagnosed with fungal superinfection. All patients underwent surgical excision with favorable long-term outcomes. CONCLUSION Our study revealed a 5.99% incident rate of CE superinfection. Regarding the concurrent fungal infections in hydatid cysts, the patient's symptoms and laboratory and imaging findings are inconclusive and histopathological evaluation seems to be the most reliable option. Surgical resection is the gold-standard treatment option with favorable outcomes and potentially can be curative.
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Affiliation(s)
- Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Shekouhi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Marjan Motamedi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Science, Shiraz, Iran.
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Hadipour M, Fasihi Harandi M, Mirhendi H, Yousofi Darani H. Diagnosis of echinococcosis by detecting circulating cell-free DNA and miRNA. Expert Rev Mol Diagn 2023; 23:133-142. [PMID: 36756744 DOI: 10.1080/14737159.2023.2178903] [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: 02/10/2023]
Abstract
INTRODUCTION Diagnosis of echinococcosis is difficult and usually performed based on clinical findings, imaging, and serological test. However, all of them have limitations, especially in follow-up approaches. AREAS COVERED Detection of cell-free DNA (cfDNA) and micro-RNA (miRNA) is currently a hot topic for diagnosis of echinococcosis diseases. For detecting cell-free DNA in echinococcosis patient's samples such as sera, some techniques are based on next-generation sequencing (NGS), DNA-deep sequencing, some are based on PCR-based methods, and a few works related to the detection of miRNA for the diagnosis of human echinococcosis. EXPERT OPINION In the detection of cell-free DNA in echinococcosis patient' samples, NGS and DNA-deep sequencing have shown high level of sensitivity, but are not suitable for routine clinical examination as they are expensive and inaccessible in the majority of endemic areas. However, PCR-based methods have shown a sensitivity of about 20-25%. To improve the sensitivity of these tests, improving the DNA extraction method, designing appropriate primers for detecting short-length fragments of circulating DNA, using a higher volume of a serum sample, and application of more sensitive PCR methods are recommended. In the field of miRNA detection, further works are recommended.
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Affiliation(s)
- Mahboubeh Hadipour
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
| | - Majid Fasihi Harandi
- Research center for Hydatid disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Mirhendi
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
| | - Hossein Yousofi Darani
- Department of parasitology and mycology, Faculty of medicine, Isfahan University of Medical sciences, Isfahan, Iran
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Cystic Echinococcosis in Children: Ten Years of Experience and Which Laboratory Result in Evaluating Ruptured Cases? JOURNAL OF CONTEMPORARY MEDICINE 2023. [DOI: 10.16899/jcm.1207494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Aim
Hydatid disease (Echinococcosis) is a common zoonosis in countries that are involved in livestock such as our country. Our study aims to evaluate pediatric cases with hydatid disease over the last decade in our region and to determine the significance of initial clinical and laboratory findings in distinguishing ruptured hydatid cyst cases.
Materials and Methods
A retrospective analysis was made on demographic characteristics, presenting symptoms, physical examination, laboratory and radiological findings, and treatments of children with hydatid disease who were treated in our hospital and followed up regularly between January 2011 and December 2020.
Results
The study sample of 42 cases included 19 (45.2%) girls, with a median age of 125.5 (34-209) months. The most common symptom was abdominal pain (50%), and the most common physical examination finding was decreased breath sounds (23.8%). Thirty-five (83.3%) patients had single organ involvement and 7 (16.7) patients had multiple organ involvement. Cysts were detected in the right lobe of the liver in 24 (75%) of hepatic hydatid cysts and the left lobe in 7 (58.3%) of pulmonary hydatid cysts. The median size of the cysts was 57.5 (12-140) mm. The initial IHA titer, eosinophil count, eosinophil percentage, and sedimentation value were statistically significantly higher in patients with ruptured cysts than in those without rupture (p= 0.002, p= 0.003, p= 0.003, p= 0.02, respectively).
Conclusions
Initial pathological examination findings and at initial laboratory findings such as high IHA titer, eosinophil count, eosinophil percentage, sedimentation value can be used to distinguish rupture cases.
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Gharibi Z, Rahdar M, Pirestani M, Tavalla M, Tabandeh MR. The Immunization of Protoscolices P29 DNA Vaccine on Experimental Cystic Echinococosis in Balb/c Mice. Acta Parasitol 2021; 66:1114-1121. [PMID: 33813653 DOI: 10.1007/s11686-021-00367-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/01/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Cystic Echinococosis is one of the important parasitic diseases that is considered as a problem economics and health in many parts of the world. Many efforts have been performed for controlling the disease in the world. To reach a reliable vaccine against Cystic Echinococosis is one of the important duty of governments. Several antigen of hydatid cyst for vaccine candidate have been evaluated. In this study, P-29 antigen has been used for this purpose. METHODS E.g P29 antigen was cloned in Escherichia coli and transfected into the Chinese hamster ovary cell for antigen proliferation and used for vaccination in Balb/c mice. The recombinant antigen E.g-29 was shown using Western blot test. Two dilution of DNA vaccine (pCEgP-29) including 50 µg/100 µl and 100 µg/100 µl were prepared. Twenty four Balb/C male 6-8 week mouse were divided in 4 groups. The groups were included in 2 vaccination groups (pcEg.P29 50 µg/100 µl and 100 µg/100 µl dilution) as immunized groups and 2 groups of plasmid and PBS as control. The mice were injected intramuscularly 3 times with 2 weeks interval. After 3 weeks from last injection, all groups were challenged intraperitonealy with 2000 protoscolices. After 5 months, the mice were euthanized by ketamine/xylasine injection and number, size, and weight of cysts were recorded. RESULTS Immunization rate was up to 93% in vaccinated group when compared with the control group. CONCLUSION The results of this study showed that rEg.P29 could be considered as an effective vaccine for controlling of E. granulosus prevalence in intermediated host.
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Affiliation(s)
- Zahra Gharibi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Parasitology Department, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Rahdar
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Parasitology Department, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Majid Pirestani
- Parasitology and Medical Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mehdi Tavalla
- Parasitology Department, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Reza Tabandeh
- Basic Sciences Department, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Kaya H, Karahan G, Sabah D. Is Hydatid Cyst with Musculoskeletal Involvement a Problem that Causes Morbidity? Long-Term Follow-Up and Functional Results. Indian J Orthop 2021; 56:680-688. [PMID: 35342525 PMCID: PMC8921364 DOI: 10.1007/s43465-021-00556-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/25/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of study is to evaluate the involvement characteristics of hydatid cysts, which are rarely involved the musculoskeletal system, and the results of recurrence, morbidity, and functional and mental scoring. METHODS We retrospectively investigated 18 patients with skeletal hydatid disease. Patients were categorized as those with bone or skeletal muscle involvement. Pre- and post-operative physical component scores (PCS) and mental component scores (MCS) on the functional Short Form 12-item Survey were recorded in these patients.We compared the functional scores, number of recurrences, and lesion volumes between patients with hydatid cyst of bone (HCOB) and those with hydatid cyst of soft tissue (HCOST). RESULTS This study included 11 women and 7 men with bone hydatid cysts. Patients' mean age was 38 years (range 22-70 years). Patients were followed up for a mean of 118.16 months (range 49-230 months). The mean lesion volume was 447.39 cm3 (36-1260 cm3). The 12th and 48th month PCS, the PCS was lower in the HCOB group during both periods (p = 0.04 and p = 0.001, respectively). The 48th month MCS was lower in the HCOB group (p = 0.04). Postoperative residual cysts were detected in five patients who underwent surgical treatment for bone c; all residual lesions were located in the pelvis. CONCLUSIONS Bone hydatid cysts are associated with high recurrence rates, and treatment is challenging. In view of the low functional results and high infection and recurrence rates observed in patients over long-term follow-up, particularly in those with pelvic hydatid cysts, we conclude that this disease is associated with significant morbidity.
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Affiliation(s)
- Huseyin Kaya
- grid.8302.90000 0001 1092 2592Orthopedics and Traumatology Tumor Surgery Department, Ege University Faculty of Medicine, Izmir, 35040 Turkey
| | - Gokhan Karahan
- grid.414850.c0000 0004 0642 8921Sports Traumatology, Arthroscopy, Shoulder and Elbow Surgery, Istanbul Basaksehir Pine and Sakura City Training and Research Hospital, Basaksehir Olimpiyat Bulvarı Yolu, 34480 Basaksehir, Istanbul Turkey
| | - Dündar Sabah
- grid.8302.90000 0001 1092 2592Orthopedics and Traumatology Tumor Surgery Department, Ege University Faculty of Medicine, Izmir, 35040 Turkey
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Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts. PLoS Negl Trop Dis 2021; 15:e0009648. [PMID: 34415898 PMCID: PMC8378729 DOI: 10.1371/journal.pntd.0009648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a complex disease for which clear understanding of clinical manifestations is needed to avoid misdiagnosis, inappropriate treatment, and severe complications. We evaluated the accuracy of a whole-blood stimulation test based on Interleukin (IL)-4 detection in response to Antigen B (AgB) of Echinococcus granulosus sensu lato to discriminate cyst viability and detect cyst reactivation in patients with hepatic CE. METHODOLOGY/PRINCIPAL FINDINGS Thirty patients with CE3b cysts and 37 patients with spontaneously-inactivated CE4-CE5 cysts were recruited (T0). After enrollment, 5 patients with CE3b cysts received albendazole, resulting in cyst solidification (CE4) in 4/5. Within a two-year follow-up, the whole-blood test was repeated at two time-points, in ≥14 (T1) and in ≥4 (T2) patients per group. IL-4 and a panel of other soluble factors were measured in the stimulated plasma. Baseline IL-4 levels were significantly higher in patients with CE3b compared to those with CE4 cysts (p = 0.006). Test accuracy for CE3b diagnosis had a sensitivity of 33-60% and a specificity of 76-95%, depending on the cut-off applied. Overall, IL-4 levels did not change significantly over time in either group; however, patients within the CE3b group showed a significant decrease of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF at T1 compared to T0 (p≤0.042). CONCLUSIONS/SIGNIFICANCE Whole-blood IL-4-response to AgB is significantly higher in patients with active compared to inactive CE but apparently not modulated over time after treatment. On the contrary, the levels of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF significantly decreased in active CE during follow-up. Additional studies are needed to understand whether these findings might have a clinical significance for patients' follow-up.
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Núñez-Torres OP, Chávez-Vargas AF. Prevalencia de la hidatidosis en hígados bovinos y pérdidas económicas en el camal municipal de la ciudad de Puyo-Ecuador. JOURNAL OF THE SELVA ANDINA ANIMAL SCIENCE 2020. [DOI: 10.36610/j.jsaas.2020.070200072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Núñez-Torres OP, Chávez-Vargas AF. Prevalence of hydatidosis in bovine livers and economic losses in the municipal bed of the city of Puyo-Ecuador. JOURNAL OF THE SELVA ANDINA ANIMAL SCIENCE 2020. [DOI: 10.36610/j.jsaas.2020.070200072x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mahajan S, Thapar S, Khillan V, Gupta P, Rastogi A, Gupta E. Comparative Evaluation of Echinococcus Serology with Cytology for the Diagnosis of Hepatic Hydatid Disease. J Lab Physicians 2020; 12:98-102. [PMID: 32905299 PMCID: PMC7467829 DOI: 10.1055/s-0040-1716460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objectives The purpose of this study is to determine the diagnostic efficacy of enzyme-linked immunosorbent assay (ELISA) in radiologically confirmed liver mass lesions for the diagnosis of hepatic hydatid disease (HHD) and to compare the diagnostic performance of ELISA with fine needle aspiration cytology (FNAC) (taken as standard) for HHD diagnosis. Materials and Methods This retrospective study included blood samples of 223 patients with radiologically confirmed liver mass lesions in which immunoglobulin G (IgG) anti- Echinococcus antibodies were tested using a commercial IgG ELISA (RIDASCREEN, R-Biopharm AG, Darmstadt, Germany). Results of ELISA, ultrasonography, FNAC, and liver function tests were obtained from the hospital information system. ELISA results were compared with those of FNAC to analyze the diagnostic efficacy of ELISA for HHD diagnosis. Statistical Analysis Comparison of the results obtained from ELISA was performed with respect to FNAC results (taken as standard) to analyze the diagnostic efficacy of ELISA for HHD detection. Data has been represented as median (range) or in frequencies. Wilson score was used to assess 95% confidence interval of diagnostic parameters. The analysis was performed using SPSS Version 22.0 (IBM Corp.) and Open Epi (version 3.01). Results Out of 223 cases with liver mass lesions, Echinococcus IgG was reactive in 62 (28%) cases and FNAC was positive in 16 (7.2%) cases. Since two cases were FNAC-positive but IgG-nonreactive, total HHD cases were 64 (28.7%). Echinococcus IgG reactive cases were seen more in the extremes of age group, that is, 1 to 10 years and 81 to 90 years. Taking FNAC as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of ELISA were 87.5, 76.8, 22.6, and 98.7%, respectively. Cytology-positive cases demonstrated a mean ELISA optical density/cut-off (OD/CO) of 4.2 ± 3 standard deviation. Conclusion ELISA in radiologically confirmed liver mass cases is highly sensitive in detecting HHD and hence should be used along with ultrasonography for the screening of HHD followed by confirmation with cytology even in cases with a higher OD/CO of ELISA.
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Affiliation(s)
- Supriya Mahajan
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, Delhi, India
| | - Shalini Thapar
- Department of Radiology, Institute of Liver and Biliary Sciences, Delhi, India
| | - Vikas Khillan
- Department of Microbiology, Institute of Liver and Biliary Sciences, Delhi, India
| | - Pradheer Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, Delhi, India
| | - Archana Rastogi
- Department of Pathology, Institute of Liver and Biliary Sciences, Delhi, India
| | - Ekta Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, Delhi, India
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Kniepeiss D, Talakic E, Schemmer P. Echinococcus granulosus: A novel parenchymal sparing surgical treatment. Hepatobiliary Pancreat Dis Int 2020; 19:390-393. [PMID: 32165067 DOI: 10.1016/j.hbpd.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/06/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Daniela Kniepeiss
- General, Visceral and Transplant Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria
| | - Emina Talakic
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 20, 8036 Graz, Austria
| | - Peter Schemmer
- General, Visceral and Transplant Surgery, Department of Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
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Comprehensive characterization of plasma cell-free Echinococcus spp. DNA in echinococcosis patients using ultra-high-throughput sequencing. PLoS Negl Trop Dis 2020; 14:e0008148. [PMID: 32282820 PMCID: PMC7209354 DOI: 10.1371/journal.pntd.0008148] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 05/08/2020] [Accepted: 02/18/2020] [Indexed: 12/18/2022] Open
Abstract
Background Echinococcosis is a life-threatening parasitic disease caused by Echinococcus spp. tapeworms with over one million people affected globally at any time. The Echinococcus spp. tapeworms in the human body release DNA to the circulatory system, which can be a biomarker for echinococcosis. Cell-free DNA (cfDNA) is widely used in medical research and has been applied in various clinical settings. As for echinococcosis, several PCR-based tests had been trialed to detect cell-free Echinococcus spp. DNA in plasma or serum, but the sensitivity was about 20% to 25%. Low sensitivity of PCR-based methods might be related to our limited understanding of the features of cell-free Echinococcus spp. DNA in plasma, including its concentration, fragment pattern and release source. In this study, we applied ultra-high-throughput sequencing to comprehensively investigate the characteristics of cell-free Echinococcus spp. DNA in plasma of echinococcosis patients. Methodology/Principal findings We collected plasma samples from 23 echinococcosis patients. Total plasma cfDNA was extracted and sequenced with a high-throughput sequencing platform. An average of 282 million read pairs were obtained for each plasma sample. Sequencing data were analyzed with bioinformatics workflow combined with Echinococcus spp. sequence database. After identification of cell-free Echinococcus spp. reads, we found that the cell-free Echinococcus spp. reads accounted for 1.8e-5 to 4.0e-9 of the total clean reads. Comparing fragment length distribution of cfDNA between Echinococcus spp. and humans showed that cell-free Echinococcus spp. DNA of cystic echinococcosis (CE) had a broad length range, while that of alveolar echinococcosis (AE) had an obvious peak at about 135 bp. We found that most of the cell-free Echinococcus spp. DNA reads were from the nuclear genome with an even distribution, which might indicate a random release pattern of cell-free Echinococcus spp. DNA. Conclusions/Significance With ultra-high-throughput sequencing technology, we analyzed the concentration, fragment length, release source, and other characteristics of cell-free Echinococcus spp. DNA in the plasma of echinococcosis patients. A better understanding of the characteristics of cell-free Echinococcus spp. DNA in plasma may facilitate their future application as a biomarker for diagnosis. Echinococcosis is one of the most neglected tropical diseases caused by the metacestodes of Echinococcus spp. tapeworms, which affect both humans and livestock. Plasma cell-free DNA (cfDNA) consists of nucleic acid fragments found extracellularly and may contain DNA released from the parasites. Research shows that a variety of parasites can be detected from plasma cfDNA. Cell-free Echinococcus spp. DNA in plasma or serum had been tested with PCR-based methods, but these PCR methods had low sensitivity ranged from 20% to 25%. Low sensitivity may be due to our limited understanding of cell-free Echinococcus spp. DNA in plasma. Here, we take advantage of high-throughput sequencing to get a comprehensive characterization of cell-free Echinococcus spp. DNA. Our results showed that with high-throughput sequencing we could detect cell-free Echinococcus spp. DNA in all samples, though at a very low level. Based on the sequencing data, we found that cell-free Echinococcus spp. DNA in plasma had a different fragment length distribution to cell-free human DNA, and fragment length distribution of cell-free Echinococcus spp. DNA is also different between cystic echinococcosis (CE) and alveolar echinococcosis (AE). The sequencing data can also help trace the release source of cell-free Echinococcus spp. DNA from the genome. According to the mapping results of cell-free Echinococcus spp. DNA reads, we found that most of them were from the nuclear genome rather than the mitochondrial genome, and their release position showed an even distribution on the genome. These characteristics of cell-free Echinococcus spp. DNA in echinococcosis patients’ plasma could facilitate their future application in research or clinical settings.
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Tilioua S, Mezioug D, Amir-Tidadini ZC, Medjdoub YM, Touil-Boukoffa C. Potential role of NF-κB pathway in the immuno-inflammatory responses during human cystic echinococcosis. Acta Trop 2020; 203:105306. [PMID: 31891707 DOI: 10.1016/j.actatropica.2019.105306] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 11/08/2019] [Accepted: 12/16/2019] [Indexed: 01/03/2023]
Abstract
Cystic echinococcosis (CE) induces in the human host innate and adaptive immune response that plays an important role in controlling the immunopathogenesis. Due to the crucial role of nuclear factor kappa B (NF-κB) in regulating immuno-inflammatory processes, we investigated its potential contribution in systemic and local immuno-inflammatory responses in primary CE patients and relapsed patients. The expression of NF-κB and inducible nitric oxide synthase (iNOS) was analyzed in peripheral blood mononuclear cells (PBMC) as well as in pericystic layer of pulmonary hydatid cysts from Algerian primary CE patients and relapsed patients. Tumor necrosis factor alpha (TNF-α) and nitric oxide (NO) production was evaluated in plasma samples. Our results showed high iNOS and NF-κB expression in both PBMCs and pericystic histiocytes from primary CE patients. In addition, substantial amounts of systemic NO and TNF-α were detected in the same patients. Remarkably, relapsed patients exhibited a low NF-κB and iNOS expression associated with low amounts of plasmatic TNF-α and NO. Collectively, NF-κB/iNOS pathway is involved in the host defense mechanisms at the systemic and local level during primary CE. Our results indicate that the inhibition of this pathway in relapsed patients will attenuate protective immunity and promote parasite escape. This study allowed to identify a novel predictive biomarkers of hydatidosis.
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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]
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Esperanza Adrover M, Pedernera M, Bonne M, Lebeau B, Bucalá V, Gallo L. Synthesis and characterization of mesoporous SBA-15 and SBA-16 as carriers to improve albendazole dissolution rate. Saudi Pharm J 2019; 28:15-24. [PMID: 31920429 PMCID: PMC6950956 DOI: 10.1016/j.jsps.2019.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/02/2019] [Indexed: 02/08/2023] Open
Abstract
Albendazole (ABZ, anti-parasitic active pharmaceutical ingredient) is a crystalline low water-soluble drug, thus the dissolution rate in gastrointestinal fluids is limited. Consequently, the improvement of the water solubility and dissolution rate of ABZ implies a great challenge for a more efficient treatment of hydatidosis. In this context, SBA-15 and SBA-16 ordered mesoporous silica materials were synthetized and loaded with ABZ. X-ray diffraction, FT-IR spectroscopy, nitrogen physisorption manometry, particle size distribution and scanning electronic microscopy were used to characterize unloaded and loaded materials (ABZ/SBA-15 and ABZ/SBA-16). The loaded ABZ amount in the carriers was estimated by elemental analysis. For the loaded materials, the drug solubility and release profile were evaluated. In addition, mathematical models were compared to explain the dissolution kinetics of ABZ from mesoporous solids. ABZ was successfully loaded into the mesopores. The amorphous state of the adsorbed ABZ was confirmed by differential scanning calorimetry that resulted in a notable increment in the dissolution rate compared to crystalline ABZ. Drug release behaviors were well simulated by the Weibull model for ABZ/SBA-15 and by the Gompertz function for pure ABZ and ABZ/SBA-16. The SBA-15 carrier exhibited the highest drug loading and dissolution rate becoming a promising material to improve ABZ bioavailability.
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Affiliation(s)
- María Esperanza Adrover
- Departamento de Ingeniería Química, Universidad Nacional del Sur (UNS), Av. Alem 1253, 8000 Bahía Blanca, Argentina.,Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Camino La Carrindanga Km 7, 8000 Bahía Blanca, Argentina
| | - Marisa Pedernera
- Departamento de Ingeniería Química, Universidad Nacional del Sur (UNS), Av. Alem 1253, 8000 Bahía Blanca, Argentina.,Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Camino La Carrindanga Km 7, 8000 Bahía Blanca, Argentina
| | - Magali Bonne
- Université de Haute Alsace (UHA), CNRS, IS2M UMR 7361, 68100 Mulhouse, France.,Université de Strasbourg, 67000 Strasbourg, France
| | - Bénédicte Lebeau
- Université de Haute Alsace (UHA), CNRS, IS2M UMR 7361, 68100 Mulhouse, France.,Université de Strasbourg, 67000 Strasbourg, France
| | - Verónica Bucalá
- Departamento de Ingeniería Química, Universidad Nacional del Sur (UNS), Av. Alem 1253, 8000 Bahía Blanca, Argentina.,Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Camino La Carrindanga Km 7, 8000 Bahía Blanca, Argentina
| | - Loreana Gallo
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), San Juan 670, 8000 Bahía Blanca, Argentina.,Planta Piloto de Ingeniería Química, PLAPIQUI (UNS-CONICET), Camino La Carrindanga Km 7, 8000 Bahía Blanca, Argentina
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23
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Ahmadpour E, Godrati-Azar Z, Spotin A, Norouzi R, Hamishehkar H, Nami S, Heydarian P, Rajabi S, Mohammadi M, Perez-Cordon G. Nanostructured lipid carriers of ivermectin as a novel drug delivery system in hydatidosis. Parasit Vectors 2019; 12:469. [PMID: 31601244 PMCID: PMC6788095 DOI: 10.1186/s13071-019-3719-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background The larval stage of the tapeworm Echinococcus granulosus is the causative agent of hydatid disease in humans. This zoonotic parasitic infection remains a major health problem in certain areas of the world where is still endemic. In view of the ineffectiveness of some drug treatments, the surgical removal of cysts remains the preferred treatment option together with the administration of albendazole and mebendazole. However, severe side effects of these drugs have been reported which demands developing new scolicidal agents that confer suitable efficacy and fewer side effects during surgery. Methods To that purpose, in the present work we assessed the effectiveness of ivermectin (IVM), a macrocyclic lactone endectocide that has shown to be an effective nematocidal drug against other important parasitic infections. To overcome the limitations observed in some drug formulations and resistance, we used nano lipid carriers (NLCs) as a targeted and sustained drug delivery system for IVM. We evaluated the in vitro cestocidal and apoptotic effects of NLCs-loaded IVM versus IVM by quantifying the expression of caspase-3 mRNA. Results We found that after 60 and 120 min of administration, 800 μg/ml and 400 μg/ml NLCs-loaded IVM induced 100% mortality, respectively. On the other hand, the 800 μg/ml of IVM induced 100% mortality rate 150 min after administration. Additionally, we found that NLCs-loaded IVM induced higher mRNA caspase-3 expression suggesting a more potent apoptotic effect on the parasite. Conclusions These data suggest that NLCs-loaded IVM may be a promising alternative to current treatments although in vivo studies are needed.
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Affiliation(s)
- Ehsan Ahmadpour
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. .,Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Zahra Godrati-Azar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Spotin
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Norouzi
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanam Nami
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Heydarian
- Department of Medical Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saba Rajabi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Mohammadi
- Food and Drug Safety Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gregorio Perez-Cordon
- National Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Swansea, UK.,Swansea University Medical School, Swansea University, Swansea, UK
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Abstract
PURPOSE OF REVIEW This review draws attention to patients with cystic echinococcosis migrating from highly endemic to non-endemic countries with limited experience in cystic echinococcosis management, to ultrasound-based cyst staging, and to the WHO cyst classification as a powerful, to date underused tool to triage patients into the four currently available treatment modalities. RECENT FINDINGS In non- and low-prevalence countries, cystic echinococcosis is often misclassified. Differential diagnoses, such as simple cysts and other benign and malignant space-occupying lesions, have similar appearances on imaging. Serology is confirmatory but often disappointing due to sensitivity and specificity problems. There is increasing confidence in assigning uncomplicated cystic echinococcosis cysts to the four treatment modalities [drug treatment (benzimidazoles), percutaneous methods, surgery, watch and wait] on the basis of cyst stage (WHO cyst classification), size and location. However, current best practice is still not widely implemented outside cystic echinococcosis treatment centres, and further consolidation is needed by well-designed clinical trials. Recently published long-term follow-up studies have shown that patients with inactive cyst stages CE4 and CE5 benefit, especially since they do not need any treatment at all if they have not received prior benzimidazole or percutaneous therapy. Instead, cysts that have reached cyst stages CE4 and CE5 through drug treatment do need careful follow-up as they often relapse. Surgical procedures in which the cysts are opened and percutaneous approaches require very careful control of cyst content spillage to the peritoneum, pleura and intravascularly to prevent dissemination - a still too often neglected issue with severe consequences for patients. SUMMARY Though a neglected disease with predominantly expert-opinion-based treatment strategies, cystic echinococcosis patients can greatly benefit from interdisciplinary management in cystic echinococcosis treatment centres and cyst-stage-based assignment of treatment modalities. Increased suspicion for cystic echinococcosis in migrants from endemic to non-endemic countries is urgently needed at the current level of global mobility.
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25
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Escolà-Vergé L, Salvador F, Sánchez-Montalvá A, Escudero-Fernández JM, Sulleiro E, Rando A, Bilbao I, Lázaro JL, Serres X, Salvador J, Molina I. Retrospective Study of Cystic Echinococcosis in a Recent Cohort of a Referral Center for Liver Surgery. J Gastrointest Surg 2019; 23:1148-1156. [PMID: 30242646 DOI: 10.1007/s11605-018-3971-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/09/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) is a zoonosis endemic in Spain caused by the larval stage of the cestode Echinococcus granulosus and is one of the 18 neglected tropical diseases recognized by the WHO. The aim of this study was to describe the epidemiological and clinical data of CE in a surgical referral hospital. METHODS A retrospective descriptive study of all adults' patients diagnosed with CE and followed at Vall d'Hebron University Hospital in Barcelona, Spain, between 2000 and 2015. RESULTS We found 151 cases, 78 (51.7%) women, and median age at diagnosis was 68 (range, 15-92) years. Diagnosis was a radiological finding in 97 (64.2%) and the most frequent location was the liver [135 (89.4%) patients]. Nearly 80% of the cysts were calcified and serology was positive in 48 (51.6%). The WHO-IWGE classification was only available in 70 of the 104 (67.3%) cases of liver cysts that had an ultrasound. First therapeutic plan was "watch and wait" followed by surgery. International recommendations were not always followed, particularly in CE4 and CE5 stages, and 20% needed a change of treatment because of progression or recurrence. Patients treated surgically were younger, more symptomatic, and had larger and less calcified cysts in multiple sites. Serology was not useful for CE diagnosis and neither serology nor calcification of the cyst helped to predict viability. CONCLUSIONS The formation of multidisciplinary teams in reference hospitals could help to improve CE diagnosis, its management, and follow-up, since international recommendations are not usually followed.
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Affiliation(s)
- Laura Escolà-Vergé
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, P° Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Fernando Salvador
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, P° Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, P° Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | | | - Elena Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Ariadna Rando
- Microbiology Department, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Itxarone Bilbao
- Department of Hepatopancreatobiliary Surgery and Transplants, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - José Luis Lázaro
- Department of Hepatopancreatobiliary Surgery and Transplants, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Xavier Serres
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Salvador
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, P° Vall d'Hebron 119-129, 08035, Barcelona, Spain
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Albendazole-lipid nanocapsules: Optimization, characterization and chemoprophylactic efficacy in mice infected with Echinococcus granulosus. Exp Parasitol 2019; 198:79-86. [PMID: 30769018 DOI: 10.1016/j.exppara.2019.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 01/03/2019] [Accepted: 02/10/2019] [Indexed: 11/20/2022]
Abstract
Cystic echinococcosis (CE), which is caused during the metacestode larval stage of Echinococcus granulosus, is a life-threatening disease and is very difficult to treat. At present, the FDA-approved antihelmintic drugs are mebendazole (MBZ), albendazole (ABZ) and its principal metabolite ABZ sulfoxide (ABZSO), but as these have a therapeutic efficacy over 50%, underlining the need for new drug delivery systems. The aim of this work was the optimization and characterization of previously developed ABZ lipid nanocapsules (ABZ-LNCs) and evaluate their efficacy in mice infected with E. granulosus. LNCs were prepared by the phase inversion technique and characterized in terms of size, surface charge, drug loading, and in vitro stability followed by an in vivo proof-of-concept using a murine model infected with E. granulosus. Stable particle dispersions with a narrow size distribution and high efficiency of encapsulation (≥90%) were obtained. ABZ-LNCs showed a greater chemoprophylactic efficacy than ABZ suspension administered by the oral route as 4 out of the 10 ABZ-LNCs treated mice did not develop any cysts, whereas the infection progressed in all mice from the ABZ suspension group. Regarding the ultrastructural studies of cysts, mice treated with ABZ-LNCs or ABZ suspension revealed changes in the germinal layer. However, the extent of the damage appeared to be greater after ABZ-LNC administration compared to the suspension treatment. These results suggest that ABZ-LNCs could be a promising novel candidate for ABZ delivery to treat CE.
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Elelu N, Aiyedun JO, Mohammed IG, Oludairo OO, Odetokun IA, Mohammed KM, Bale JO, Nuru S. Neglected zoonotic diseases in Nigeria: role of the public health veterinarian. Pan Afr Med J 2019; 32:36. [PMID: 31143341 PMCID: PMC6522207 DOI: 10.11604/pamj.2019.32.36.15659] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 12/12/2018] [Indexed: 12/13/2022] Open
Abstract
Zoonotic diseases accounts for about 75% of emerging infectious disease and can be devastating to both human and animal health globally. A subset of zoonotic diseases is referred to as "neglected zoonotic diseases - NZDs" as they mainly affect poor populations who live in close proximity to domestic or wild animals often in areas where access to health and adequate sanitary facilities are not available. Furthermore, underestimation of the burden of NZD has continually led to its further neglect in least developed countries such as Nigeria. Controlling zoonotic infections including NZDs in animals is crucial in reducing human infections. Veterinarians provides an understanding of the epidemiology of infectious diseases in animal population and are therefore integral for the overall reduction in global burden of NZDs worldwide. Due to the current lack of and in some cases weak involvement of Veterinarians in policy issues related to zoonotic diseases, there is need to elucidate their importance in NZDs control in Nigeria. This review therefore summarises the neglected zoonotic diseases so far documented in Nigeria and also highlight the important role of the Veterinarian in their prevention and control within both human and animal population. Important recommendations to strengthen the role of the public health Veterinarian for sustainable control of NZDs were made.
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Affiliation(s)
- Nusirat Elelu
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Julius Olaniyi Aiyedun
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Ibraheem Ghali Mohammed
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Oladapo Oyedeji Oludairo
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Ismail Ayoade Odetokun
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Kaltume Mamman Mohammed
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - James Olaniyi Bale
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
| | - Saka Nuru
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Kwara State, Nigeria
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Abd El-Khalek AM, El-Sayed NTM, Elalfy H, Besheer T, Farid K, ElAgezy M, Elkashef W, Alhawarey A, El-Bendary M, Hasan Elmokadem A. Percutaneous US-guided combined ethanol and tetracycline injection for treating symptomatic simple and hydatid hepatic cysts. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018; 49:797-803. [DOI: 10.1016/j.ejrnm.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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29
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Brunetti E, Tamarozzi F, Macpherson C, Filice C, Piontek MS, Kabaalioglu A, Dong Y, Atkinson N, Richter J, Schreiber-Dietrich D, Dietrich CF. Ultrasound and Cystic Echinococcosis. Ultrasound Int Open 2018; 4:E70-E78. [PMID: 30364890 PMCID: PMC6199172 DOI: 10.1055/a-0650-3807] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 05/25/2018] [Accepted: 06/18/2018] [Indexed: 02/08/2023] Open
Abstract
The introduction of imaging techniques in clinical practice 40 years ago changed the clinical management of many diseases, including cystic echinococcosis (CE). For the first time cysts were clearly seen before surgery. Among the available imaging techniques, ultrasound (US) has unique properties that can be used to study and manage cystic echinococcosis. It is harmless, can image almost all organs and systems, can be repeated as often as required, is portable, requires no patient preparation, is relatively inexpensive and guides diagnosis, treatment and follow-up without radiation exposure and harm to the patient. US is the only imaging technique which can be used in field settings to assess CE prevalence because it can be run even on solar power or a small generator in remote field locations. Thanks to US classifications, the concept of stage-specific treatments was introduced and because US is repeatable, the scientific community has gained a clearer understanding of the natural history of the disease. This paper reviews the scope of US in CE, describes its strengths and weaknesses compared to other imaging techniques and its relationship with serodiagnosis and discusses sonographic features that may be helpful in differential diagnosis.
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Affiliation(s)
- Enrico Brunetti
- San Matteo Hospital Foundation, University of Pavia, Unit of Infectious and Tropical Diseases, Pavia, Italy
| | - Francesca Tamarozzi
- Center for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | | | - Carlo Filice
- San Matteo Hospital Foundation, University of Pavia, Unit of Infectious and Tropical Diseases, Pavia, Italy
| | - Markus Schindler Piontek
- Caritas Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Medical Clinic 2, Bad Mergentheim, Germany
| | | | - Yi Dong
- Zhongshan Hospital, Ultrasound, Shanghai, China
| | - Nathan Atkinson
- John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Department of Gastroenterology, Oxford, New Zealand
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Berlin, Germany
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Vatankhah A, Ghaffari SMR, Vatankhah RG, Piurkó V, Tímár J, Avan A, Jazayeri MH. Characterization of cellular and humoral immune responses to alkaline phosphatase from fertile hydatid cysts in the human peripheral blood. J Cell Physiol 2018; 234:2765-2777. [DOI: 10.1002/jcp.27092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/28/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Ali Vatankhah
- Department of PathologySemmelweis UniversityBudapest Hungary
| | | | | | - Violetta Piurkó
- Department of PathologySemmelweis UniversityBudapest Hungary
| | - József Tímár
- Department of PathologySemmelweis UniversityBudapest Hungary
| | - Amir Avan
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhad Iran
| | - Mir H. Jazayeri
- Immunology Research CenterIran University of Medical SciencesTehran Iran
- Department of Immunology, School of MedicineIran University of Medical SciencesTehran Iran
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31
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Diagnostic Value of IL-4, IL-10 and IL-12 in Detection of Hepatic Hydatid Cyst Using Receiver Operating Characteristic Curve. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.2.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Flisser A. Eliminating cystic echinococcosis in the 21st century. THE LANCET. INFECTIOUS DISEASES 2018; 18:703-704. [PMID: 29793822 DOI: 10.1016/s1473-3099(18)30299-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Ana Flisser
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico.
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33
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Tropical Medicine and Anaesthesia; part 2. BJA Educ 2018; 18:75-81. [DOI: 10.1016/j.bjae.2017.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/20/2022] Open
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Chen S, Li N, Yang F, Wu J, Hu Y, Yu S, Chen Q, Wang X, Wang X, Liu Y, Zheng J. Medical treatment of an unusual cerebral hydatid disease. BMC Infect Dis 2018; 18:12. [PMID: 29304756 PMCID: PMC5756415 DOI: 10.1186/s12879-017-2935-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hydatid disease is a worldwide zoonosis produced by the larval stage of cestodes of the Echinococcus genus. Hydatid disease primarily involves the liver and lungs. The brain is involved in less than 2% of cases. Surgery has long been the only choice for the treatment, but chemotherapy has been successfully replaced surgery in some special cases. CASE PRESENTATION We report a rare hydatid disease case which presented with multiple lesions in right frontal lobe, an uncommon site, and in the liver and lungs. A 28-year-old woman presented with 6 months history of recurrent convulsion. Cranial magnetic resonance imaging found multiple lesions in right frontal lobe, so she was hospitalized for surgical treatment and received sodium valproate by oral for controlling epilepsy. Before the operation, other lesions were found in the liver and lungs by computerized tomography scan. There were multiple pulmonary nodules near the pleura and large cyst in the liver. The pathology of liver showed that it may be a hydatid disease. Then, positive serum antibodies for echinococcus antigen further confirmed our diagnosis. Since her central nerve system was involved, she received four pills (800 mg, about 17 mg/kg/day) albendazole treatment for 18 months without operation. Her symptoms abated and a follow-up magnetic resonance imaging showed that the lesion had obviously diminished after treatment. She was recurrence free 2 years after we stopped albendazole treatment. CONCLUSIONS This case reveals an uncommon pattern of intracranial hydatid disease. Albendazole can be beneficial for some inoperable cerebral hydatid disease patients.
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Affiliation(s)
- Shu Chen
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Ning Li
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Feifei Yang
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiqin Wu
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuekai Hu
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Shenglei Yu
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Qi Chen
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuan Wang
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinyu Wang
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuanyuan Liu
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianming Zheng
- Department of infectious diseases, Huashan Hospital, Fudan University, Shanghai, China.
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Schwarze V, Mueller-Peltzer K, Negrão de Figueiredo G, Lindner F, Rübenthaler J, Clevert DA. The use of contrast-enhanced ultrasound (CEUS) for the diagnostic evaluation of hepatic echinococcosis. Clin Hemorheol Microcirc 2018; 70:449-455. [PMID: 30347607 DOI: 10.3233/ch-189310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hepatic echinococcosis (HE) is a zoonosis and depicts a rare but potentially lethal disease caused by larval infestation of E. multilocularis (alveolar echinococcosis, AE) and E. granulosus (cystic echinocococcosis, CE). In many countries, HE is a critical public health problem. Clinically, HE patients initially are often asymptomatic for years. Depending on the echinococcal manifestations patients can later develop unspecific symptoms as fatigue, abdominal pain and may present with elevated transaminases, jaundice and hepatomegaly. The combination of grey scale ultrasound and serological tests has been the gold standard for the screening and diagnosis of HE. Besides MRI, CT and FDG-PET scans, safe and directly accessible contrast-enhanced ultrasound (CEUS) may easily help to indirectly describe perilesional inflammation. Upon diagnosis of HE, an appropriate therapeutical strategy should be evaluated in a multidisciplinary way. OBJECTIVE The aim of the present retrospective monocenter study is to assess the diagnostic performance of CEUS examination in the evaluation of hepatic echinococcal manifestation by comparison with CT, MRI, FDG-PET scans and histopathology. METHODS Out of 36 patients with echinococcal disease (16 patients with E. multilocularis infection, 12 patients with E. granulosus infection and 8 patient with unspecified Echinococcus infection) 8 HE patients (4 patients with E. multilocularis, 2 patients with E. granulosus and 2 patients with unspecified echinococcal liver disease) were included in this study on whom CEUS was performed between 2008-2016. The applied contrast agent was a second-generation blood pool agent (SonoVue ®, Bracco, Milan, Italy). CEUS examinations were performed and interpreted by a single experienced radiologist with more than 15 years of experience. RESULTS All patients were examined without occurrence of any side effects. In all 4 AE patients, contrast enhancement could be detected by means of CEUS and was confirmed by MRI or PET-CT scan. In the remaining 4 patients (CE and unspecified echinococcosis), doppler ultrasonography, CEUS and corresponding CT or MRI scans could not detect any hypervascularization of the lesions of interest. The histopathological analysis did not reveal any viable parasite material. CEUS showed a sensitivity of 100% and a specificity of 100% compared to MRI, CT or FDG-PET-CT. CONCLUSIONS CEUS depicts a safe method for the evaluation of echinococcal liver disease. In addition to serological tests and grey scale ultrasound, CEUS imaging could be integrated as an easily accessible tool helping to describe hypervascularization as a sonomorphological correlate for active perilesional inflammation of echinococcal manifestations. CEUS may further help to differentiate between CE and AE and also to evaluate treatment outcome.
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Affiliation(s)
- V Schwarze
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - K Mueller-Peltzer
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - G Negrão de Figueiredo
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - F Lindner
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - J Rübenthaler
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
| | - D-A Clevert
- Department of Radiology, Interdisciplinary Ultrasound Center, Ludwig-Maximilians-University Munich - Grosshadern Campus, Munich, Germany
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Ristić M, Veterinary Center Subotica, Subotica , Serbia, Pavlović IP, Miladinović Tasić N, Babić R, Kocić B. E PIDEMIOLOGICAL IMPO RTANC E OF GREEN AREAS AND PUBLIC PLACES CONTAM INATED WITH CANINE F ECES IN URBAN ENVIRONMENTAL CONDITIONS. ACTA MEDICA MEDIANAE 2017. [DOI: 10.5633/amm.2017.0314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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37
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Solomon N, Kachani M, Zeyhle E, Macpherson CNL. The natural history of cystic echinococcosis in untreated and albendazole-treated patients. Acta Trop 2017; 171:52-57. [PMID: 28336270 DOI: 10.1016/j.actatropica.2017.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 12/28/2022]
Abstract
The World Health Organization (WHO) treatment protocols for cystic echinococcosis (CE) are based on the standardized ultrasound (US) classification. This study examined whether the classification reflected the natural history of CE in untreated and albendazole-treated patients. Data were collected during mass US screenings in CE endemic regions among transhumant populations, the Turkana and Berber peoples of Kenya and Morocco. Cysts were classified using the WHO classification. Patient records occurring prior to treatment, and after albendazole administration, were selected. 852 paired before/after observations of 360 cysts from 257 patients were analyzed. A McNemar-Bowker χ2 test for symmetry was significant (p<0.0001). 744 observations (87.3%) maintained the same class, and 101 (11.9%) progressed, consistent with the classification. Regression to CE3B occurred in seven of 116 CE4 cyst observations (6.0%). A McNemar-Bowker χ2 test of 1414 paired before/after observations of 288 cysts from 157 albendazole-treated patients was significant (p<0.0001). 1236 observations (87.4%) maintained the same class, and 149 (10.5%) progressed, consistent with the classification. Regression to CE3B occurred in 29 of 206 CE4 observations (14.1%). Significant asymmetry confirms the WHO classification's applicability to the natural history of CE and albendazole-induced changes. Regressions may reflect the stability of CE3B cysts.
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Affiliation(s)
- N Solomon
- Windward Islands Research and Education Foundation, Grenada; St. George's University School of Medicine, Grenada.
| | - M Kachani
- Western University of Health Sciences, United States.
| | - E Zeyhle
- Meru University of Science and Technology, Kenya.
| | - C N L Macpherson
- Windward Islands Research and Education Foundation, Grenada; St. George's University School of Medicine, Grenada; St. George's University School of Veterinary Medicine, Grenada.
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Fattahi Masoom SH, Lari SM, Fattahi AS, Ahmadnia N, Rajabi M, NaderiKalat M. Albendazole therapy in human lung and liver hydatid cysts: A 13-year experience. CLINICAL RESPIRATORY JOURNAL 2017; 12:1076-1083. [PMID: 28319358 DOI: 10.1111/crj.12630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/11/2017] [Accepted: 02/26/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) is an endemic disease in Iran. This study has aimed to report the efficacy of Albendazole therapy in patients with CE. METHOD Among 164 patients with echinococcosis who were referred to the surgery clinic, Ghaem hospital, Mashhad University of Medical Sciences between 2001 and 2013, two were diagnosed with alveolar echinococcosis (AE) and 162 with CE; 43 of whom underwent surgery. The rest 119 patients received medical therapy by Albendazole 15 mg/kg/day for three phases. Each phase included 6 weeks of Albendazole therapy followed by 2 weeks of no medication. The patients were classified according to radiologic evaluations into four groups: (1) cured, (2) improved, (3) unchanged, and (4) worsened or relapsed. RESULTS Patients who completed more phases had significantly greater chances of better response. Of the 56 patients who completed all three phases, 37 (66.1%) were cured, 15 (26.8%) improved, 4 (7.1%) remained unchanged, and none worsened or relapsed. [Odds ratio (OR):4.78, 95% confidence interval (CI): 2.95-7.74, P < .0001]. CONCLUSION Albendazole can be beneficial for inoperable, multiple cysts, and multiple organs CE patients.
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Affiliation(s)
- Seyed Hossein Fattahi Masoom
- Thoracic Surgery, Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Asieh Sadat Fattahi
- General Surgery, Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Ahmadnia
- Student Research Committee, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahla Rajabi
- Student Research Committee, Mashhad University of Medical Science, Mashhad, Iran
| | - Maliheh NaderiKalat
- Student Research Committee, Mashhad University of Medical Science, Mashhad, Iran
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Abstract
Human cystic echinococcosis (CE) has been eliminated or significantly reduced as a public health problem in several previously highly endemic regions. This has been achieved by the long-term application of prevention and control measures primarily targeted to deworming dogs, health education, meat inspection, and effective surveillance in livestock and human populations. Human CE, however, remains a serious neglected zoonotic disease in many resource-poor pastoral regions. The incidence of human alveolar echinococcosis (AE) has increased in continental Europe and is a major public health problem in parts of Eurasia. Better understanding of wildlife ecology for fox and small mammal hosts has enabled targeted anthelmintic baiting of fox populations and development of spatially explicit models to predict population dynamics for key intermediate host species and human AE risk in endemic landscapes. Challenges that remain for echinococcosis control include effective intervention in resource-poor communities, better availability of surveillance tools, optimal application of livestock vaccination, and management and ecology of dog and wildlife host populations.
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40
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Echinococcosis. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Schwarz NG, Loderstaedt U, Hahn A, Hinz R, Zautner AE, Eibach D, Fischer M, Hagen RM, Frickmann H. Microbiological laboratory diagnostics of neglected zoonotic diseases (NZDs). Acta Trop 2017; 165:40-65. [PMID: 26391646 DOI: 10.1016/j.actatropica.2015.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 08/03/2015] [Accepted: 09/04/2015] [Indexed: 02/06/2023]
Abstract
This review reports on laboratory diagnostic approaches for selected, highly pathogenic neglected zoonotic diseases, i.e. anthrax, bovine tuberculosis, brucellosis, echinococcosis, leishmaniasis, rabies, Taenia solium-associated diseases (neuro-/cysticercosis & taeniasis) and trypanosomiasis. Diagnostic options, including microscopy, culture, matrix-assisted laser-desorption-ionisation time-of-flight mass spectrometry, molecular approaches and serology are introduced. These procedures are critically discussed regarding their diagnostic reliability and state of evaluation. For rare diseases reliable evaluation data are scarce due to the rarity of samples. If bio-safety level 3 is required for cultural growth, but such high standards of laboratory infrastructure are not available, serological and molecular approaches from inactivated sample material might be alternatives. Multiple subsequent testing using various test platforms in a stepwise approach may improve sensitivity and specificity. Cheap and easy to use tests, usually called "rapid diagnostic tests" (RDTs) may impact disease control measures, but should not preclude developing countries from state of the art diagnostics.
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Mihmanli M, Idiz UO, Kaya C, Demir U, Bostanci O, Omeroglu S, Bozkurt E. Current status of diagnosis and treatment of hepatic echinococcosis. World J Hepatol 2016; 8:1169-1181. [PMID: 27729953 PMCID: PMC5055586 DOI: 10.4254/wjh.v8.i28.1169] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/21/2016] [Accepted: 07/11/2016] [Indexed: 02/06/2023] Open
Abstract
Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis) infections are the most common parasitic diseases that affect the liver. The disease course is typically slow and the patients tend to remain asymptomatic for many years. Often the diagnosis is incidental. Right upper quadrant abdominal pain, hepatitis, cholangitis, and anaphylaxis due to dissemination of the cyst are the main presenting symptoms. Ultrasonography is important in diagnosis. The World Health Organization classification, based on ultrasonographic findings, is used for staging of the disease and treatment selection. In addition to the imaging methods, immunological investigations are used to support the diagnosis. The available treatment options for E. granulosus infection include open surgery, percutaneous interventions, and pharmacotherapy. Aggressive surgery is the first-choice treatment for E. multilocularis infection, while pharmacotherapy is used as an adjunct to surgery. Due to a paucity of clinical studies, empirical evidence on the treatment of E. granulosus and E. multilocularis infections is largely lacking; there are no prominent and widely accepted clinical algorithms yet. In this article, we review the diagnosis and treatment of E. granulosus and E. multilocularis infections in the light of recent evidence.
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Affiliation(s)
- Memmet Mihmanli
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Ufuk Oguz Idiz
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Cemal Kaya
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Uygar Demir
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Ozgur Bostanci
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Sinan Omeroglu
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
| | - Emre Bozkurt
- Memmet Mihmanli, Ufuk Oguz Idiz, Cemal Kaya, Uygar Demir, Ozgur Bostanci, Sinan Omeroglu, Emre Bozkurt, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, 34371 Istanbul, Turkey
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Moroni S, Moscatelli G, Bournissen FG, González N, Ballering G, Freilij H, Salgueiro F, Altcheh J. Abdominal Cystic Echinococcosis Treated with Albendazole. A Pediatric Cohort Study. PLoS One 2016; 11:e0160472. [PMID: 27589236 PMCID: PMC5010188 DOI: 10.1371/journal.pone.0160472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 07/20/2016] [Indexed: 01/06/2023] Open
Abstract
Introduction Cystic echinococcosis is endemic in Argentina. The standard pharmacological treatment for the disease is albendazole, but surgery is a common alternative. Even though primary infection occurs mainly in the pediatric population, the optimal therapeutic option in pediatrics is not clearly defined and few pediatric cohorts with cystic echinococcosis treated with albendazole have been described to date. Objective To describe therapeutic response to albendazole in a cohort of pediatric patients with abdominal cystic echinococcosis. Population and Methods Patients (0–18 years old) with abdominal cystic echinococcosis who were treated with albendazole between January 1998 and August 2013. Diagnosis of abdominal cystic echinococcosis was made by ultrasound. All patients received albendazole, 10–15 mg/kg/day. Epidemiological data, symptoms, number, location and outcome of the cysts, serology and treatment received were analyzed. The parameter used to assess treatment response was cyst changes evaluated by ultrasound follow up using the WHO-IWGE classification. Results A total of 28 patients (with 46 abdominal cysts) were included in the cohort. Mean age at enrolment was 9.4 years and mean duration of follow-up, 23.8 months. All patients resided in rural areas and had had contact with dogs. The asymptomatic form of the disease was the most common presentation. All patients received albendazole (mean duration: 142.5 days), with low incidence of adverse events. Albendazole had a positive effect on most of the cysts. Surgery was performed in 13 patients. Conclusion Treatment with albendazole for uncomplicated cystic echinococcosis cysts is safe and effective, and can potentially reduce the need for surgical intervention.
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Affiliation(s)
- Samanta Moroni
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
- * E-mail:
| | - Guillermo Moscatelli
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Facundo García Bournissen
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Nicolás González
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Griselda Ballering
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Héctor Freilij
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Fabián Salgueiro
- Department of Surgery, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
| | - Jaime Altcheh
- Parasitology and Chagas Service, Buenos Aires Children Hospital Ricardo Gutiérrez, Capital Federal, Buenos Aires, Argentina
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Kahlfuß S, Flieger RR, Roepke TK, Yilmaz K. Diagnosis and treatment of cardiac echinococcosis. Heart 2016; 102:1348-53. [DOI: 10.1136/heartjnl-2016-309350] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/25/2016] [Indexed: 01/22/2023] Open
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Wang H, Li Z, Gao F, Zhao J, Zhu M, He X, Niu N, Zhao W. Immunoprotection of recombinant Eg.P29 against Echinococcus granulosus in sheep. Vet Res Commun 2016; 40:73-9. [PMID: 27094043 PMCID: PMC4870292 DOI: 10.1007/s11259-016-9656-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 04/04/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aims to investigate the immunoprotection of recombinant Eg.P29 (rEg.P29) vaccine and analyze the underlying mechanism in sheep. METHODS Three groups of male sheep were immunized subcutaneously with rEg.P29 and PBS, Freund's complete adjuvant as controls, respectively. After prime-boost vaccination, the sheep were challenged with encapsulated Echinococcus granulosus eggs. The percentage of protection in sheep was determined 36 weeks after the infection. Humoral immune response was analyzed for specific IgG, IgG1, IgG2, IgM and IgE levels. Moreover, cytokines including interferon (IFN)-γ, interleukin (IL)-2, IL-4,and IL-10 were also evaluated. RESULTS Immunization with rEg.P29 induced protective immune responses up to 94.5 %, compared with immunoadjuvant group. The levels of specific IgG, IgG1, IgG2, and IgE as well as IFN-γ, IL-2, and IL-4 significantly increased after two immunizations (P < 0.05); however, the levels of IgM and IL-10 did not show difference. CONCLUSION rEg.P29 showed Immunoprotection and induced Th1 and Th2 immune responses; hence, rEg.P29 is a potential vaccine for E. granulosus infection.
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Affiliation(s)
- Hao Wang
- Department of Pathogenic Biology and Medical Immunology, Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.,Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Zihua Li
- Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Fu Gao
- Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.,Institute of Clinical Laboratory, Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Jiaqing Zhao
- Department of Pathogenic Biology and Medical Immunology, Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.,Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Mingxing Zhu
- Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.,Centre of Scientific Technology of Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Xin He
- Department of Pathogenic Biology and Medical Immunology, Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Nan Niu
- Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.,Institute of Clinical Laboratory, Ningxia Medical University, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China
| | - Wei Zhao
- Key Laboratory of Hydatid Disease, Ningxia Medical University & Ningxia Institute of Medicine, Hui Autonomous Region, Yinchuan, Ningxia, 750004, China.
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Song X, Hu D, Zhong X, Wang N, Gu X, Wang T, Peng X, Yang G. Characterization of a Secretory Annexin in Echinococcus granulosus. Am J Trop Med Hyg 2016; 94:626-33. [PMID: 26787154 DOI: 10.4269/ajtmh.15-0452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 12/01/2015] [Indexed: 01/22/2023] Open
Abstract
Cystic echinococcosis, caused by Echinococcus granulosus, is a widespread parasitic zoonosis causing economic loss and public health problems. Annexins are important proteins usually present in the plasma membrane, but previous studies have shown that an annexin B33 protein of E. granulosus (Eg-ANX) could be detected in the excretory/secretory products and cyst fluid. In this study, we cloned and characterized Eg-ANX. In silico analysis showed that the amino acid sequence of Eg-ANX was conserved and lacked any signal peptides. The phospholipid-binding activity of recombinant Eg-ANX (rEg-ANX) was tested; liposomes could bind to rEg-ANX only in the presence of Ca(2+). In addition, we performed western blotting and immunohistochemical analyses to further validate the secretory properties of Eg-ANX. The protein could be detected in the cyst fluid of E. granulosus and was also present in the intermediate host tissues, which suggested that Eg-ANX might play an important role in parasite-host interaction.
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Affiliation(s)
- Xingju Song
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Dandan Hu
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Xiuqin Zhong
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Ning Wang
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Xiaobin Gu
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Tao Wang
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Xuerong Peng
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
| | - Guangyou Yang
- Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China; Department of Chemistry, College of Life and Basic Science, Sichuan Agricultural University, Ya'an, China
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Li H, Song T, Shao Y, Aili T, Ahan A, Wen H. Comparative Evaluation of Liposomal Albendazole and Tablet-Albendazole Against Hepatic Cystic Echinococcosis: A Non-Randomized Clinical Trial. Medicine (Baltimore) 2016; 95:e2237. [PMID: 26825878 PMCID: PMC5291548 DOI: 10.1097/md.0000000000002237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In this study, we aimed to compare the clinical efficacy of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) for the treatment of human hepatic cystic echinococcosis (CE). Sixty patients with single cyst (CE1) or daughter cyst (CE2) were included in this study and were nonrandomly divided into the L-ABZ group (n = 30, 10 mg/kg per day, p.o., b.i.d.) and T-ABZ group (n = 30, 12-20 mg/kg per day, p.o., b.i.d.), respectively. The treatment duration lasted for 6 months, during which dynamic follow-up was carried out to evaluate the clinical efficacy through calculating the total effective rates (TERs). Measurement data and numerous data were analyzed by the chi-square test. Two-sided tests were performed for all the statistical tests. In our study, 2 patients were lost in the follow-up in the L-ABZ group. One patient was lost in the follow-up in the T-ABZ group, and 1 patient was withdrawal from the study due to receiving surgery. Significant difference was identified in the 3-month TERs of L-ABZ group and T-ABZ group (33.3% vs 76.7%, P < 0.05). Also, remarkable difference was noted in the 6-month TERs in the L-ABZ group and T-ABZ group (66.7% vs 93.3%, P = 0.01). No statistical difference was noticed in the incidence rate of adverse reactions in both groups (P > 0.05). Based on our study, both T-ABZ and L-ABZ are effective for treating human CE. The TER in the L-ABZ group is superior to that of T-ABZ.
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Affiliation(s)
- Haitao Li
- From the State Key Lab Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis (HL, TS, YS, TA, AA, HW); Hepatobiliary & Hydatid Department, Digestive and Vascular Surgery Centre (HT, TA, AA, HW); and Department of Ultrasonography, First Affiliated Hospital, Xinjiang Medical University, Urumqi, China (TS, YS)
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Ben-Shimol S, Sagi O, Houri O, Bazarsky E, Berkowitz A, Bulkowstein S, Barrett C, Greenberg D. Cystic echinococcosis in Southern Israel. Acta Parasitol 2016; 61:178-86. [PMID: 26751890 DOI: 10.1515/ap-2016-0024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/14/2015] [Indexed: 11/15/2022]
Abstract
The aim of this retrospective, population-based study was to characterize demographically and clinically cystic-echinococcosis (CE) in southern Israel, between 2005 and 2012. Newly-diagnosed (nd-CE) and past-diagnosed (pd-CE, diagnosed before the study) cases were defined. Two populations live in southern-Israel, receiving medical treatment at a single hospital: the Jewish and the Bedouin populations (resembling resource-rich and resource-poor populations, respectively). 126 CE cases were identified; 55 nd-CE and 71 pd-CE. Mean annual nd-CE incidence per 100,000 in the Bedouin and Jewish populations were 2.7 ± 1.2 and 0.4 ± 0.3, respectively (P<0.001). None of the Bedouin and 86.5% of the Jewish patients were born outside Israel. Liver and lung involvement were recorded in 85.7% and 15.1% of overall-CE, respectively. Abdominal pain, cough, fever, eosinophilia and asymptomatic disease were documented in 63.6%, 32.7%, 27.3%, 41.5% and 12.7% of nd-CE, respectively. Serology sensitivity for first test and any positive test were 67.3% and 83.3%, respectively. Computed tomography, ultrasonography and X-ray diagnosis were documented in 79.2%, 58.4% and 17.0% of overall-CE, respectively, with ultrasonography mainly used in liver-CE and X-ray in lung-CE. Treatment included surgery and albendazole in 50.0% and 55.3% of CE, respectively. We conclude that CE is endemic in southern-Israel among the Bedouin population, while disease is probably mainly imported in the Jewish population. Liver involvement and eosinophilia rates were high compared with those of other endemic regions, possibly due to differences in the timing of diagnosis. These findings may help developing treatment and prevention strategies.
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Tsagozis P, Brosjö O. Giant hydatid cyst of the pelvis, femur and retroperitoneal space: surgical treatment with extended hemipelvectomy. BMJ Case Rep 2015; 2015:bcr-2015-209715. [PMID: 25969495 DOI: 10.1136/bcr-2015-209715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hydatid disease of the bone is a very rare manifestation of the disease, and is often associated with debilitating symptoms. We present a rare case of skeletal hydatidosis in a 56-year-old man who had been misdiagnosed for many years. Massive involvement of the pelvic bones and soft tissues was evident. An extended hemipelvectomy was performed in order to achieve resection of the affected segments with a clear surgical margin. The patient recovered uneventfully and there are no signs of recurrence of the disease.
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Affiliation(s)
- Panagiotis Tsagozis
- Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
| | - Otte Brosjö
- Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
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50
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Lv H, Jiang Y, Liu G, Zhang S, Peng X. Surgical treatment of multiple hydatid cysts in the liver of a pediatric patient. Am J Trop Med Hyg 2015; 92:595-8. [PMID: 25561565 DOI: 10.4269/ajtmh.14-0445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Multiple hydatid cysts in the liver rarely occur in the pediatric population. Here, we present the case of a 16-year-old girl who presented with six hydatid cysts in the liver. The cysts were surgically removed and all found to be infertile. Interestingly, the patient had post-operative eosinophilia. From this experience, we conclude that individualized treatment is necessary for patients with multiple hydatid cysts.
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Affiliation(s)
- Hailong Lv
- Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Province, China; Department of Histology and Embryology, Medical College, Shihezi University, Shihezi, Xinjiang Province, China
| | - Yufeng Jiang
- Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Province, China; Department of Histology and Embryology, Medical College, Shihezi University, Shihezi, Xinjiang Province, China
| | - Guisheng Liu
- Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Province, China; Department of Histology and Embryology, Medical College, Shihezi University, Shihezi, Xinjiang Province, China
| | - Shijie Zhang
- Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Province, China; Department of Histology and Embryology, Medical College, Shihezi University, Shihezi, Xinjiang Province, China
| | - Xinyu Peng
- Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Province, China; Department of Histology and Embryology, Medical College, Shihezi University, Shihezi, Xinjiang Province, China
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