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L'échinococcose alvéolaire est une parasitose endémique sévissant dans certaines zones froides de l'hémisphère Nord incluant notamment l'Est de la France, la Suisse, l'Allemagne, le Canada ou les États-Unis. Largement sous-diagnostiquée, elle est liée à l'infection par Echinococcus multilocularis , un petit taenia appartenant à la classe des cestodes, pouvant entraîner une atteinte multisystémique notamment chez le patient âgé ou immunodéprimé. Nous rapportons le cas d'une patiente de 82 ans, immunodéprimée par une corticothérapie prolongée et un traitement par dupilumab. Elle était adressée dans notre service pour bilan diagnostique de lésions hépatiques et pulmonaires atypiques, initialement suspectes de tuberculose ou de maladie associée aux IgG4. L'hypothèse d'une échinococcose alvéolaire à E. multilocularis a pu être évoquée sur un faisceau d'arguments, puis confirmée par diagnostic moléculaire. Nous évoquons et discutons le rôle du dupilumab dans l'évolution systémique et la présentation atypique de la maladie, par l'induction d'une immunodépression spécifique. L'échinococcose alvéolaire devrait être systématiquement recherchée en cas de maladie systémique comprenant une atteinte hépatique et pulmonaire au premier plan, surtout chez le sujet immunodéprimé. Alveolar echinococcosis is an endemic parasitic disease prevalent in certain cold regions of the Northern Hemisphere, including Eastern France, Switzerland, Germany, Canada, and the United States. Widely underdiagnosed, it is associated with infection by Echinococcus multilocularis , a small tapeworm belonging to the cestode class, capable of causing multi-systemic involvement, particularly in elderly or immunocompromised patients. We present the case of an 82-year-old patient, immunocompromised due to prolonged corticosteroid therapy and treatment with dupilumab. She was referred to our department for a diagnostic assessment of atypical hepatic and pulmonary lesions, initially suspected of tuberculosis or an IgG4-related disease. The hypothesis of alveolar echinococcosis caused by E. multilocularis was eventually considered based on a set of arguments, further confirmed by molecular diagnosis. We discuss the role of dupilumab in the systemic evolution and atypical presentation of the disease, through the induction of a specific immunosuppression. Alveolar echinococcosis should be systematically considered in case of systemic disease with prominent hepatic and pulmonary involvement, especially in immunocompromised patients. [ABSTRACT FROM AUTHOR]

Occult cystobiliary fistula (CBF) is a common complication of hepatic hydatid cyst (HHC). It is often the cause of high morbidity of conservative treatment of HHC. This study aimed to determine the predictive factors of occult CBF to establish the indications for the investigation and treatment of these CBFs. This was a prospective study that included all operated HHCs over a 3-year period. HHCs complicated with large CBFs were not included in the study. Systematic cholecystectomy and methylene blue test for all cysts were performed. A total of 46 patients operated on with 113 cysts were included in this study. The median cyst size was 6.7 cm (IQR, 1-38). A total of 114 CBFs were detected in 51 cysts (45.1%). The postoperative course was simple in 95.0% of cases. The specific morbidity rate was 2.7%. In a bivariate study, absence of mass and abdominal pain on palpation, hemoglobin level >11.55 g/dL, negative hydatid serology, cyst size, absence of calcifications, vascular compression, existence of a single cyst, and localization at segment VIII were predictive factors of occult CBF. At the end of the multivariate study, cyst size was determined to be the only predictive factor for occult CBF. A threshold of 3 cm was used. Cyst size is a major predictive factor for occult CBF. [ABSTRACT FROM AUTHOR]

Echinococcal liver cysts are predominantly located in the right lobe of the liver and are mostly asymptomatic. A frank intra-biliary rupture (IBR) of hydatid cyst is uncommon, having variable clinical presentation and treatment options. We present a case of a 60-year-old male patient who presented with pain in the upper abdomen associated with vomiting but without jaundice. On investigations, he was diagnosed to have a left lobe hepatic hydatid cyst (HHC) with IBR for which left hepatectomy with bile duct exploration was performed. It highlights the benign nature of the disease for which seldom major hepatectomies have to be performed. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis (AE) is a life-threatening zoonotic infection caused by Echinococcus multilocularis , an intestinal cestode of carnivorous animals (mostly canids). Its life cycle includes an adult stage in the intestines of carnivores and a larval stage (metacestode) in tissues of herbivores or omnivores. Humans are accidental/aberrant hosts and harbor the metacestode only. The disease presents as a continuously growing tumor-like liver mass with local or metastatic spread to distant organs, with mortality approaching 90% if untreated or partially treated. Diagnosis is based on characteristic imaging, serology and histopathology, and confirmation by nucleic acid amplification test. The geographical distribution of E. multilocularis covers most of the northern hemisphere, with human cases in Europe, Japan, Central Asia, and now North America. The recent establishment of a new parasite strain that is pathogenic to humans in Canada and the United States poses an emerging medical and public health threat and warrants a reassessment of our approach to this parasite. [ABSTRACT FROM AUTHOR]

[Display omitted] • Genotyping of Echinococcus multilocularis based on the whole mitochondrial (mt) genome was performed. • Information on genetic diversity was obtained for 30 visceral samples from alveolar echinococcosis (AE) patients. • Full mtDNA was compared with three mt genes and nuclear EmsB microsatellite genotyping. • We found 14 haplotypes based on full-mtDNA, six with cob - cox1 - nad2 genes and five with EmsB. • It was possible to trace the geographical origin of AE infections in patients. Alveolar echinococcosis (AE) is a parasitosis that is expanding worldwide, including in Europe. The development of genotypic markers is essential to follow its spatiotemporal evolution. Sequencing of the commonly used mitochondrial genes cob , cox1 , and nad2 shows low discriminatory power, and analysis of the microsatellite marker EmsB does not allow nucleotide sequence analysis. We aimed to develop a new method for the genotyping of Echinococcus multilocularis based on whole mitochondrial genome (mitogenome) sequencing, to determine the genetic diversity among 30 human visceral samples from French patients, and compare this method with those currently in use. Sequencing of the whole mitochondrial genome was carried out after amplification by PCR, using one uniplex and two multiplex reactions to cover the 13,738 bp of the mitogenome, combined with Illumina technology. Thirty complete mitogenome sequences were obtained from AE lesions. One showed strong identity with Asian genotypes (99.98% identity) in a patient who had travelled to China. The other 29 mitogenomes could be differentiated into 13 haplotypes, showing higher haplotype and nucleotide diversity than when using the cob , cox1 , and nad2 gene sequences alone. The mitochondrial genotyping data and EmsB profiles did not overlap, probably because one method uses the mitochondrial genome and the other the nuclear genome. The pairwise fixation index (F st) value between individuals living inside and those living outside the endemic area was high (F st = 0.222, P = 0.002). This is consistent with the hypothesis of an expansion from historical endemic areas to peripheral regions. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis (AE) results of an infection with the larval stage of Echinococcus multilocularis. It has been increasingly described in individuals with impaired immune responsiveness. This narrative review aims at describing the presentation of AE according to the type of immune impairment, based on retrospective cohorts and case reports. Implications for patient management and future research are proposed accordingly. Targeted search was conducted in PubMed using ((alveolar echinococcosis) OR (multilocularis)) AND ((immunosuppressive) OR (immunodeficiency) OR (AIDS) OR (solid organ transplant) OR (autoimmunity) OR (immune deficiency)). Only publications in English were considered. Seventeen publications were found, including 13 reports of 55 AE in immunocompromised patients (AE/IS) and 4 retrospective studies of 755 AE immunocompetent patients and 115 AE/IS (13%). The cohorts included 9 (1%) solid organ transplantation (SOT) recipients, 2 (0.2%) HIV patients, 41 (4.7%) with chronic inflammatory/autoimmune diseases (I/AID) and 72 (8.3%) with malignancies. SOT, I/AID and malignancies, but not HIV infection, were significantly associated with AE (odds ratios of 10.8, 1.6, 5.9, and 1.3, respectively). Compared to AE immunocompetent patients, AE/IS was associated with earlier diagnosis (PNM stages I–II: 49/85 (58%) vs. 137/348 (39%), p < 0.001), high rate of atypical imaging (24/50 (48%) vs. 106/375 (28%), p < 0.01), and low sensitivity of serology (19/77 (25%) vs. 265/329 (81%), p < 0.001). Unusually extensive or disseminated infections were described in SOT and I/AID patients. Patients who live in endemic areas should benefit from serology before onset of a long-term immunosuppressive therapy, even if the cost-benefit ratio has to be evaluated. Physicians should explain AE to immunocompromised patients and think about AE when finding a liver lesion. Further research should address gaps in knowledge of AE/IS. Especially, extensive and accurate records of AE cases have to be collected by multinational registries. [ABSTRACT FROM AUTHOR]

• Programmed death-ligand 1 (PD-L1) is prognostic in alveolar echinococcosis (AE). • PD-L1 is overexpressed in the surgical specimens of patients with AE recurrence. • Patients with AE with PD-L1 liver expression <1% showed a better disease-free survival. Alveolar echinococcosis (AE) recurrence is one of the major stakes in patients undergoing surgery, the main curative treatment. Preliminary data demonstrated an effect of programmed death-ligand1 (PD-L1) inhibitors on AE proliferation in animals. The current study aimed to analyze the prognostic value of PD-L1 expression in tissue samples of patients with AE undergoing surgery. A cross-sectional study of patients operated for AE between 2002 and 2017 was performed. Patients with recurrence were matched 1: 2 with patients without recurrence. The matching criteria were PNM staging (P = hepatic localization of the parasite, N = extra-hepatic involvement of neighboring organs, and M = absence or presence of metastasis), resection status, preoperative albendazole treatment, and lesion size. PD-L1 immunohistochemistry staining was performed in surgical liver specimens. The expression of PD-L1 was assessed in immune cells. Disease-free survival was calculated using the Kaplan-Meier method. Among 68 consecutive patients, eight patients with recurrence were matched to 16 patients without recurrence. PD-L1 was overexpressed in patients with recurrence (recurrence: PD-L1 <1%: one, PD-L1 ≥1%: seven; no recurrence: PD-L1 <1%: nine, PD-L1 ≥1%: seven, P = 0.040). Moreover, patients with lower PD-L1 expression (<1%) showed better median disease-free survival (120 months, 95% confidence interval 104-135 vs 74, 95% confidence interval 44-104, P = 0.050). These findings highlight the proof of concept of PD-L1 in AE, but further data on its prognostic importance and the role of immune checkpoint blockade as a promising therapeutical strategy are needed. [ABSTRACT FROM AUTHOR]

The neglected zoonosis cystic echinococcosis affects mainly pastoral and rural communities in both low-income and upper-middle-income countries. In Europe, it should be regarded as an orphan and rare disease. Although human cystic echinococcosis is a notifiable parasitic infectious disease in most European countries, in practice it is largely under-reported by national health systems. To fill this gap, we extracted data on the number, incidence, and trend of human cases in Europe through a systematic review approach, using both the scientific and grey literature and accounting for the period of publication from 1997 to 2021. The highest number of possible human cases at the national level was calculated from various data sources to generate a descriptive model of human cystic echinococcosis in Europe. We identified 64 745 human cystic echinococcosis cases from 40 European countries. The mean annual incidence from 1997 to 2020 throughout Europe was 0·64 cases per 100 000 people and in EU member states was 0·50 cases per 100 000 people. Based on incidence rates and trends detected in this study, the current epicentre of cystic echinococcosis in Europe is in the southeastern European countries, whereas historical endemic European Mediterranean countries have recorded a decrease in the number of cases over the time. [ABSTRACT FROM AUTHOR]

• The silver nanoparticles (ANP) were green synthesized using astragalus spinosus. • ANP exhibited significant in vitro protoscolicidal activity. • ANP increased the expression of caspase-3 and caspase-9 genes. • ANP reduced the number, size, and weight of hydatid cysts in mice. • ANP increase the expression of antioxidant genes and decreased the inflammatory genes. The present investigation aims to develop and evaluate silver nanoparticles (AgNP) synthesized through environmentally friendly methods and to assess their effectiveness against hydatid cysts through in vitro, ex vivo, and in vivo experiments. The green synthesis of ANP was accomplished using the precipitation technique with Astragalus spinosus extract. The in vitro protoscolicidal effects of ANP were evaluated on hydatid cyst protoscoleces (PTS) through eosin exclusion test. The study also investigated the effect of ANP on the gene expression levels of caspase-3 and 9, as well as the external morphology of PTS. The in vivo efficacy was assessed by analyzing the quantity, dimensions, and weight of hydatid cysts in infected mice. Real-time PCR was used to analyze the gene expression levels of antioxidant and inflammatory cytokines. ANP exhibited significant (p < 0.001) in vitro protoscolicidal activity in a dose- and time-dependent manner. Treatment with ANP resulted in creases and protrusions on the plasma membrane, indicating bleb formation and an increase in the expression of caspase-3 and caspase-9 genes. Notably, there was a significant (p < 0.001) reduction in the number, size, and weight of hydatid cysts following ANP treatment. Administration of ANP resulted in a significant increase in the expression of antioxidant genes (glutathione peroxidase and superoxide dismutase) and a notable decrease in oxidative stress markers, as well as in the expression levels of Interleukin-4 (IL-4) and IL-10. Due to its antioxidant and anti-inflammatory properties, ANP shows potential as a scolicidal agent and holds promise in managing hydatid cysts in a mouse model. Nevertheless, further clinical trials are imperative to validate the efficacy of ANP in treating hydatidosis. [ABSTRACT FROM AUTHOR]

Ciliated cyst of the liver is rarely seen in the pediatric population and considered as a benign tumor often discovered incidentally. We report the case of a 12-year-old child with a history of contact with dogs, admitted to our department of pediatric surgery because of an abdominal trauma. He had no significant medical history. All blood tests were within normal limits. A computed tomography scan was performed and revealed a 60-mm cystic lesion with dense contents in segment IV of the liver, suspicious for a biliary cyst or a hydatid cyst. Magnetic resonance imaging was in line with the diagnosis of a type I hydatid cyst of the liver according to the Gharbi classification. The patient underwent a laparoscopic resection of the cyst without spilling any content in the peritoneal cavity. The pathological examination of the specimen confirmed the presence of a cystic formation lined by ciliated pseudostratified epithelium without signs of infection or malignancy, confirming the diagnosis of a ciliated cyst of the liver. The postoperative course was uneventful. At 6 months of follow up he remains asymptomatic and has a normal abdominal ultrasound. Ciliated cysts should be included in the differential diagnosis of cystic lesions of the liver. The therapeutic management is a subject of debate. [ABSTRACT FROM AUTHOR]

[Display omitted] Spinal cystic echinococcosis (CE) is a rare but malignant zoonosis that can cause disability or even death in more than half of patients. Due to the complex pathological features, it is not curable by conventional drugs and surgery, so new therapeutic targets urgently need to be discovered. In this study, we clarify the occurrence of the phenomenon of spinal encapsulation angiogenesis and explore its underlying molecular mechanisms. A co-culture system was established by protoscoleces (PSCs) with human umbilical vein endothelial cells (HUVECs) which showed a high expression level of Nrf2. A short hairpin RNA (shRNA) and Sulforaphane (SFN) affecting the expression of Nrf2 were used to treat HUVECs. The results showed that Nrf2 could promote the tube formation of HUVECs. Nrf2 also exerts a protective effect against HUVECs, which is achieved by promoting NQO1 expression to stabilize ROS levels. Furthermore, autophagy activation significantly promotes angiogenesis in the spinal echinococcosis model (SEM) as a result of Nrf2 regulation of oxidative stress. These results suggest that the ROS/Nrf2/autophagy axis can induce angiogenesis and may be a potential target for the treatment of spinal cystic echinococcosis. [ABSTRACT FROM AUTHOR]

Echinococcosis and tuberculosis are two common zoonotic diseases that can cause severe pulmonary infections. Early screening and treatment monitoring are of great significance, especially in areas with limited medical resources. Herein, we designed an operation-friendly and rapid magnetic enrichment-silver acetylene chromogenic immunoassay (Me-Sacia) to monitor the antibody. The main components included secondary antibody-modified magnetic nanoparticles (MNP-Ab2) as capture nanoparticles, specific peptide (EG95 or CFP10)-modified silver nanoparticles (AgNP-PTs) as detection nanoparticles, and alkyne-modified gold nanoflowers as chromogenic nanoparticles. Based on the magnetic separation and plasma luminescence techniques, Me-Sacia could completely replace the colorimetric assay of biological enzymes. It reduced the detection time to approximately 1 h and simplified the labor-intensive and equipment-intensive processes associated with conventional ELISA. Meanwhile, the Me-Sacia showed universality for various blood samples and intuitive observation with the naked eye. Compared to conventional ELISA, Me-Sacia lowered the detection limit by approximately 96.8 %, increased the overall speed by approximately 15 times, and improved sensitivity by approximately 7.2 %, with a 100 % specificity and a coefficient of variation (CV) of less than 15 %. [Display omitted] • Construct an operation-friendly ELISA integrating magnetic separation and plasma luminescence. • Simplify the time-consuming and equipment-intensive processes of conventional ELISA. • Compare the colorimetric effects of silver-alkyne reaction with nanospheres and nanoflowers. • Achieve accurate monitoring in clinical samples, including serum, plasma, and whole blood. [ABSTRACT FROM AUTHOR]

Hydatid disease is caused by the larval stages of the canine tapeworm Echinococcus granulosus. It is one of the most critical helminthic diseases, representing worldwide public health and socio-economic concern. This study aimed to investigate the expression of apoptosis and immune response within hepatic tissues of humans and sheep infected with the Hydatid cyst. Paraffin-embedded tissue was prepared from each tissue sample and used for histopathological examination by Haematoxylin- Eosin. Also, toluidine blue staining was used for mast cell detection, while an immunohistochemical study was performed to assess CD3 T lymphocytes, CD4 helper T lymphocytes, CD8 cytotoxic T lymphocytes, CD20 memory B lymphocytes, CD68 macrophage, and caspase-3 antibodies. The histological examination revealed significant changes, including the infiltration of inflammatory cells, predominantly lymphocytes with scattered giant cells, necrotic hepatic tissue, and fibrosis. Toluidine blue stain revealed a higher number of mast cells (5 cells/field) in humans compared to sheep (3.6 cells/field). The immunohistochemical analysis confirmed that the CD3 were the most predominant inflammatory cell in the hepatic tissue of humans (intensive 70%), and sheep (moderate 38.47%). Caspase-3 was observed in all samples in different grades and mostly in human liver tissue. This data could aid in recognizing immunological markers for differentiating disease progression, as well as enhance the understanding of local immune responses to cystic Echinococcosis (CE). The findings could provide preliminary data for future studies on immune responses associated with Hydatid cysts. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis, a zoonosis caused by cestodes belonging to the Echinococcus granulosus sensu lato (s.l.) genetic complex, affects humans and diverse livestock species. Although a veterinary vaccine exhibiting high levels of antibody-mediated protection has successfully reached the market, the large genetic diversity among parasite isolates and their particular host preferences, makes still necessary the search for novel vaccine candidates. Glutathione transferases (GSTs) constitute attractive targets for immunoprophylaxis due to their outstanding relevance in helminth detoxification processes, against both exogenous and endogenous stressors. Among the six GSTs known to be expressed in E. granulosus s.l., EgGST1 (Mu-class), EgGST2 (Sigma-class), and EgGST3 (a still non-classifiable isoenzyme), show the highest proteomic expression. Therefore, their recombinant forms -rEgGST1, rEgGST2 and rEgGST3- were herein analyzed regarding their potential to induce long-term antiparasite protection in mice. Only immunization with rEgGST1 induced long-lasting protection; and accordingly, rEgGST1-specific antibodies enhanced the parasite killing through both the classical activation of the host complement system and the antibody-dependent cellular cytotoxicity by macrophages. These results support further testing of rEgGST1 as a vaccine candidate in diverse hosts due to the broad expression of EgGST1 in different parasite stages and tissues. [ABSTRACT FROM AUTHOR]

Suprasellar cysticercosis is a rare entity. Only a few cases are reported in the literature. 1 Clinically, present with visual loss and endocrinopathy and radiologically mimic craniopharyngioma, cystic pituitary adenoma, and Rathke cleft cyst. 2 We present the case of a 34-year-old woman with a history of diminution of vision for 2 months. On examination, her visual acuity was 6/9 bilaterally, per the Snellen chart. The visual field showed incomplete temporal hemianopia in the right eye and a severely depressed field in the left eye. She was evaluated with magnetic resonance imaging (MRI) of the brain, which showed multiple well-defined enhancing cystic lesions in the suprasellar cistern splaying the optic chiasm. Enzyme-linked immunoelectrotransfer blot testing was not done due to the lack of availability at our center. She underwent left pterional craniotomy and excision of the cysts. Multiple cysts were noted during surgery, and all were dissected from the surrounding structures. However, there was a spillage of cystic contents during excision, and they are not associated with any adverse reactions, unlike hydatid cysts. 3 She recovered well. Histopathology suggestive of cysticercal cyst, no scolexes. As per Infectious Diseases Society of America, non-operated subarachnoid neurocysticercosis requires prolonged antiparasitic agents along with steroids. 4 She received 6 weeks of albendazole 15 mg/kg/day and steroids tapered over 3 weeks. At 2 years of follow-up, her visual acuity improved to 6/6 with a normal visual field. Follow-up MRI showed complete removal of all cysts with no relapse. Early surgery is safe and effective. Visual outcome depends on the timing of the diagnosis and prompt intervention. [ABSTRACT FROM AUTHOR]

• Cystic echinococcosis is still a very serious problem in mediterranean areas. • Non-regular dog deworming and providing offal to dogs are the main risky practices. • Low levels of knowledge and awareness of CE observed among north african farmers. Cystic echinococcosis (CE), caused by the tapeworm Echinococcus granulosus , is a zoonotic parasitic disease that still represents a serious threat to human and animal health worldwide. The Mediterranean basin is recognized as one of the major hotspots of CE due to several factors, including the presence of diverse intermediate host species as well as socio-economic and cultural conditions of local communities. This study aims to take a closer look at epidemiological data on CE in the Mediterranean area and assess the knowledge attitudes and practices of shepherds towards this disease in four countries (Algeria, Greece, Italy and Tunisia), highly endemic for CE, with the final goal of identifying highly endemic risk areas and practices in use which might potentially allow the persistence of E. granulosus infection in these areas. To update the epidemiological scenario of CE in Mediterranean areas, a comprehensive review of peer-reviewed literature on CE prevalence data published during the 2017–2023 period was carried out and, through a geographical information system (GIS), a map displaying the current CE distribution in the Mediterranean area was generated. In addition, a questionnaire survey was conducted through in-depth interviews of the farmers to collect information on their management system as well as knowledge attitudes and practices towards CE. From the farmer-participatory survey some risky practices emerged including the non-regular deworming of dogs or the use of ineffective drugs or dosing, as well as the provision of uncooked animal viscera to dogs. Finally, lower levels of knowledge and awareness of the disease was observed among farmers from North Africa compared with those of European countries. In conclusion, the results obtained highlight that CE is still a very serious problem in Mediterranean areas and increased efforts are needed to promote awareness among farmers and to turn research results into policy in order to reduce the spread of this disease, according to the One Health perspective. [Display omitted] [ABSTRACT FROM AUTHOR]

The rate of deep organ space/surgical site infection after conservative surgery for hepatic cystic echinococcosis (HCE) ranges from 12% to 26% with a post-operative mortality rate between 0% and 7.5%. This systematic review with meta-analysis aimed to investigate whether omentoplasty (OP) following conservative surgery for HCE leads to decreased rates of morbidity and mortality compared to external tube drainage ETD. We identified 4540 articles through database searching. After verifying the inclusion and exclusion criteria, we retained eight studies for final analysis: two randomized controlled trials (RCT), one prospective comparative study and five retrospective comparative studies. The main outcome measure was organ space/surgical site (OS/SS) morbidity that was limited to "deep organ space/surgical site infection (Deep OS/SSI) with or without re-operation". The eight studies reported results for deep OS/SSI (6/374 (OP) and 60/403 (ETD), respectively). There were statistically significantly less deep OS/SSI with OP (vs. ETD) OR = 0.17 95%CI [0.05, 0.62] (P = 0.007). A random-effect meta-regression, including the eight studies, showed an interaction in favor of OP. There were also statistically significant less biliary leakage ± fistula and overall morbidity in OP compared to ETD. On the other hand, no statistically significant difference was found concerning deep bleeding, mortality and recurrence between these two groups. This meta-analysis with a meta-regression showed that there were statistically significant less deep OS/SSI, biliary leakage ± fistula and overall morbidity in OP compared to ETD. [ABSTRACT FROM AUTHOR]

Echinococcus ortleppi is the genotype G5 of Echinococcus granulosus sensu lato and is a zoonotic canine tapeworm of which larvae causes cystic diseases in domestic animals and also humans. While this species is highly endemic and widely spread in domestic animals, human infection is extremely rare and only sporadic, and thus, entire picture of human cystic echinococcosis due to infection with E. ortleppi is unclear. We have made an extensive literature review on the cases of E. ortleppi infection in humans and found a total of 19 cases from various places in the world with recent emergence in Asian countries. [Display omitted] • Human cases of Echinococcus ortleppi infection was reviewed. • Different from infections in animals, human cases predominated in northern hemisphere. • Recent emergence of human cases in Asia needs attention. [ABSTRACT FROM AUTHOR]

Echinococcosis is a parasitic disease caused by Echinocccus granulosus and Echinococcus multilocularis and declared a neglected tropical disease by the World Health Organization. The disease is a significant cause of morbidity and mortality, especially in India, Australia, China, Turkey, South America, the Middle East, and Eastern European countries. Bibliometric analysis is a popular research trend that gains the advantage of evaluating all the studies about one specific topic and emphasizing the importance and place of the subject in the literature. With this study, we aim to evaluate all the global published literature in the Web of Science core collection database about urinary tract echinococcosis between 1945 and 2024. All documents indexed in the Web of Science core collection database between 1945 and 2024 were scanned on March 29, 2024. VOSviewer program 1.6.20 and MS Office Excel 2017 programs were used for forward analysis. 152 documents were obtained, 102 of which were indexed in SCI-Expanded journals. Turkey (21.71%) was the leading country in terms of the total number of documents, followed by India (21.05%), but citations of Indian publications were higher (21.77%). Spain was in the first rank in terms of average citations per document (19.33). Most of the documents were original articles (78.29%). Okan Akhan was the most prolific author, with three documents. The most-cited document was conducted in 1997 by Angulo et al. and received 74 citations. With seven publications, Urology Case Reports was the journal that published the most documents on urinary tract echinococcosis. Evaluating the studies on urinary system echinococcosis with bibliometric analysis, it is understood that although the number of studies has gradually increased over the years, they are still less than expected. We recommend that more studies be conducted to determine the true prevalence of echinococcosis and ensure more effective management of the disease, especially in countries where it is endemic. • Urinary tract involvement constitutes 6.4-6.7% of all echinococcosis cases, while renal involvement constitutes 3-4%. • The number of documents on urinary tract echinococcosis is only 152, compared with 8551 documents about echinococcosis. • Turkey was the leading country in terms of the total number of documents. Okan Akhan was the most prolific author. • The most cited document was conducted in 1997 by Angulo et al. and received 74 citations. • More studies ought to be planned to ensure effective management of echinococcosis, especially in endemic countries. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis, resulting from infection with Echinococcus granulosus , poses a significant challenge as a neglected tropical disease owing to the lack of any known effective treatment. Primarily affecting under-resourced, remote, and conflict-ridden regions, the disease is compounded by the limitations of current detection techniques, such as microscopy, physical imaging, ELISA, and qPCR, which are unsuitable for application in these areas. The emergence of CRISPR/Cas12a as a promising tool for nucleic acid detection, characterized by its unparalleled specificity, heightened sensitivity, and rapid detection time, offers a potential solution. In this study, we present a one-pot CRISPR/Cas12a detection method for E. granulosus (genotype G1, sheep strain) integrating recombinase polymerase amplification (RPA) with suboptimal protospacer adjacent motif (PAM) and structured CRISPR RNA (crRNA) to enhance reaction efficiency. The evaluation of the assay's performance using hydatid cyst spiked dog feces and the examination of 62 dog fecal samples collected from various regions of Western China demonstrate its efficacy. The assay permits visual observation of test results about 15 minutes under blue light and displays superior portability and reaction speed relative to qPCR, achieving a sensitivity level of 10 copies of standard plasmids of the target gene. Analytic specificity was verified against four tapeworm species (E. multilocularis , H. taeniaeformis , M. benedeni , and D. caninum) and two other helminths (T. canis and F. hepatica), with negative results also noted for Mesocestoides sp. This study presents a rapid, sensitive, and time-efficient DNA detection method for E. granulosus of hydatid cyst spiked and clinical dog feces, potential serving as an alternative tool for field detection. This novel assay is primarily used to diagnose the definitive host of E. granulosus. Further validation using a larger set of clinical fecal samples is warranted, along with additional exploration of more effective approaches for nucleic acid release. ● The design of crRNAs considered suboptimal PAMs and non-canonical secondary structures. ● Suboptimal crRNA promotes rapid amplicon accumulation by weakening cleavage. ● The use of suboptimal CRISPR-RNA enables rapid detection within 15 minutes. ● The detection limit of this assay is 10 plasmid copies/reaction. ● It has no cross-reactivity with a wide range of helminths, including Echinococcus multilocularis. [ABSTRACT FROM AUTHOR]

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

The Echinococcus granulosus sensu lato species complex is responsible for the neglected zoonotic disease known as cystic echinococcosis (CE). Humans and livestock are infected via fecal-oral transmission. CE remains prevalent in Western China, Central Asia, South America, Eastern Africa, and the Mediterranean. Approximately one million individuals worldwide are affected, influencing veterinary and public health, as well as social and economic matters. The infection causes slow-growing cysts, predominantly in the liver and lungs, but can also develop in other organs. The exact progression of these cysts is uncertain. This study aimed to understand the survival mechanisms of liver and lung CE cysts from cattle by determining their metabolite profiles through metabolomics and multivariate statistical analyses. Non-targeted metabolomic approaches were conducted using quadrupole-time-of-flight liquid chromatography/mass spectrometry (LC-QTOF-MS) to distinguish between liver and lung CE cysts. Data processing to extract the peaks on complex chromatograms was performed using XCMS. PCA and OPLS-DA plots obtained through multiple statistical analyses showed interactions of metabolites within and between groups. Metabolites such as glutathione, prostaglandin, folic acid, and cortisol that cause different immunological reactions have been identified both in liver and lung hydatid cysts, but in different ratios. Considering the differences in the metabolomic profiles of the liver and lung cysts determined in the present study will contribute research to enlighten the nature of the cyst and develop specific therapeutic strategies. [Display omitted] [ABSTRACT FROM AUTHOR]

• In AE, MTLN is identified as a biomarker of M2 macrophages, which mediates the energy metabolism of macrophages. • The mouse model showed that MTLN was related to M2 macrophages. • Cell experiments showed that the expression of MTLN increased with time. The pathogen of alveolar echinococcosis (AE) is Echinococcus multilocularis (E. multilocularis), which has the characteristics of diffuse infiltration and growth and has a high mortality rate. At present, the role of macrophages in AE infection has attracted more and more attention, but the new biomarkers and polarization mechanisms of macrophages are rarely studied. In this study, CIBERSORT and WGCNA algorithms were used to establish a weighted gene co-expression network, and MTLN was identified as a biological marker of M2-type macrophages, which participated in energy metabolism of macrophages and mediated inflammatory response, but the role of MTLN in AE was not studied. In this study, liver tissue samples from AE patients were collected and immunofluorescence co-localization showed the relationship between MTLN and macrophage distribution. E. multilocularis infected mouse model was established to analyze the expression of MTLN, liver fibrosis, and inflammatory reaction after E. multilocularis infection. The cell experiment simulated the liver microenvironment of E. multilocularis infected human body and analyzed the expression of MTLN by QRT-PCR and western blot in vitro. The data showed that liver fibrosis occurred in AE patients, and MTLN was activated near the focus. After E. multilocularis infected mice, the expression of MTLN increased with time. In the cell experiment, after the antigen of E. multilocularis protoscolex stimulated normal liver cells, the expression of MTLN increased 48 h, at this time, M2 was up-regulated and M1 was down-regulated. Therefore, MTLN may be the key gene to regulate the polarization of M2 macrophages and cause fibrosis. [ABSTRACT FROM AUTHOR]

Hydatid cysts caused by Echinococcus granulosus are a serious health problem that requires effective treatment. This study aimed to evaluate the scolicidal and apoptotic effects of copper oxide (CuO) and gamma alumina (γ-Al 2 O 3) with or without chitosan (Chit), using Rosmarinus officinalis extract and chemical methods on protoscolices (PSCs) in vitro. The nanomaterials (NMs) were characterized by FTIR, EDS, DLS, XRD, FESEM, PDI, and zeta potential (ZP). Scolicidal and apoptotic effects of NMs were tested against PSCs at different concentrations and exposure times. The CuO NPs showed the highest scolicidal effect (33.26 %) among all NMs at 1.6 mg/mL and 60 min, followed by phytosynthesized CuO/γ-Al 2 O 3 NC (23.41 %). The chitosan-modified CuO/γ-Al 2 O 3 NC and the chemically synthesized CuO/γ-Al 2 O 3 NC had less effect. The CuO NPs and the phytosynthesized CuO/γ-Al 2 O 3 NC also significantly increased the expression of the caspase - 3 gene in the PSCs at 0.4 mg/mL, indicating the induction of apoptosis. In conclusion, this study suggests that the phytosynthesized CuO/γ-Al 2 O 3 NC and the CuO NPs could be potential candidates for treating echinococcosis by killing the PSCs through apoptosis. Further studies are needed to verify the in vivo efficacy and toxicity of these NMs and to optimize their delivery and targeting systems. • Novel nanomaterials treat cystic echinococcosis. • CuO nanoparticles exhibit the highest scolicidal activity among tested nanomaterials. • Nanomaterials induce apoptosis in PSCs via caspase-3 gene expression. • Phytosynthesized NCs excel due to smaller size, stability, and bioactive compounds [ABSTRACT FROM AUTHOR]

• Hydatid cyst isolates were characterize using the nad5 gene (759 bp). • E. granulosus s.s. isolates were identified as G1 (n = 61) and G3 (n = 10). • A total of 23 haplotypes were obtained from the 71 E. granulosus s.s. samples. • The main haplotype was Hap01 (60.56 %), consisting of the G1 genotype. • The second largest haplotype was Hap04, consisting entirely of the G3 genotype. Cystic echinococcosis (CE) is a common zoonotic disease caused by the larval form of Echinococcus granulosus sensu lato. This study determined the genotype and haplotype differences using the NADH dehydrogenase subunit 5 gene in hydatid cyst samples. Human (n = 12), cattle (n = 28), and sheep (n = 31) hydatid cyst isolates were included. Seventy-one genomic DNA samples were successfully extracted, and a 759 bp mitochondrial NADH dehydrogenase subunit 5 gene fragment was amplified by PCR. Following the sequence analysis, E. granulosus sensu stricto isolates were identified as G1 (n = 61) and G3 (n = 10). A total of 23 haplotypes were obtained from the 71 E. granulosus s.s. G1 and G3 samples. The main haplotype was Hap01 (60.56 %), which consisted of the G1 genotype. The second largest haplotype was Hap04, which consisted entirely of the G3 genotype. Hap14 acted as a bridge between the G1 and G3 genotypes. This study identifies G1 as the dominant genotype in humans and farm animals in Turkey. High haplotype and nucleotide diversity in genotypes were observed. Additionally, this is the first report on the phylogeography and gene flow models of the E. granulosus s.s. population in Turkey using the NADH dehydrogenase subunit 5 gene, the best marker distinguishing between G1 and G3 genotypes. [ABSTRACT FROM AUTHOR]

Primary (isolated) splenic hydatid cyst is rare and accounts for less than 2 % of hydatid patients, even in endemic regions. Diagnosis of splenic hydatid cyst can be challenging due to the rarity of the condition and its nonspecific symptoms. Surgery is the mainstay of treatment. This case report discusses management options for such a rare condition. We present a 33-year-old female patient with abdominal pain for six months and splenomegaly. Ultrasonography and CT scan showed a giant splenic cyst with clear walls and multi-vesicular contents suggestive of a hydatid cyst. There was no involvement of the liver or other organs. Indirect hemagglutination was positive for Echinococcus. Through a left subcostal incision total splenectomy was performed. The patient was discharged from hospital on the sixth postoperative day. No local recurrence was detected during postoperative follow up. Primary splenic hydatid disease is rare. It may be detected incidentally or present with nonspecific complaints. If untreated, a splenic hydatid cyst can lead to various potentially severe complications, including cyst rupture and secondary infection. Standard treatment is open total or partial splenectomy: preservation surgery should always be considered, to avoid post splenectomy infection, especially in young patients. Primary splenic hydatid cyst is rare even in endemic areas. Symptoms may be non-specific. Standard treatment is open total or partial splenectomy. • The spleen is the third most common site of hydatid disease, after the liver and lungs • Splenic hydatid cyst can be either primary (isolated to the spleen only) or secondary (accompanied by hydatid cysts in other organs) • Primary splenic hydatid cyst is rare even in endemic regions • Diagnosing hydatid cyst disease of the spleen can be challenging due to the rarity of the condition and often nonspecific symptoms • Surgery is the usual management of hydatid cyst of the spleen [ABSTRACT FROM AUTHOR]

Echinococcus granulosus is a zoonotic parasite infects many livestock species, especially cattle, sheep, goat and buffalo, causing cystic echinococcosis. The aim of this study was to demonstrate the presence of the parasite and parasitic tissue damage histopathologically and to determine the role of oxidative stress in the tissue damage through the immunohistochemical detection of the oxidative damage-marker malondialdehyde (MDA) and the antioxidant response-marker superoxide dismutase (SOD). The material of the study consisted of 20 liver samples with Echinococcus cysts and 10 E.granulosus - negative healthy liver samples obtained from different cattle at various times from slaughterhouses in Kırıkkale province, Turkey. Histopathologically, Echinococcus cysts of various sizes were observed along with the surrounding fibrous connective tissue. Giant cells, mononuclear cells, and eosinophilic leukocytes were found between the fibrous connective tissue and the cyst. In the parenchymal tissue distant from the cyst, inflammatory changes were observed, including vacuolation and necrosis in hepatocytes, congestion and dilation sinusoidal capillaries. Immunohistochemically, MDA immunopositivity was observed in both hepatocytes surrounding the cyst and areas distant from the cyst, while SOD immunopositivity was mainly detected in fibrous connective tissue and hepatocytes surrounding the Echinococcus cysts. A significant increase in MDA immunoreactivity was observed in E.granulosus s.l. -infected livers. Although no statistically significant change was observed in SOD immunopositivity in the liver tissues with cystic echinococcosis, regional variations were noted. Germinal layer (GL) of Echinococcus cyst showed immunopositive staining for MDA, while laminated layer (LL) exhibited immunonegative staining. To the authors' best understanding, this study represents a pioneering effort in showcasing and evaluating the immunoreactivities of MDA and SOD within the liver tissue afflicted with Echinococcus cysts. Simultaneously, the examination extends to encompass tissue damage and the infiltration of inflammatory cells. This study highlights the role of oxidative stress in the pathogenesis of Cystic Echinococcosis (CE) and the need for further investigation of antioxidant defense mechanisms and their regional variations. • E. granulosus causes cystic echinococcosis in cattle, posing zoonotic risks. • Oxidative stress plays a role in tissue damage caused by E. granulosus infection. • MDA, an oxidative damage marker, rises in E. granulosus -infected liver tissues. • SOD, an antioxidant enzyme, primarily found in connective tissue and hepatocytes around hydatid cysts. [ABSTRACT FROM AUTHOR]

• Multiple debridement of cavity lesions can be used to treat spinal echinococcosis. • A large case series of spinal echinococcosis is reported. • An individualized presurgical plan should be carefully considered. The purpose of this study was to evaluate and document the complications and outcomes (bone and functional) of multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis. From January 2007 to February 2019, the medical records and imaging of all patients with mid or advanced spinal echinococcosis, who were treated by multiple debridement of cavity lesions, were evaluated retrospectively. The Braithwaite and Less classification system of spinal echinococcosis and the Frankel classification system were used to evaluate the results, both preoperatively and postoperatively. Between January 2007 and February 2019, 33 patients met the criteria and were included in this study, with a mean postoperative follow-up time of 4.9 (1–10) years. They included 18 males (54.5%) and 15 females (45.4%), with a mean age of 41.5 years (range 23–70 years). A satisfactory recovery of lower-limb motor function was found in 32 patients, while 24 patients (72.7%) presented with recurrence of spinal echinococcosis. Multiple debridement and spinal cord decompression, combined with antiparasitic chemotherapy after surgery, are effective methods for delaying or preventing disease progression or recurrence. A recurrence of infection is common in most cases. CT and MRI are the preferred methods for diagnosing this disease. [ABSTRACT FROM AUTHOR]

Objective: This study aims to search for reliable serological biomarkers allowing the early prediction of cystic echinococcosis (CE) post-operative outcomes.Methods: We applied immunoprecipitation (IP) of Echinococcus granulosus protoscolex antigens with pediatric CE patients' plasma collected at 1-month and 1-year post-surgery, followed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). We compared IP proteomic content from relapsed patients within the first-year post-surgery (RCE) to cases with no relapses until 3 post-operative years (NRCE). Selected proteins were recombinantly synthesized and assessed for their prognostic performance by Enzyme-linked immunosorbent assay (ELISA).Results: A total of 305 immunoreactive parasitic proteins were identified, 59 of which were significantly more abundant in RCE than NRCE for both time-points. Four proteins showed the most promising characteristics for predicting CE outcomes: cytoplasmic malate dehydrogenase (Eg-cMDH), citrate synthase (Eg-CS), annexin A6 and severin. ELISA-IgG against the four markers were significantly lower at 1-year post-surgery than 1-month in NRCE, in contrast to RCE that displayed either stable or higher levels. The Eg-cMDH and Eg-CS showed the best prognostic performance, with respective probabilities of being "relapse-free" of 83% and 81%, if a decrease of IgG levels occurred between 1-month and 1-year post-surgery.Conclusion: The Eg-cMDH and Eg-CS are promising biomarkers to predict early CE post-surgical outcomes. [ABSTRACT FROM AUTHOR]

• Hydatid disease of the breast is extremely rare. • It masquerades various cystic and solid lesions of the breast. • Radiocytopathologic correlation ascertains the diagnosis of breast hydatid disease. • It also minimizes the risk of intraoperative complications. • Breat hydatid cyst can be successfully managed with radical pericystectomy. Hydatid disease is a zoonosis caused by the Echinococcus species. The liver and lungs are where it generally seen, with breast involvement being extremely uncommon. This is a case of a woman aged 28 years who presented with a progressive painless swelling on the left breast, which was fluctuant and nontender, detected on the upper outer quadrant. The cytologic evaluation yielded a crystal-clear fluidal aspirate composed of a few laminated metachromatic materials and the mass sonographically appeared as an anechoic cystic mass having a double-layered wall with posterior acoustic enhancement. A radical pericystectomy was performed after the preoperative diagnosis of breast hydatid cyst was entertained, and the diagnosis was later confirmed by histopathology. Although isolated breast hydatid cysts are uncommon, they can happen and may mimic other cystic and solid masses of the breast clinically. Thus, radiologic assessment with cytopathologic correlation is imperative for precise preoperative diagnosis and to minimize the risk of intraoperative complications. [ABSTRACT FROM AUTHOR]

Echinococcus spp. tapeworms can cause serious diseases in mammals, including humans. Within the E. granulosus species complex, metacestodes produce unilocular cysts that are responsible for cystic echinococcosis in animal intermediate hosts. Canids are definitive hosts, harbouring adult cestodes in their intestines. Adult E. canadensis were recovered from the small intestine of 1 of 262 coyotes (Canis latrans) from Nova Scotia, Canada. Subsequently, we found unilocular cysts in lungs and livers of 4 of 8 sympatric moose (Alces alces) from Cape Breton Island. DNA was extracted from three cysts using the Qiagen DNeasy Blood and Tissue kit and assayed by polymerase chain reaction (PCR) with primers (cest4 and cest5) for a 117-bp region of the small subunit of ribosomal RNA of E. granulosus sensu lato , and further validated as E. canadensis G8 using primers targeting nicotinamide adenosine dinucleotide dehydrogenase subunit 1 (ND1) and cytochrome c oxidase subunit 1 (CO1) mitochondrial genes. These are the first records of E. canadensis in any of the three Maritime provinces, which include Nova Scotia, New Brunswick, and Prince Edward Island. The parasite was thought to be absent in this region due to extirpation of wolves (Canis spp.) in the 1800s. These findings suggest that further wildlife surveillance and risk assessment is warranted. • Adult Echinococcus canadensis were recovered from small intestines of a coyote from Nova Scotia. • We also found cysts in lungs and livers of sympatric moose from Cape Breton Island. • DNA in cysts was confirmed as belonging to E. canadensis. • These are the 1st records of E. canadensis in the Maritimes, where it was presumed absent due to extirpation of wolves. [ABSTRACT FROM AUTHOR]

Echinococcosis is a major public health problem and an emerging/re-emerging disease. It was proposed that Echinococcus cell-free DNA (cfDNA) could be used in diagnosing human echinococcosis, though earlier attempts failed. Here, we update the research on detecting Echinococcus cfDNA in echinococcosis patients' samples and highlight future research directions. [ABSTRACT FROM AUTHOR]

Over decades, surgery has been the only accepted mode of treatment for liver hydatid cysts. It had been a surgical dogma for a long that hydatid disease is an absolute contraindication for needle puncture/aspiration as it can cause anaphylaxis, death, and dissemination. We envisaged prospectively perform percutaneous drainage as a primary form of treatment for hepatic hydatidosis. Through extensive and very careful experimentation, we proved that aspiration of hydatid cysts can be performed safely and is the ideal way to manage a subset of patients with hydatid cysts in the liver. The patient and cyst characteristics good and not good for percutaneous drainage were carefully selected. The procedure of percutaneous drainage of hepatic hydatid cysts involves four sequential steps as defined in the alphabets of the title PAIR , denoting puncture (P), Aspiration (A), Instillation (I), and Reaspiration (R). During and postprocedure, we enforced strict monitoring given the anticipated anaphylaxis. The first PAIR procedure was performed in June 1988. The results of percutaneous drainage of 21 cysts in 12 patients were reported in 1991. Next, a prospective study was done to show that concomitant Albendazole therapy is recommended as an adjuvant to percutaneous drainage for hepatic hydatidosis. In a seminal prospective study comparing percutaneous drainage and surgery, we showed that percutaneous drainage is as good as surgery in the management of uncomplicated hydatid cysts with fewer complications and shorter hospital stays. Lastly, long-term follow-up results of percutaneous drainage on a large cohort of patients with hepatic hydatid cysts were reported, with excellent results and no evidence of local, peritoneal or systemic dissemination. Based on these data percutaneous drainage, the so-called PAIR technique has established itself as a novel therapeutic advance in hepatic hydatid disease. [ABSTRACT FROM AUTHOR]

• Plasma IL-27 is a biomarker for assessing biological viability in HCE patients. • IL-23 seems to be negatively associated with disease progression in HAE patients. • Cytokine secretion patterns are associated with biological viability of lesions. To investigate potential biomarkers for distinguishing biological viability of hepatic cystic echinococcosis. Using Luminex assay we measured plasma concentrations of cytokine and chemokine in patients with active and non-active cysts (hepatic cystic echinococcosis (HCE), n = 47) and stable/progressive hepatic alveolar echinococcosis (HAE, n = 38), and in comparable infection-free volunteers (n = 48). Disease progression was staged according to the classification standard. Compared with healthy controls, enhanced elevation was found of T helper 22 type cytokine interleukin (IL)-22 and chemokines Eotaxin, interferon-γ inducible protein-10, monocyte chemoattractant protein-1, and stromal cell-derived factor-1α concentrations in HAE patients, and IL-22, growth-related oncogene α, monocyte chemoattractant protein-1, regulated on activation normal T-expressed and secreted, and stromal cell-derived factor-1α concentrations in HCE patients (P < 0.05–0.001). For HCE patients, only IL-27 concentrations in non-active HCE were significantly lower than in active HCE. In logistic regression analysis, IL-27 <20.79 pg/mL was an independent risk factor for HCE biological viability with receiver operating characteristic analysis at a 44.23 pg/mL cut-off resulting in 0.72 area under the curve. Our findings correlate multiple cytokine and chemokine secretion patterns in HAE and HCE patients with different disease progression stages. IL-27 could serve as a referring biomarker for distinguishing HCE biological viability and provide a preliminary foundation for clinical decision-making. [ABSTRACT FROM AUTHOR]

Lungs are the second most common site for hydatid disease after the liver. Giant hydatid cyst (GHC) of the lung is a special clinical entity in children and is related to higher lung tissue elasticity. To compare clinical and imaging features, types of surgical interventions, and postoperative complications in pulmonary GHC and non-giant pulmonary hydatid cysts (NGHC) in children. A retrospective study was undertaken. The data analyzed were taken from medical records of children with pulmonary hydatid cyst (PHC) hospitalized in a pulmonary department in Tunisia between January 2004 and February 2019. Cysts were divided according to their size into GHC (≥10 cm) and NGHC (< 10 cm). In the study period, 108 PHC were recorded in 84 children. GHC accounted for 21 (19.4%) and NGHC for 87 (80.6%). The median of age of the children was 11 years (IQR 1–9, IQR 3–14) and the mean age was 11.6 years (10.5 in GHC vs. 11.4 years in NGHC). Hemoptysis was found in 25% of the GHC group vs. 48.4% of the NGHC group (P = 0.27). Cysts were multiple in 23.8% of cases and predominated in the right in 64.3% of cases and in the inferior lobes in 71.4% of the cases. GHCs were less frequently complicated (60% vs. 78.1% in NGHC, P ≤ 0.11), although not significantly. Parenchymal resection was realized in 50% of GHC vs. 18.8% of NGHC (P = 0.006). No significant difference was found in postoperative complications between the two groups and there was no recurrence in either group. GHC is a special clinical entity in children. It requires major surgery with parenchymal resection, and therefore early diagnostic and therapeutic management is warranted. [ABSTRACT FROM AUTHOR]

[Display omitted] • Parasitism of Echinococcus multilocularis in dogs is prevalent, but unevenly studied. • The most informative true prevalence is rarely estimated in dogs. • For dogs, few studies analyse risk factors, despite their potential significance. • Rural, untethered dogs used for hunting are more prone to E. multilocularis infection. • Future studies should adopt a common framework to estimate prevalence accurately. Echinococcus multilocularis , the aetiological agent of human Alveolar Echinococcosis, is transmitted between small mammals and wild or domestic canids. Dogs infected with E. multilocularis as dead-end hosts. Whereas E. multilocularis infections in wild hosts and humans have been well-studied in recent decades, infections in domestic dogs are sparsely reported. This literature review and meta-analysis highlighted gaps in the available data and provided a re-assessment of the global distribution of domestic dog E. multilocularis infections. We found 46 published articles documenting the prevalence of E. multilocularis in domestic dogs from 21 countries across Europe, Asia and North America. Apparent prevalence estimates ranged from 0.00% (0.00–0.33%) in Germany to 55.50% (26.67–81.12%) in China. Most studies were conducted in areas of high human Alveolar Echinococcosis. By accounting for reassessed diagnostic sensitivity and specificity, we estimated true prevalence in a subset of studies, which varied between 0.00% (0.00–12.42%) and 41.09% (21.12–65.81%), as these true prevalence estimates were seldom reported in the articles themselves. Articles also showed a heavy emphasis on rural dogs, dismissing urban ones, which is concerning due to the role urbanisation plays in the transmission of zoonotic diseases, especially those utilising pets as definitive hosts. Lastly, population studies on canine Alveolar Echinococcosis were absent, highlighting the relative focus on human rather than animal health. We thus developed a framework for investigating domestic dog E. multilocularis infections and performing risk assessment of dog-associated transmission to fill the gaps found in the literature. [ABSTRACT FROM AUTHOR]

[Display omitted] • LncRNAs related to AE were detected and characterized. • Totally 621 mRNA transcripts were found as differentially expressed between the controls and patients. • 58 of the lncRNA biomarker candidates were up-regulated, and 176 of the lncRNA biomarkers were down-regulated. • Detected lncRNAs mostly played role in cancer pathways. Alveolar echinococcosis is a severe zoonotic disease caused by the pseudotumoral intrahepatic development of the larval stage of the tapeworm Echinococcus multilocularis. The diagnosis of alveolar echinococcosis is hard since it has features of liver cancer. LncRNAs are among the non-coding RNAs that have received the most attention in recent biomarker studies. Here, we aimed to identify the serum-derived exosomal lncRNAs associated with alveolar echinococcosis in humans with RNA-seq. After RNA isolation from exosomes, we performed RNA-seq to determine the lncRNAs. We found 8 target genes in the cis direction and a total of 6468 gene targets for lncRNAs were identified in the trans direction. Totally 621 mRNA transcripts were found as differentially expressed between the controls and patients. 278 of them were up-regulated and 343 were down-regulated. Moreover, 234 lncRNAs were found as differentially expressed between the controls and patients. 58 of them were up-regulated, and 176 of them were down-regulated. The top five biological pathways regulated by identified lncRNAs were detected in this study. As a result, it is thought that these results will contribute to lncRNA-based biomarker studies that can be used in the early diagnosis of alveolar echinococcosis in humans. [ABSTRACT FROM AUTHOR]

Hydatid cysts are a parasitic disease that occurs when humans ingest contaminated food or water containing parasitic eggs. It is a common disease worldwide, especially in cattle breeding areas. In rare cases, the primary cysts contain daughter cysts inside them, as seen in this case. We report a 28-year-old rural woman who presented with a history of sputum-producing cough, dyspnea, hemoptysis, and pain in the right side of the chest. The chest-abdomen-pelvis MSCT revealed a large number of cysts (more than 200 cysts) with daughter cysts inside them in the right lung and mediastinum. The cysts were surgically resected. After surgery, albendazole 200 mg twice a day was prescribed, with monitoring of liver function. In the lungs, hydatid cysts are commonly found in the right lung (50 %), left lung (40 %), and may also be bilateral (10 %). The presence of multivesicular cysts in the lung is very rare. There are two hypotheses concerning the daughter cysts' formation. The first one suggests the effect of repeated mechanical trauma, while the other proposes the defensive mechanism of the patient. Diagnosis of the hydatid cysts in the lung is primarily through radiographic investigations such as Chest X-ray and CT scan. Surgery is still the main method to manage pulmonary hydatid cysts. Although rare, multivesicular hydatid cysts in the lung should be considered, as they can mimic other diseases such as tumors and can cause an embolus in the pulmonary artery. • Hydatid cysts are common in the lung mainly as a single cyst, while multiple cysts are less common. • Daughter cysts' formation "multivesicular hydatid cysts" is unusual. • Surgery is the best approach to manage pulmonary hydatid cysts. [ABSTRACT FROM AUTHOR]

The tapeworm Echinococcus granulosus sensu lato is the causative agent of cystic echinococcosis (CE), often known as hydatid disease. Over two-thirds of all occurrences of this zoonotic disease process in humans are caused by hepatic infection. Clinicians should have a low threshold to consider CE as a differential diagnosis in patients with positive serology and suggestive radiological findings, especially in endemic regions, because signs and symptoms are typically non-specific, especially in early disease. This is a case report of a 26-year-old male who presented with increasing lower abdominal discomfort, mild pain, sense of fullness in the lower abdomen, described as (I'm having a ball in my abdomen), with a history of early satiation and tenesmus, frequency of urine, and history of weight loss and general weakness of 10-months duration. The diagnosis of a hydatid cyst in the mesorectum was made. The cyst was completely excised via open surgery. No local recurrence has been detected up to the present time. Given how uncommon a site like this is, this case report helps broaden the differential diagnosis of soft tissue masses in such settings, especially in endemic areas. It also describes in great detail how these locations are affected by the hydatid disease. The mesorectal hydatid cyst was challenging to diagnose initially due to its infrequent incidence and uncommon location. In a few rare cases, the diagnosis of a hydatid cyst might be guided by the detection of the cyst membrane and daughter cysts in the germinal membrane. • The mesorectal hydatid cyst was challenging to diagnose • Its infrequent incidence and uncommon location. • In a few rare cases, the diagnosis of a hydatid cyst might be guided by the detection of the cyst membrane and daughter cysts in the germinal membrane. [ABSTRACT FROM AUTHOR]

Hydatid cyst is a common infestation caused by helminths in humans and usually involves the liver and lungs. Primarily, cases of hydatid cysts in the thigh muscles are extremely rare and are generally in the form of case reports. It is an important disease due to its insidious course, its confusion with other soft tissue pathologies, delay in diagnosis and painstaking surgery. In our study, the largest case series in the literature, the clinical stages of the diagnosis, treatment and follow-up of 9 hydatid cysts that develop primarily in the thigh muscles were evaluated. The risk of recurrence in primary hydatid cyst of the thigh can be reduced with rapid diagnosis, careful preoperative planning, complete surgical resection by avoiding cyst rupture and concomitant anthelmintic chemotherapy. [ABSTRACT FROM AUTHOR]