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PubMed2002

[Clinical and morphofunctional characteristics of hydatid liver echinococcosis].

AIM: To examine the levels of aspartate aminotransferase (AsAT) and alaninaminotransferase (AlAT) in homogenates of hepatic biopsies from patients with echinococcosis. MATERIAL AND METHODS: Clinical, biochemical examinations, ultrasonic examination of the liver were made in 49 patients with hydatid echinococcosis of the liver and 5 control patients operated on for extrahepatic pathology. Morphological picture of the liver was examined with light microscopy. AsAT and AlAT activity in hepatic tissue were estimated with 2,4-dinitrophenilhydrazin method. RESULTS: There were marked cellular and extracellular disorders and significant lowering of transaminases in the pericystic zone of hepatic tissue vs such indices for far from the echynococcal cyst sites of the liver. CONCLUSION: In hepatic echinococcosis hepatic tissue undergoes diffuse alteration associated with severe morphofunctional disorders which require adequate preoperative preparation of the patients, in postoperative period adequate intensive therapy is needed.

Adolescent↗

PubMed1999

[Evaluation of diagnostic value of 18 kDa antigen in alveolar echinococcosis].

AIM: To evaluate the 18 kDa antigen in diagnosis of human alveolar echinococcosis. METHODS: A total of 214 sera from patients with alveolar echinococcosis (AE, 33), cystic echinococcosis (CE, 69), cysticercosis (30) and healthy controls (82) were examined by Western blotting to detect the antibodies against 18 kDa antigen using both antigens from protoscoleces of E. granulosus (Eg) and E. multilocularis (Em). All the sera were tested simultaneously by ELISA to detect the antibodies against hydatid cystic fluid antigens of sheep as a comparison. RESULTS: The positive rate by ELISA was 93.9% in AE, 85.5% in CE, 50% in cysticercosis and 6.1% in healthy controls, respectively, suggesting a critical cross-reaction and a certain degree of nonspecific reaction. The serum positive rates by Western blotting with the 18 kDa antigen of Eg and Em were 90.9% and 90.9% in AE, 10.1% and 13% in CE, 13.3% and 16.7% in cysticercosis, respectively. No positive was found in the sera from healthy controls. CONCLUSION: The 18 kDa antigen may be used in the differential diagnosis of AE from CE.

Antigens, Helminth↗

PubMed2001

[Efficacy of ablendazole emulsion in treatment of 212 patients with cystic echinococcosis].

OBJECTIVE: To verify the efficacy of abendazole emulsion, a new formulation of abendazole, in treatment of human cystic echinococcosis. METHODS: 212 patients with liver cystic echinococcosis were treated orally with albendazole emulsion at a daily dose of 10 mg/kg or 12.5 mg/kg for 3 to 12 months or over one year. The therapeutic efficacy was mainly evaluated by image feature examined with B ultrasound examination, a short-term efficacy at the completion of treatment and a long-term efficacy followed-up for 1-4 years. RESULTS: In 212 patients treated with albendazole emulsion at a daily dose of 10 mg/kg and 12.5 mg/kg, the average cure rate, improved rate and the rate of no avail were 74.5%, 99.1% and 0.9% respectively after termination of the treatment, and the average long-term rates were 83.1%, 89.3% and 0.6% respectively. Recurrence occurred in 18 patients(10.2%). The results indicated that the best efficacy was seen in patients treated with albendazole 12.5 mg/kg daily for 9 months. Better response was also found when the recurrent patients were re-treated with albendazole. CONCLUSION: The efficacy of albendazole emulsion on patients with liver cystic echinococcosis is much better than that of albendazole tablet or capsule and mebendazole. Meanwhile, the efficacy of albendazole emulsion is stable with less adverse effects. The results suggest that albendazole emulsion could be the drug of choice for treatment of cystic hydatid disease.

Albendazole↗

PubMedDate not supplied

[The clinical aspects of the problem of echinococcosis and the means for its resolution].

The author assesses the basic clinical aspects of the problem of echinococcosis. Discusses the problems related to clinical realization of the invasion, clinical and morphologic parameters of the pathologic process development in echinococcosis, as well as problems in the diagnosis, treatment, and organization of the treatment-and-prophylaxis service in areas endemic for this condition. Outlines the major trends of further research of echinococcosis, that may be implemented at a new problem-solving unit that is to be created.

Databases, Factual↗

PubMedDate not supplied

[The stimulation of superoxide formation by human neutrophils under the action of blood serum from echinococcosis patients].

The effect of blood serum of patients with liver echinococcosis on the superoxide production by neutrophils of donors was studied. The patients observed were distributed to 2 groups: 1) those with uncomplicated disease and 2) those with festered cyst. Blood serum of patients with echinococcosis was proved to stimulate superoxide production by donor neutrophils by 107-483% in comparison with donor's serum. The serum from patients with festered cyst was shown to have no pronounced effect on superoxide production but a day after echinococcectomy the maximal stimulation was observed, which was 12.03 +/- 0.96 nM/superoxide per 10(6) cells (donor serum 2.49 nM per 10(6) cells). It might be caused by stress effect of the operation. In this group of patients the stimulating effect was gradually decreasing after the operation reaching the control level. In patients with uncomplicated echinococcosis, the stimulation of superoxide production was most profound in the preoperational period (6.70 +/- 0.65 nM per 10(6) cells), and after the operation the stimulating effect gradually disappeared. It is supposed that the phenomenon described is caused by specific antigens which are produced by the helminth.

Echinococcosis, Hepatic↗

PubMed2003

Echinococcosis multilocularis in south-eastern Anatolia, Turkey.

OBJECTIVE: To quantify the human prevalence, elucidate possible risk factors and present other epidemiological parameters of human alveolar echinococcosis in the south-eastern region of Turkey. DESIGN: A retrospective study. SETTINGS: South-eastern region (Anatolia) of Turkey by two medical centres: Dicle University Medical Faculty in Diyarbakir and Harran University Medical Faculty in Urfa. SUBJECTS: Forty seven cases of human alveolar echinococcosis were presented between the period of 1980 and 2000. METHODS: For the majority of our patients, personal anamnestic, clinical data and addresses were available from their files, and we visited their villages to investigate the risk factors for human alveolar echinococcosis. Epidemiological parameters were evaluated. RESULTS: The 47 cases consisted of 18 (38.3%) males and 29 (61.7%) females. The average age was 34.6 years. In all cases, lesions occurred in the liver. No village or district had more than one case. The majority of patients (73.8%) were farmers and 33 had a history of dog ownership. CONCLUSION: This region has a higher incidence than Turkey as a whole, and domestic dogs and free-ranging dogs seem to be the main source of infection.

Adolescent↗

PubMed2003

[Dynamic observation on ultrasonographic image during chemotherapy of hepatic cystic echinococcosis and a proposal for ultrasonic classification].

OBJECTIVE: To submit a proposal for the classification of ultrasonographic image in patients with hepatic cystic echinococcosis, on the basis of characteristic and distribution of ultrasonic image of hydatid cysts in cases and systematic observation on dynamic changes of sonographic image under treatment with emulsion albendazole and in relation to clinical efficacy. METHODS: The ultrasonic image of 645 cysts in 497 cases with liver cystic echinococcosis was classified. The distribution of different types of image in patients was analyzed. A comparative analysis of correspondence between the sonographic type and clinical efficacy was made in association with the rule of changes in ultrasonic features during chemotherapy. RESULTS: The ultrasonographic image of hydatid cysts was divided into six types. The distribution of ultrasonic types in patients reflected the process of natural evolution of cysts in human bodies. The dynamic change of ultrasonic image during treatment was identical with the natural evolution process of hydatid cysts. CONCLUSION: The proposal for ultrasonographic classification submitted reflects a long evolutionary process from growth to death of hydatid cysts in human body. The dynamic change of hydatid cysts during chemotherapy indicated that the effect of drug has accelerated this process. Therefore this classification may be applied in diagnosis and to judge the chemotherapeutic efficacy of cystic echinococcosis.

Adolescent↗

PubMed2003

[Electrocardiographic picture of a previous myocardial infarction in a patient with liver echinococcosis cyst].

We report a case of a 32-year-old man who was hospitalized at the Department of Surgery for hepatic cystic echinococcosis. Standard preoperative electrocardiogram revealed the presence of Q waves in the inferior leads, suggesting the presence of a previous myocardial infarction. Two-dimensional echocardiography showed a hepatic cystic echinococcosis raising the diaphragmatic wall of the left ventricle. The electrocardiogram performed the day after surgery showed disappearance of Q waves in the inferior leads. Thus, it is suggested that the preoperative electrocardiographic picture of a previous myocardial infarction was determined by the mass of the hepatic cystic echinococcosis.

Adult↗

PubMed2003

Epidemiology of alveolar echinococcosis with particular reference to China and Europe.

Human alveolar echinococcosis (AE), caused by the metacestode of the fox tapeworm Echinococcus multilocularis, is the most pathogenic zoonosis in temperate and arctic regions of the northern hemisphere. Prospective collection of human cases in some areas and mass screenings using ultrasound imaging and confirmation with serological techniques have markedly improved our knowledge of the epidemiology of the disease in humans during the past two decades. Transmission occurs when eggs of the tapeworm, excreted by the final hosts (usually foxes but also dogs, wolves and cats), are ingested accidentally by humans or during normal feeding by a variety of rodents and small lagomorphs. However, the species of host animals differ according to regional changes in mammalian fauna. This review mostly focuses on epidemiology of alveolar echinococcosis in those parts of the world where new and more accurate epidemiological data are now available, i.e. China and Europe, as well as on new epidemiological trends that can be suspected from recent case reports and/or from recent changes in animal epidemiology of E. multilocularis infection. The People's Republic of China (PRC) is a newly recognized focus on AE in Asia. Human AE cases were firstly recognized in Xinjiang Uygur Autonomous Region and Qinghai Provinces at the end of 1950s and infected animals were first reported from Ningxia in central China and northeast of Inner Mongolia in the 1980s. E. multilocularis (and human cases of AE) appears to occur in three areas: (1) Northeastern China (northeast focus): including Inner Mongolia Autonomous region and Heliongjiang Province (2) Central China (central focus): including Gansu Province, Ningxia Hui Autonomous Region, Sichuan Province, Qinghai Province and Tibet Autonomous Region and (3) Northwestern China: including Xinjiang Uygur Autonomous Region, bordered with Mongolia, Russia, Kazakhstan and Kyrgyzstan. The highest prevalence of the disease, up to 15 per cent of the population in some villages, is reached in China. In Europe, data from the European Echinococcosis Registry (EurEchinoReg: 1982-2000) show 53 autochthonous cases of AE in Austria, 3 in Belgium, 235 in France, 126 in Germany, 1 in Greece, and 112 in Switzerland, and 15 'imported' cases, especially from central Asia; 14 cases were collected in Poland, a country not previously considered endemic for AE. Improved diagnostic technology, as well as a real increase in the infection rate and an extension to new areas, can explain that more than 500 cases have been reported for these 2 decades while less than 900 cases were published for the previous 7 decades. New epidemiological trends are related to an unprecedented increase in the fox population in Europe, to the unexpected development of urban foxes in Japan and in Europe, and to changes in the environmental situation in many countries worldwide due to climatic or anthropic factors which might influence the host-predator relationship in the animal reservoir and/or the behavioural characteristics of the populations in the endemic areas.

Adolescent↗

PubMed2003

[Cardiopericardial echinococcosis].

UNLABELLED: Cardiac hydatid cysts are rare and represent 0.5 to 2% off all hydatid cyst in human. We describe clinical and echographic features in 12 patients with cardiac echinococcosis, admitted between 1992 and 2001. Average age was 40 years (16-60 years). The cysts were located in the left ventricle wall (3 patients), right ventricle wall (3 patients) right atrium (3 patients) and pericardial cavity (3 patients). Cardiac Hydatid cyst diagnosis was established by transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) in all cases. Computed tomography and magnetic resonance imaging confirmed echographic finding. All patients were operated. The operation finding confirmed the imaging data. Only one patient died in the post operative period. No recurrence or associated complication were reported in the late follow up. CONCLUSION: In presence of atypical symptomatology in a patient coming from an endemic area of hydatid cyst the diagnosis of cardiac echinococcosis is possible. TTE and TEE are the imaging procedure of choice and sufficient for the diagnosis of cardiac hydatid cyst. CT and/or MRI provide more information about the extension of echinococcosis diseases in other intra or extrathoracic location.

Adolescent↗

PubMed2001

Diagnosis of cystic echinococcosis: ultrasound imaging or countercurrent immunoelectrophoresis?

Cystic echinococcosis is a major zoonotic diseases in the Islamic Republic of Iran. This study was carried out in 3 general hospitals in Shiraz. We examined the records of all 1227 surgical patients with a surgically-proven diagnosis of cystic echinococcosis for the 20-year period 1978-98. The results of countercurrent immunoelectrophoresis were compared with pathology and ultrasound reports to determine whether serological tests could be helpful for diagnosis. Countercurrent immunoelectrophoresis could detect only 62.0% of cases, whereas the pathology and ultrasound results were positive for 96.3% of cases. This study confirms the usefulness of ultrasound and suggests that only in doubtful cases would countercurrent immunoelectrophoresis be useful for diagnosing cystic echinococcosis.

Biopsy↗

PubMed2004

Short report: endemic focus of cystic echinococcosis in a coastal city of Peru.

No evidence of Echinococcus granulosus infection has been described in the coastal region of Peru, with the exception of the capital city of Lima. Anecdotal evidence suggests the existence of a focus of echinococcosis in the coastal city of Chincha, located south of Lima. We conducted a preliminary epidemiologic study in Chincha, which included an ultrasound, chest radiography, and serologic survey of abattoir workers, a review of medical records from local hospitals, and examination of the intestines of stray dogs to determine the presence of canine echinococcosis. Among 25 abattoir workers examined for the presence of cystic echinococcosis, we found three (12%) subjects with echinococcal cysts. A review of medical records showed a surgical incidence of 32/100,000 for the period 1996-1998. Three of 48 dogs (6.25%) were found to be infected with E. granulosus tapeworms. This study demonstrates the existence of an undocumented endemic focus of E. granulosus previously unknown in the coastal region of Peru.

Abattoirs↗

PubMed2004

[Cyst puncture aspiration in 40 cases of abdominal echinococcosis].

OBJECTIVE: To evaluate the efficacy of cyst puncture aspiration in treating abdominal echinococcosis. METHOD: A retrospective analysis was performed in 40 cases of abdominal echinococcosis with formation of isolated single cyst in close adhesion with the abdominal wall, for which cyst puncture aspiration was carried out under ultrasound guidance. RESULTS: No death occurred in these patients and only 15 developed mild fever. The days for antibiotic use, jaundice resolution, bile secretion, time of extubation and hospital stay were 2.88+/-0.65, 3.50+/-0.71, 4.25+/-0.96, 5.38+/-0.98 and 9.35+/-1.08 days, respectively. Ultrasound examination in the follow-up showed no relapse in these patients, with the time of the residue adhesive cyst closure and calcification of 4.50+/-1.13 and 13.90+/-2.38 months, respectively. CONCLUSION: Cyst puncture aspiration under ultrasound guidance produces good therapeutic effects on abdominal echinococcosis with isolated single cyst closely adhering to the abdominal wall.

Abdomen↗

PubMed2005

Negative-ELISA using native and filtrated cystic fluid antigens to rule out cystic echinococcosis.

An increasing number of cases of echinococcosis in Thailand have been imported, probably native infections and medical transfers. Serodiagnosis is one diagnostic choice for interpreting infections before a further step is done. Due to limited antigen, indirect ELISA has been used as a negative screening test for IgG-detection to rule out echinococcosis. Native hydatid cystic fluid (HCF) antigen from Belgium was used for such testing, in which the ODs-ELISA of samples were compared with those of two positive controls. Subsequently, hydatid cyst fluid from a Thai patient was obtained and the filtrated cyst fluid antigen [(<30)-(>10) kDa, HCF30.10] was prepared to develop negative screening results for the serum samples. By using HCF, three of twenty-four samples resulted in higher ODs-ELISA than the controls. In an attempt to observe the cross-reactivity of this native antigen, IgG-antibodies from many helminthiases cross-reacted and showed high ODs-ELISA. The HCF30.10 Ag was used to develop the test and analyze IgG-antibodies from 5 positive controls (2 parasite-confirmed and 3 positive-serodiagnosed), 183 heterologous cases of 29 diseases and 50 healthy control sera. At a cut-off value of 0.484, the test had 100% sensitivity and 42% specificity. Only Malayan filariasis, onchocercosis, fascioliasis, amebiasis, giardiasis and blastocystosis gave true negatives. Antibodies from nematodiases strongly cross-reacted with HCF30.10 Ag. Nine of fifty (18%) healthy serum controls produced higher OD-values than the cut-off. The routine ELISA uses the HCF30.10 Ag to produce a negative result to echinococcosis, because limited cystic fluid antigen (Thai patient) for test improvement, a lot of cross-reactions and only two protoscolex-positive controls are available.

Animals↗

PubMed2006

Unique family clustering of human echinococcosis cases in a chinese community.

We have identified a significant focus and unusual clustering of human cases of cystic echinococcosis (CE) and alveolar echinococcosis (AE) in the village of Nanwan, Xiji County, Ningxia Hui Autonomous Region, in one of the most highly endemic areas for both diseases in China. The village, a Chinese Hui Islamic community, is composed of 167 members of four extended families. A total of 28 people died (12 of echinococcosis) since the village was first settled in the 1950s. Despite similar life patterns, the number of AE and CE cases occurring in each family was different. Overall, the prevalences of AE and CE were 9% (20 cases) and 5.9% (13 cases), with a combined prevalence of 14.9%. In contrast to CE, a comparison of the prevalence of AE indicated significant differences between the four family clusters. Although suggestive that host genotype might play a role in susceptibility to AE, this hypothesis requires further investigation.

Adolescent↗

PubMed2006

[Recurrence of echinococcosis: pathogenesis, prophylaxis, early diagnosis and treatment].

Complex of measures for prophylaxis of echinococcosis recurrence was developed basing on experimental and clinical studies. Results of surgical treatment of echinococcosis of different location in 983 patients were analyzed. Complex approach to the treatment reduced the rate of recurrences to 0.6% (p=0,0002). Criteria of recovery and algorithm of early diagnosis of echinococcosis recurrence are presented.

Adolescent↗

PubMed2006

[Echinococcosis in Bosnia and Herzegovina].

Echinococcosis is zoonosis transmitted by dogs in livestock-raising areas and accidentally affects man. Disease is endemic in certain parts of the world, including our country particularly region of Herzegovina. The most frequent site of hydatid cysts in the liver (78 %), followed by the lungs (17 %), and less frequently, the spleen, kidneys, heart, bones, central nervous system, and elsewhere. The diagnosis is based on clinical features, imaging examinations and serology. In the treatment of hydatidosis, three options are available: surgery, medical treatment by benzimidazole carbamates and percutaneous drainage. Drug therapy has scolicidal activity bat are clinically effective in less than 30 % of patients with hepatic hydatidosis. Surgery is no longer the treatment of first choice for hydatidosis located in abdomen. Percutaneous drainage associated with albendazole therapy is safe and efficient treatment for hydatid cysts in abdomen and retroperitoneal space. Surgery should be reserved for patient with hydatid cysts where PAIR with albendazole therapy can not be performed. Moreover, a multidisciplinary approach is advisable to assure a better clinical management to patients with cystic echinococcosis and eradication of hydatidosis. The socio-economic impact of cystic echinococcosis is reviewed with special reference to the following topics: consequences in man and livestock, costs and benefits of control programmes and economic procedures for evaluating control programmes. The durability of control programs is the corner stone for obtaining a significant decrease of hydatid infection. Many consequences in man and livestock are difficult to evaluate from an economic point of view, because some basic data are difficult to obtain in our country. Health education represents essential elements in the control and eradication campaigns of echinococcosis/hydatidosis.

Bosnia and Herzegovina↗

PubMed1990

First report on the occurrence of human cases of alveolar echinococcosis in the northeast of Austria.

Since Posselt (1928) it is known, that Echinococcus multilocularis, the causative organism of alveolar echinococcosis, is prevalent in the western and southern provinces of Austria (Vorarlberg, The Tyrol, Salzburg, Carinthia, Styria). Recent distributional data confirmed the existence of these endemic areas in the mountain range of the Alps. Within the period from 1983 to 1988 human cases of obviously autochthonous alveolar echinococcosis were detected in the northeast of Austria, north of the river Danube, for the first time. This paper presents a clinical, diagnostic, therapeutical and epidemiological documentation of these three cases (2 females, 1 male), which represent the eastern most records of autochthonous E. multilocularis infections of the Central European distribution area of alveolar echinococcosis.

Austria↗