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1.
PLoS Negl Trop Dis ; 18(5): e0012183, 2024 May.
Article in English | MEDLINE | ID: mdl-38814859

ABSTRACT

Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.


Subject(s)
Echinococcosis , Humans , Echinococcosis/diagnosis , Echinococcosis/surgery , Animals , Heart Diseases/parasitology , Heart Diseases/surgery , Echinococcus granulosus , Heart/parasitology
2.
BMC Surg ; 24(1): 160, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38760696

ABSTRACT

INTRODUCTION: Hydatid disease, endemic in Mediterranean countries, primarily affects the liver, but can manifest in diverse organs. Non-hepatic and non-pulmonary cysts often pose diagnostic challenges. This study examines patients with hydatid cysts in atypical locations. METHODS AND RESULTS: From 2013 to 2020, our center treated 250 echinococcosis patients, among whom 11 cases (4.4%) with hydatid disease in uncommon sites were retrospectively reviewed. The distribution of unusual cyst locations and their clinical implications are discussed. CONCLUSION: Diagnosing hydatid cysts in uncommon locations is a formidable challenge. Surgeons should always contemplate the prospect of an unconventional cyst location when encountering patients with cystic masses in endemic regions. Failing to consider this possibility could lead to unfavorable outcomes.


Subject(s)
Echinococcosis , Humans , Retrospective Studies , Echinococcosis/diagnosis , Echinococcosis/surgery , Male , Female , Adult , Middle Aged , Aged , Young Adult , Adolescent
4.
Ann Transplant ; 29: e942358, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38622855

ABSTRACT

BACKGROUND Hepatic cystic echinococcosis (HCE) is a frequently overlooked parasitic liver disease, for which the commonly recommended treatment is radical resection. However, this approach is often associated with severe comorbidities such as HBV/HCV, cirrhosis, and hepatic carcinoma, among others. CASE REPORT In this report, we present a case successfully managed by ex vivo liver resection and autologous liver transplantation (ELRA). In the described case, ex vivo resection was not feasible due to recurrent lesions and infections invading the portal vein, which resulted in portal vein cavernous transformation. CONCLUSIONS Through this paper, we aim to detail the treatment process, showcasing the feasibility and advantages of ELRA. Additionally, we propose a novel approach for the treatment of this disease, while emphasizing the importance of radical resection surgery to prevent long-term complications.


Subject(s)
Echinococcosis, Hepatic , Echinococcosis , Humans , Transplantation, Autologous , Portal Vein/surgery , Echinococcosis, Hepatic/complications , Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Hepatic/surgery , Hepatectomy/methods , Echinococcosis/surgery , Echinococcosis/complications , Echinococcosis/pathology
8.
Turkiye Parazitol Derg ; 48(1): 62-65, 2024 03 05.
Article in English | MEDLINE | ID: mdl-38449370

ABSTRACT

Hydatid cyst is a zoonotic disease and is an important health problem, especially in developing countries. Hydatic cysts are typically observed in the liver and lungs. Cardiac and brain involvement are rare manifestations. Cardiac hydatic cysts are usually located in the left ventricle. Brain involvement is frequently seen as a primary cerebral cyst and is almost always solitary. However, secondary intracerebral cysts are also seen as a result of cardiac cysts rupturing into the left ventricle spontaneously or iatrogenically, and these are usually multiple. Herein, we report a case that has two rare clinical manifestations of hydatid cysts.


Subject(s)
Cysts , Echinococcosis , Echinococcus , Animals , Humans , Cysts/diagnostic imaging , Cysts/surgery , Heart , Liver , Echinococcosis/diagnostic imaging , Echinococcosis/surgery
10.
Ann Parasitol ; 69(3-4)2024.
Article in English | MEDLINE | ID: mdl-38423520

ABSTRACT

Treatment of liver hydatid cysts is still in most cases surgical. To avoid the recurrence of hydatid cysts injection of scolicidal products inside the cystic cavity is an important step in the surgical procedure. Many scolicidal solutions are used. Hypertonic Saline Solution (HSS) is widely used by surgeons; however, there is a risk of hypertonic saline resorption and acute hypernatremia. Iatrogenic hypernatremia can be life-threatening. We report three cases of hypernatremia secondary to HSS injection for hydatid cyst disease treatment. The objective of this study was to discuss the clinical features, and treatment of this rare complication.


Subject(s)
Abdomen, Acute , Echinococcosis, Hepatic , Echinococcosis , Echinococcus , Hypernatremia , Animals , Humans , Hypernatremia/complications , Hypernatremia/drug therapy , Abdomen, Acute/complications , Abdomen, Acute/drug therapy , Echinococcosis/surgery , Echinococcosis, Hepatic/complications , Echinococcosis, Hepatic/surgery , Echinococcosis, Hepatic/drug therapy , Saline Solution, Hypertonic/therapeutic use
11.
Arab J Gastroenterol ; 25(2): 230-233, 2024 May.
Article in English | MEDLINE | ID: mdl-38238228

ABSTRACT

Hydatidosis is an endemic disease in certain areas in the world particularly in the Mediterranean, the Middle East, and South America, caused by a cestode known as Echinococcus granulosus. Humans are the accidental intermediate hosts. The liver and the lungs are the most commonly involved organ. If the parasite passes through the pulmonary capillary bed, the hydatid cyst may develop at any site in the body like bone, pancreas, brain, kidney, and orbit. Isolated spleen hydatid cyst is very rare. We hereby report one observation of isolated hydatid cyst of the spleen in a patient living in non-endemic area and without any potential risk.


Subject(s)
Echinococcosis , Splenic Diseases , Humans , Echinococcosis/diagnosis , Echinococcosis/surgery , Splenic Diseases/parasitology , Splenic Diseases/diagnosis , Splenic Diseases/diagnostic imaging , Male , Adult , Tomography, X-Ray Computed , Female , Albendazole/therapeutic use
12.
Ulus Travma Acil Cerrahi Derg ; 30(1): 68-71, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38226569

ABSTRACT

Gossypiboma is a non-absorbable material that is forgotten during surgery. These are medicolegal pathology that leads to diagnostic confusion from abscess to tumor. We present the case of gossypiboma detected in laparotomy in a 57-year-old male patient who had a history of operation due to a hydatid cyst 22 years ago and was referred to our center due to hydatid recurrence. The case should suggest a history of surgical gossypiboma, especially in asymptomatic patients. In this preventable pathology, the strategy during sur-gery and the careful and proper attitude of the surgical team are the main determinants.


Subject(s)
Echinococcosis, Hepatic , Echinococcosis , Foreign Bodies , Male , Humans , Middle Aged , Echinococcosis, Hepatic/diagnosis , Echinococcosis, Hepatic/surgery , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Echinococcosis/diagnosis , Echinococcosis/surgery , Abscess , Laparotomy
13.
Childs Nerv Syst ; 40(2): 335-343, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37243810

ABSTRACT

Hydatidosis is a parasitic infestation whose etiological agent is the larva of the cestode Echinococcus granulosus. It is a zoonosis, and the human being behaves as an accidental intermediate host in the parasitic cycle with pediatric predominance. The most frequent clinical presentation is hepatic, followed by pulmonary, with cerebral hydatidosis being extremely rare. Imaging is characteristic, generally dealing with single cystic lesion, usually unilocular and less frequently multilocular, located mainly intraaxially. Extradural hydatid cyst, whether primary or secondary, remains very rare or even exceptional. The primary disease remains extremely rare, and its clinical picture is related to the number, size, and location of the lesions. Infection within these cerebral hydatid cysts remains an extremely rare occurrence, and only few cases were reported previously in the literature. The authors report the nosological review of the clinical, imaging, surgical, and histopathological records of a pediatric primary osteolytic extradural and complicated hydatid cyst in a 5-year-old North African male patient coming from a rural area who presented for progressive onset of a painless left parieto-occipital soft swelling without any neurological disorder with good outcomes after surgery. The authors report this case due the fact that it had not been documented before in the pediatric population and to the success of the specialized treatment.


Subject(s)
Brain Neoplasms , Echinococcosis , Humans , Male , Child , Child, Preschool , Echinococcosis/complications , Echinococcosis/diagnostic imaging , Echinococcosis/surgery , Skull/diagnostic imaging , Skull/surgery , Skull/pathology , Brain Neoplasms/complications
14.
HPB (Oxford) ; 26(2): 224-233, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37867084

ABSTRACT

INTRODUCTION: Recurrence after curative resection of hepatic alveolar echinococcosis remains a clinical challenge. The current study tested if assessment of anti-recEm18 allows for postsurgical patient surveillance. METHODS: A retrospective study with patients undergoing liver resection for alveolar echinococcosis (n = 88) at the University Hospital Bern from 2002 to 2020 and at the University Hospital and Medical Center Ulm from 2011 to 2017 was performed. Analysis was directed to determine a potential association of pre- and postoperative values of anti-recEm18 with clinical outcomes. RESULTS: Anti-recEm18 had a linear correlation to the maximum lesion diameter (R2 = 0.558). Three trajectories of anti-recEm18 were identified based on a threshold of 10 AU/ml: "Em18-low" (n = 31), "responders" (n = 53) and "residual disease" (n = 4). The decline of anti-recEm18 in "responders" reached a plateau after 10.9 months at which levels decreased by 90%. The only patient with recurrence in the entire population was also the only patient with a secondary increase of anti-recEm18. CONCLUSION: In patients with preoperative elevated values, anti-recEm18 confirms curative surgery at 12 months follow-up and allows for long-term surveillance.


Subject(s)
Echinococcosis, Hepatic , Echinococcosis , Humans , Echinococcosis, Hepatic/surgery , Retrospective Studies , Follow-Up Studies , Echinococcosis/surgery , Hepatectomy/adverse effects
16.
Childs Nerv Syst ; 40(2): 321-325, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37855879

ABSTRACT

Hydatid disease is very common around the Mediterranean basin and endemic in some parts of the world. Cerebral involvement remains rare, represents only about 2% of all hydatid localizations and mainly affects the pediatric population. Extradural hydatid cyst is very rare or even exceptional when it is associated with or followed by intracerebral disseminations. Here, the authors report a new exceptional case of an early multiple intra-axial hydatid dissemination in a 5-year-old North African male patient from a rural area who underwent surgery 3 months after a primary osteolytic extradural and complicated hydatid cyst with good clinical and radiological outcomes.


Subject(s)
Echinococcosis , Humans , Male , Child , Child, Preschool , Echinococcosis/complications , Echinococcosis/diagnostic imaging , Echinococcosis/surgery , Radiography
17.
J Med Case Rep ; 17(1): 541, 2023 Dec 14.
Article in English | MEDLINE | ID: mdl-38093379

ABSTRACT

BACKGROUND: Peritoneal cystic echinococcosis happens usually after traumatic rupture or after surgical treatment. Primary peritoneal cystic echinococcosis is a very rare case that constitutes a diagnostic and therapeutic challenge. CASE REPORT: A 30-year-old Tunisian man was admitted for hypogastric pain since 4 months. He has a 10 cm hypogastric mass. Biological-tests were normal. A computed tomography Scan showed a cystic mass on the pelvis measuring 13 × 17 cm without echinococcosis cyst in the liver. The patient was operated and we found a cystic mass of 17 cm located on the Douglas cul-de-sac that suggest a pelvic hydatid cyst. We have performed an aspiration of the cyst confirms the diagnosis followed by injection of hypertonic solution, extarction of the germinal layer and a maximal reduction of the pericyst. The postoperative course was uneventful. CONCLUSION: Trough our case, we try to focus on the diagnosis and therapeutic options of this rare entity that we should think of in front of a patient with isolated peritoneal cyst especially in endemic country.


Subject(s)
Cysts , Echinococcosis , Peritoneal Diseases , Male , Humans , Adult , Peritoneum/diagnostic imaging , Peritoneum/surgery , Echinococcosis/diagnostic imaging , Echinococcosis/surgery , Peritoneal Diseases/diagnostic imaging , Peritoneal Diseases/surgery , Abdominal Pain/etiology , Cysts/complications
18.
J Med Case Rep ; 17(1): 501, 2023 Dec 05.
Article in English | MEDLINE | ID: mdl-38049884

ABSTRACT

BACKGROUND: Splenic cysts are quite rare and asymptomatic. They may result from infection by a parasite, especially Echinococcus granulosus (hydatid cyst), or from non-parasitic causes. Since primary splenic cysts are not common, simple cysts can be misdiagnosed with a hydatid cyst in endemic areas. CASE PRESENTATION: We reported a 14-year-old Iranian girl initially presented with a vague abdominal pain, which progressed to left shoulder pain, fullness, early satiety, and shortness of breath and remained undiagnosed for 7 months despite seeking medical attention. Finally, imaging revealed a massive splenic cyst measuring 220 mm × 150 mm × 160 mm raising concern for a hydatid cyst due to regional endemicity. Consequently, the patient underwent total splenectomy. However, histopathological examination surprisingly revealed a simple non-parasitic cyst. CONCLUSIONS: Detecting rare simple spleen cysts requires early ultrasonography (US) and careful reassessment of diagnoses for non-responsive or worsening symptoms. Distinguishing them from splenic hydatidosis, especially in endemic areas, demands thorough paraclinical evaluations and patient history regarding potential parasitic exposure. While total splenectomy is the primary treatment for these huge cysts, the optimal surgical approach should be tailored case by case. These insights emphasize a comprehensive diagnostic approach to enhance accuracy and optimize patient care for these uncommon cysts.


Subject(s)
Cysts , Echinococcosis , Parasites , Splenic Diseases , Female , Animals , Humans , Adolescent , Iran , Splenic Diseases/diagnostic imaging , Splenic Diseases/surgery , Cysts/diagnostic imaging , Cysts/surgery , Echinococcosis/diagnostic imaging , Echinococcosis/surgery
19.
Parasitol Res ; 123(1): 40, 2023 Dec 14.
Article in English | MEDLINE | ID: mdl-38095718

ABSTRACT

Echinococcal disease (hydatid disease (HD) is an endemic parasitosis caused by Echinococcus granulosus in the larval stage, and it is typically due to the production of unilocular cystic lesions, usually involving the liver for the majority of patients and the lungs in 25%, but also any other organs can be potentially involved in developing echinococcal disease. We report a case of extrahepatic, retroperitoneal echinococcal disease, caused by Echinococcus granulosus. The patient underwent a surgical removal of the abdominal mass, revealed by abdominal ultrasound and computerized tomography scanning, and in the founded clinical and radiological suspicion of echinococcal disease, multiple bioptical samples were sent for microbiological analysis and albendazole therapy was started; Echinococcus granulosus protoscolices were found on the bioptical sample, and the diagnosis was successfully confirmed. According to the current parasitology literature on echinococcal disease, extrahepatic localization, although rare, can be found, and it should be considered in the differential diagnosis of an abdominal mass when epidemiological risk factors and anamnestic data are present, regardless of the usual site of the disease.


Subject(s)
Echinococcosis , Echinococcus granulosus , Echinococcus , Animals , Humans , Echinococcosis/diagnosis , Echinococcosis/drug therapy , Echinococcosis/surgery , Albendazole/therapeutic use , Risk Factors
20.
PLoS Negl Trop Dis ; 17(12): e0011813, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38064500

ABSTRACT

BACKGROUND: Cystic echinococcosis (CE) is an endemic disease in southern Chile. The aim of this study was to ascertain the prevalence of CE among relatives of patients who underwent surgical intervention for this disease in Cautín, a province of southern Chile. METHODOLOGY/PRINCIPAL FINDINGS: Cross-sectional study. Relatives of patients who underwent surgery for hepatic echinococcosis (HE), who lived at the same address, during the period 2000-2020 were studied. A total of 288 relatives of 322 patients who underwent surgery for HE participated in a CE screening. All these relatives were interviewed and underwent abdominal ultrasonography, chest X-ray and immunodiagnostic studies (relatives who had been diagnosed with or had undergone surgery for CE were excluded). Descriptive statistics were applied. Prevalence calculation, odds ratio (OR), and their respective 95% confidence intervals (95% CI) were determined. Abdominal or thoracic CE was verified in 42 relatives of subjects operated on for HE (mean age 41±8 years; 73.8% women; 38.1% of cases had two or more cysts), all of them new and asymptomatic cases. CE was detected in the lungs, liver, peritoneum, and spleen in 16.7%; 71.4%; 7.1%; and 4.8%, respectively. The overall prevalence of EQ during the studied time period was 14,6% (17.9% and 12.3% in relatives of first and second degree respectively (OR:1.56; CI 95%: 0.81; 3.01). CONCLUSION/SIGNIFICANCE: There is a high prevalence of CE in relatives of patients undergoing surgery by this disease in the province of Cautín, Chile.


Subject(s)
Echinococcosis, Hepatic , Echinococcosis , Humans , Female , Adult , Middle Aged , Male , Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Hepatic/epidemiology , Echinococcosis, Hepatic/surgery , Prevalence , Cross-Sectional Studies , Echinococcosis/epidemiology , Echinococcosis/surgery , Echinococcosis/diagnosis
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