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Abstract Background Hydatid disease, also known as echinococcosis, is an endemic parasitic infection, most commonly caused by Echinococcus granulosus. It may affect any organ resulting in the formation of hydatid cysts, but most frequently involves liver and lungs. Hydatid cyst arising primarily from axilla is an extremely rare manifestation of this condition, with only a few cases reported in medical literature. Case presentation Here we present the case of a 32-year-old Indian male farmer, who presented with a painless, slow-growing mass in the left axillary region of 8 months duration. Preoperative imaging led us to the diagnosis of primary axillary hydatid cyst, with no other associated cysts or masses anywhere else in the body. Following antihelmintic therapy, the cyst was surgically excised without rupture. The diagnosis was further confirmed by macroscopic and histopathological examination. Conclusion This case report highlights the importance of considering hydatid cyst in the differential diagnosis of palpable masses in the axillary region, especially in regions where the disease is endemic. Early recognition and accurate diagnosis are crucial for appropriate management and optimal patient outcomes.

Abstract Background Cystic echinococcosis, also known as hydatid disease, is a chronic and endemic illness caused by infection with a parasite called Echinococcus granulosus. In Romania, this disease has an incidence rate of 5.6 per 100,000 individuals, which is the highest in the Dobrogea region. The liver is the most affected site, accounting for 68.8% of cases, followed by the lungs at 17.2%. While cases of hydatid disease in the genital organs are rare, occurring at an incidence rate of only 0.5%, it is worth noting that cases of this disease in pregnancy worldwide are also rare, occurring at an incidence rate of 1 in 20,000 to 1 in 30,000 pregnancies. Case report A 15-year-old Eastern-European woman who was 12 weeks pregnant presented to the emergency room with acute pelvic pain, dysuria, and frequent urination. Her laboratory tests showed that she had a urinary tract infection, and pelvic ultrasound revealed that she had a mass on her right adnexa. Despite receiving treatment, her symptoms did not improve, and she had to undergo surgery to remove the mass, which turned out to be a hydatic cyst. She also had to undergo a cesarean section to deliver her baby owing to fetal distress during labor. Conclusions This medical case report provides a detailed description of a pelvic hydatid cyst that was discovered during pregnancy. What makes this case particularly noteworthy is the cyst’s unusual location—it was found at the level of the right broad ligament of the uterus. Despite the complexity of the situation, the patient was able to receive effective treatment and the cyst was successfully managed with great outcomes for both the patient and the newborn. We hope that this report serves as a valuable example of how medical professionals can navigate challenging cases and provide optimal care for their patients.

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.

Introduction: Echinococcus species are zoonotic parasites that cause hydatid disease, affecting humans and animals. The seroprevalence of hydatid disease reflects the level of exposure to this parasite and can be used as an indicator of the burden of the disease in a population. Aim: To determine the seroprevalence of hydatid disease. Materials and Methods: The study was a retrospective observational study conducted at JIPMER hospital, a tertiary care centre located in Puducherry, Southern India. In this study, hydatid serological data from January 2019 to December 2022 were collected in March 2023 and retrospectively analysed in April 2023. All the serum samples that tested positive for Enzyme Linked Immuno Sorbent Assay (ELISA) for echinococcosis during the period from January 2019 to December 2022 were included. The demographic details such as age, gender, place of residence, etc., of the patients whose samples were included were collected from their case records. These samples were then analysed using Microsoft Excel for proportions and percentages. Results: The study showed that the seroprevalence of hydatid disease was 70 (34%) out of 206 samples tested. The seroprevalence was higher in the older age group (>45 years), with 41 (58.6%) cases. It was observed that males and females were almost equally infected, with minor differences in the prevalence of 37 (52.9%) males and 33 (47.1%) females. Conclusion: As the prevalence of hydatid disease in Southern India was unknown, it was observed to be lower when compared to other states of India. This study has provided valuable information on the level of exposure of hydatid disease in the population and will help formulate disease control and prevention strategies.

Muscular echinococcosis is a rare parasitic disease caused by the tapeworms Echinococcus granulosus and Echinococcus multilocularis. Clinical symptoms are non-specific and appear late, usually when the hydatid cyst is of significant size. The combination of diagnostic imaging studies and serological tests is the key to making a correct diagnosis. The treatment of muscular echinococcosis is mainly surgical, in the form of complete resection of the hydatid cyst. Adjuvant anthelmintic therapy is also administered to reduce the risk of hydatid cyst recurrence. We present a clinical case of a 17-year-old girl with muscular echinococcosis, diagnosed and treated in our clinic.

Key Clinical Message Hydatid cyst is a sly disease that can manifest with a spectrum of symptoms in almost every part of the human body, so it is crucial to be familiar with different scenarios that a patient may present. Abstract The echinococcus granulosus parasite causes hydatid disease and is common in areas with animal husbandry and agriculture. Here, we report a middle age woman who presented with abdominal pain that further investigation revealed a cyst in subdiaphragmatic area.

Background: Hydatid cysts (HC) are zoonotic diseases that are mainly caused by . Ovarian HC is a rare condition with different and unspecified presentations. Here we report a rare case of primary ovarian HC. Case Presentation: A 47-year-old woman with chronic abdominal pain and left hemipelvic fullness was referred to the Obstetrics Clinic of the Kowsar Hospital of Qazvin. Abdominopelvic sonography revealed a cystic mass, which primarily suggested a cyst adenoma. The tumor marker levels were within normal limits. After surgical resection, histopathological examination showed a cystic mass with dimensions of 10×6×3 cm, smooth external and internal aspects, wall thickness of 0.3 cm, and multiple pieces of irregular gray membranous tissue. The patient was treated with albendazole 3 months after surgery, and a 6-month follow-up sonogram revealed no signs of recurrence.Discussion: HC has non-specific presentations. Radiologists, pathologists, and surgeons should consider HC as a differential diagnosis for any cystic mass in the pelvic cavity, especially in endemic areas. Surgical resection and albendazole administration are the chosen treatments.

Key Clinical Message Hydatid cysts, primarily found in the liver (70%), are caused by parasitic infections and can lead to severe complications such as cyst rupture. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection. Abstract Hydatid cysts are a clinical pathology resulting from parasitic infections. They may occur in different organs of the body. However, these are mostly found in the liver (70%). This can cause significant complications including cyst rupture. Several case reports have described various hydatid cyst ruptures; however, only a few have reported an intra‐biliary hydatid cyst rupture. A 24‐year‐old male patient presented with right upper quadrant pain, jaundice, dark urine, and pale stool. Imaging studies, including Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), revealed a beavertail liver, cystobiliary communication and intrahepatic biliary tree‐ruptured hydatid cysts. The cyst was in the right liver lobe, which is the most common site for hydatid cysts. Surgical intervention involving laparoscopic de‐roofing and cyst removal resulted in a smooth recovery without complications. Several case reports have described various hydatid cyst ruptures; however, only a few have reported originally placed intra‐biliary hydatid cyst ruptures. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection.

Retroperitoneal hydatid cysts are extremely rare and difficult to distinguish from other intra-abdominal pathologies, such as synovial sarcoma. In this study, we present a rare case of a complicated retroperitoneal hydatid cyst originating from the psoas muscle without any other focus. A 59-year-old male patient presented to the outpatient clinic with complaints of constipation and a feeling of gradually increasing swelling in the left lower quadrant of the abdomen and left groin area, progressing toward the left leg. In the examinations performed, a multiloculated giant hydatid cyst that filled the left pelvis in the retroperitoneal region, deviated the intra-abdominal organs to the right side, and extended to the left femoral and inguinal canals was detected. The patient underwent surgical excision and was followed up during the postoperative period. No evidence of recurrence was found at the patient’s 3rd and 6th month follow-ups. Primary muscle hydatid cysts necessitate a distinct approach to treatment and management when compared with hydatid cysts in other bodily organs. While recurrences remain a potential concern after resection, it is noteworthy that the window for the formation of fertile cysts typically spans up to 10 months. Thus, it is advisable to conduct regular postoperative follow-up examinations during the first year following surgery to ensure comprehensive monitoring and care.

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

Echinococcosis poses a significant concern in the fields of public health and veterinary care as it can be transmitted between animals and humans. The primary endemic subtypes are cystic echinococcosis (CE) and alveolar echinococcosis (AE), which result from infestation by Echinococcus granulosus and Echinococcus multilocularis, respectively. A prominent epidemic of echinococcosis greatly affects the Tibet Autonomous Region (TAR) in China. A new technique called the loop-mediated isothermal amplification–lateral flow dipstick (LAMP-LFD) test is introduced in this research to differentiate between E. granulosus and E. multilocularis using their repetitive genetic sequences. The test is characterized by its portable nature, simple operation, quick result production, high sensitivity, and low susceptibility to aerosol contamination. The LAMP-LFD method demonstrated an exceptional minimal detection limit, reaching levels as low as approximately 1 fg/μL (femtogram per microliter) of genomic DNA. The assay’s specificity was assessed, and no cross-reactivity was seen. A total of 982 dog fecal samples were collected from 54 counties in the TAR region between July 2021 and June 2022. The established method underwent validation using a commercially available ELISA kit. The agreement rate between the LAMP-LFD and ELISA methods was 97.25%, with a sensitivity of 96.05% and a specificity of 97.35%. The assay described in this study improves specificity by using a double-labeled probe, and it reduces the risk of false-positive results caused by aerosol contamination through the use of a sealed device. This makes it a suitable choice for quickly and accurately identifying the two main types of Echinococcus in field settings.

Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.

Key Clinical Message The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences. Abstract We report a unique case of a 26‐year‐old male who presented with acute urinary retention and abdominal distention. Later, CT‐urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.

Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.

Cystic echinococcosis is a zoonotic disease that is caused by the larval stages of cestodes species and belongs to the genus Echinococcus. Echinococcus granulosus (E. granulosus) causes cystic echinococcosis which is global and wider in its distribution than alveolar echinococcosis. Endemic areas of E. granulosus are Russia, Eastern Europe, the Middle East, China, and South America based on data from the World Health Organization (WHO). Incidence rates are 50 per 100,000 person-years. The life cycle of E. granulosus requires both an intermediate host and a definitive host. A human accidentally becomes an intermediate host. Upon infection, cyst formation mostly occurs in the liver (70%). At the first, the infection is usually asymptomatic. Diagnosis of cystic echinococcosis can be done by imaging techniques (ultrasound or CT/MRI), serum serologic testing for antibodies against hydatid antigens, and immunologic testing. In general, there are four different management modalities for cystic echinococcosis, such as surgery, percutaneous therapy surgery, chemotherapy, and watchful waiting.

Abstract Hydatid cyst is a zoonosis caused by ingestion of eggs of Echinococcus‐a tapeworm. Following ingestion of the eggs, oncosphere larvae are released which penetrate the intestinal wall to invade various organs of the body including liver, lungs, and skeletal muscles via. blood vessels. Due to their contractile nature and high lactic acid content, skeletal muscles are typically not a suitable site for attachment of hydatid cyst. In our case report presented below, we report a rare case of an isolated hydatid cyst of paraspinal muscle presenting as a slow‐growing asymptomatic mass in the back, posing a clinical diagnostic dilemma.

Key Clinical Message Hydatid disease, if not properly managed, can lead to mortality. Open surgery is preferred and can be a curative approach for multiple and large liver hydatid cysts. Also, regular follow‐up is required to detect recurrence.

Cystic echinococcosis (hydatid disease) is a neglected tropical disease common in Asia, South America and Sub-Saharan Africa. It is a parasitic disease caused by larval stage of Echinococcus granulosus. The commonest organs affected by hydatidosis are the liver and the lung. Primary bone hydatidosis in humans is a rare disease accounting for 1–2% of echinococcosis cases. To our knowledge secondary hydatidosis of joints is uncommon and few cases of hydatid disease of the knee joint have been reported. We present a case of primary cystic echinococcosis of the knee joint occurring in a 43-year-old female presenting mainly as disabling right knee arthritis in the form of chronic (13 years) painful swelling, which ultimately led to her inability to walk. Imaging and histopathologic examination revealed cystic echinococcosis of the right knee joint. Subsequent pulmonary, liver and bone screening for primary lesions were negative. To our knowledge, this is the first ever report on primary knee hydatid disease. It is possible that pre-existing arthritis modulated the local environment of the knee, rendering it susceptible to hydatidosis. This should be taken into account in the differential diagnosis of arthritis particularly in endemic areas.

Cystic echinococcosis is endemic and hyperendemic in Uruguay. The objective of this study was to determine the species and genotype of Echinococcus granulosus sensu lato in symptomatic patients with cystic echinococcosis who underwent surgery, together with the location and stage of the cysts. The study included 13 patients aged between 6 and 57 years old. Samples of cysts from these cases were analyzed using DNA extraction, polymerase chain reaction amplification and sequencing. The results revealed the presence of E. granulosus sensu stricto in all cases, with 12 samples belonging to the G1 genotype and 1 to the G3 genotype, suggesting that disease persistence might be related to the dog–sheep cycle. However, other intermediate hosts, such as cattle, could also be involved. Cysts were most frequently found in the liver, followed by muscle and other sites (e.g. pulmonary, vertebral, pelvic and cardiac); and stage CE1 was most frequently found, followed by CE2 and CE3b. Three cases occurred in children or adolescents, suggesting an active parasite cycle in at least some areas of the country. Since there is considerable diversity of E. granulosus sensu lato species and genotypes in South America, it is important to continue the present study in order to draw stronger epidemiological conclusions.

Key Clinical Message Hydatid disease is a zoonotic disease endemic in developing regions. It is usually caused by infection with the tapeworm Echinococcus granulosus due to contaminated food or drinks or by close contact with dogs. The lungs are the second most affected organ (25%) after the liver (>65%). Cyst rupture is the most frequent complication. Enlarging pulmonary cysts are more vulnerable to rupture, with rupturing in the bronchial tree being the most common (20%–40%). Hydropneumothorax is a consequence of complete cyst rupture into the pleural cavity and occurs in rare cases (2%–4%). Superinfection is a common complication of the ruptured cyst, which might lead to empyema. A 26‐year‐old male presented to our clinic with dyspnea that had progressed recently and made him unable to walk a few meters. He had a history of cough and exertional dyspnea and was examined by three different clinics without performing a chest X‐Ray. Physical examination revealed fever and a sick appearance. Chest X‐ray revealed complete pneumothorax with an air‐fluid level in the left hemithorax. Computerized tomography demonstrated two cysts, and one of them was ruptured, causing hydropneumothorax and empyema. The patient was treated with surgery, and follow‐up showed recovery with a fully re‐expanded lung. Rupture of pulmonary hydatid cyst is seen in the most of cases, the clinicians must be aware of such presentation and management of the pulmonary hydatid disease.

Objectives. Most authors attest that parasitic arthritis manifests itself immunologically in a non-specific way and, until now, the most important reactions remain unclear. The objective of our study was to evaluate the indices of cellular immunity specifically in patients with parasitic arthritis in the case of various infestation agents. Material and methods. In the study were included 161 patients, that were divided into 3 groups: first group (97 patients) with parasitic arthritis with echinococcosis infestation, the 2nd group (31 patients) – with parasitic arthritis with Toxocara cannis and the 3rd group (33 patients) – with parasitic arthritis with Giardia lamblia infestation. Results. Within the framework of the development of parasitic arthritis, the most significant changes occur in the immune status of the patients, with Giardia lamblia parasitic arthritis, followed by those with echinococcosis infestation parasitic arthritis and Toxocara cannis parasitic arthritic, which were characterized by a marked increase in CD2 cytotoxic lymphocytes and a decrease in the number of CD4 and CD8 lymphocytes, against the background of the physiological constant number of CD3 lymphocytes. Conclusions. Cellular immune status in parasitic arthritis is characterized by a deficit of control over the work of the system, expressed by a decrease in CD4 and CD8, against the background of the optimal concentration of CD3, but with increased cytotoxicity activity by increasing CD2.

Key Clinical Message Hydatidosis is a parasitic infection caused by the larval form of “Echinococcus granulosis.” Bone localization is rare even in endemic areas. We report an unusual case of an extensive hydatidosis of the right sacrum and femur with muscle involvement. Abstract We report the case of a man, with a history of visceral hydatidosis, who developed after 14 years an extensive hydatidosis of the sacrum and femur with muscle involvement. The treatment of visceral hydatidosis was chemotherapy with albendazole for a long term. Conservative surgical treatment is considered for bone locations.

Key Clinical Message We reported two patients, a 45‐year‐old lady and a 48‐year‐old man, known cases of untreated liver and lung hydatid cysts complicated with bronchobiliary fistulae. Surgery was performed, and bronchobiliary fistulae were diagnosed intraoperatively. Lobectomy was done on the lobe, which was chronically infected. Symptoms resolved after surgery in both cases. Green‐colored sputum in a patient with a history of echinococcosis should raise the physician's attention to the probability of a connection between the bronchial tree and the biliary tract. Surgery in advanced cases is a suitable therapeutic option.

Parasitic infections rarely involve the oral and maxillofacial regions and pose a diagnostic challenge when they do. Hydatid cysts are parasitic cysts caused by Echinococcus granulosus. Intraosseous involvement is observed in 3% of cases, of which only 2-6% are in the maxillofacial region. A scientific literature search revealed only seven cases involving the mandible. We report a rare case in a 16-year-old female patient who presented with facial asymmetry and well-defined radiolucency of the ramus. Our findings will help in understanding the diagnostic issues caused by non-specific presentation and difficulties in suspecting such a rare diagnosis as echinococcosis of the oral or maxillofacial region. A thorough systemic investigation is essential as 20-30% of these cases show multiorgan involvement.

Abstract Clinicians must pay attention to the clinical presentation and consequences of hydatid cysts in rare sites. Cysts close to the aorta require planning and assistance of a cardiac or vascular surgeon before surgical intervention can be considered.

Echinococcosis or hydatid disease is caused by the larval stage of the dog tapeworm, that is, Echinococcus granulosus, E. multilocularis, E. vogeli, or E. oligarthrus. Echinococcus granulosus causes cystic echinococcosis, which has a worldwide distribution. Liver is the most common site, affecting approximately two-third of the patients, whereas lung involvement is seen in approximately 25% of cases. This case is a very rare scenario of bilateral pulmonary hydatid cysts in a young child having exposure to a pet dog with negative hydatid serology and normal eosinophil count.

Hydatid cyst is a zoonotic disease that can affect multiple organs and is difficult to diagnose and treat. Spinal hydatid cyst (SHC) is a rare hydatid cyst involvement observed in 1% of all cases. It can induce various neurological symptoms depending on the region of the involvement. Paraplegia is one of the most prevalent neurological symptoms. In this case report, a 63-year-old male patient with bilateral lower extremity paraplegia was operated on by neurosurgery and diagnosed with SHC at the level of Th 11 vertebra in the pathological examination of surgically removed materials. Thus, we aimed to emphasize the significance of pathological and microbiological examination in the differential diagnosis of spinal disorders.

In an attempt to find new anti-echinococcal drugs, resveratrol (Rsv) effectiveness against the larval stages of Echinococcus granulosus and E. multilocularis was evaluated. The in vitro effect of Rsv on parasites was assessed via optical and electron microscopy, RT-qPCR and immunohistochemistry. In vivo efficacy was evaluated in murine models of cystic (CE) and alveolar echinococcosis (AE). The impact of infection and drug treatment on the mouse bone marrow hematopoietic stem cell (HSC) population and its differentiation into dendritic cells (BMDCs) was investigated via flow cytometry and RT-qPCR. In vitro treatment with Rsv reduced E. granulosus metacestode and protoscolex viability in a concentration-dependent manner, caused ultrastructural damage, increased autophagy gene transcription, and raised Eg-Atg8 expression while suppressing Eg-TOR. However, the intraperitoneal administration of Rsv was not only ineffective, but also promoted parasite development in mice with CE and AE. In the early infection model of AE treated with Rsv, an expansion of HSCs was observed followed by their differentiation towards BMCDs. The latter showed an anti-inflammatory phenotype and reduced LPS-stimulated activation compared to control BMDCs. We suggest that Rsv ineffectiveness could have been caused by the low intracystic concentration achieved in vivo and the drug’s hormetic effect, with opposite anti-parasitic and immunomodulatory responses in different doses.

Abstract Approximately 1–3% of cases of hydatid disease involve the central nervous system (CNS). This study aims to report an extremely rare case of supra‐infratentorially located epidural hydatid cyst with transverse venous sinus obstruction which presented with chronic cerebral vein thrombosis (CVT) signs and symptoms.

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р

Abstract Hydatidosis rarely (2%–3% of all cases) manifests as an intramuscular mass in endemic areas. This 55‐year‐old farmer with an asymptomatic thigh mass from 35 years ago presented with exertional pain in the last 40 days of the disease course. The patient started on albendazole and was cured with surgery.

In April 2022 and December 2022, the New Hampshire Department of Health and Human Services confirmed 2 cases of locally acquired human pulmonary cystic echinococcosis caused by Echinococcus granulosus tapeworms. Both patients reported dressing locally hunted moose and exposure to dogs.

Abstract The presence of primary retroperitoneal hydatid cysts is rare, even in endemic areas. The authors report a young man with a retroperitoneal hydatid cyst who underwent total cystectomy. The surgeons should suspect hydatid cysts in case of any abdominal cysts, especially in endemic areas, and avoid any spillage and puncture.

Echinococcosis, or hydatidosis, is one of the most important zoonotic diseases, which is initiated by the larval stage in the clasts of Echinococcus granulosus. For the treatment of hydatidosis, surgery is still the preferred method and the first line of treatment for symptomatic patients. Unfortunately, most of the scolicidal agents that are injected inside cysts during hydatid cyst surgery have side effects, including leaking out of the cyst and adverse effects on the living tissue of the host, such as necrosis of liver cells, which limits their use. This work was carried out to study the lethal effect of green synthesized gold nanoparticles (Au-NCs) against hydatid cyst protoscoleces. Au-NCs were green synthesized using the Saturja khuzestanica extract. Au-NCs were characterized by UV-visible absorbance assay, electron microscopy analysis, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Scolicidal properties of Au-NCs (1–5 mg/mL) were studied against protoscoleces for 10–60 min. The effect of Au-NCs on the expression level of the caspase-3 gene as well as the ultrastructural examination was studied by real-time PCR and scanning electron microscopy (SEM). The cytotoxicity of Au-NCs on hepatocellular carcinoma (HepG2) and normal embryonic kidney (HEK293) cell lines was also studied by the cell viability assay. The obtained Au-NCs are cubes and have an average size of 20–30 nm. The highest scolicidal efficacy was observed at 5 mg/mL with 100% mortality after 20 min of treatment for hydatid cyst protoscoleces. In ex vivo, Au-NCs required more incubation time, indicating more protoscolicidal effects. Au-NCs markedly upregulated the gene level of caspase-3 in protoscoleces; whereas they changed the ultra-structure of protoscoleces by weakening and disintegrating the cell wall, wrinkles, and protrusions due to the formation of blebs. We showed the effective in vitro and ex vivo scolicidal effects of Au-NCs against hydatid cyst protoscoleces by provoking the apoptosis process of caspase-3 activation and changing the ultrastructure of protoscoleces with no significant cytotoxicity against human normal cells. However, additional studies should be conducted to determine the possible harmful side effects and accurate efficacy.

Hydatid disease is a condition affecting mainly the liver or, to a lesser extent, the lungs. We present an uncommon case of a primary renal echinococcosis in a young man complaining of intermittent hematuria, dull flank pain, and palpable mass in the left lumbar and lateral abdominal area which increases its size over time. After initial self-treatment with painkillers and antibiotics, the patient was referred to a urological clinic, where the physical examination revealed a large tumour mass in the left kidney. Ultrasound showed a large multilocular renal cyst, with a CT highly suspicious for renal echinococcosis (15×12.8×24.2 cm). Serological tests confirmed presence of IgG against Echinococcus. The patient was operated using the lumbar approach and nephrectomy was performed. The man recovered completely after surgery without the need for further treatment.

Summary: Background: Alveolar echinococcosis (AE), which is caused by larval Echinococcus multilocularis, is one of the world's most dangerous neglected diseases. Currently, no fully effective treatments are available to cure this disease. Methods: In vitro protoscolicidal assay along with in vivo murine models was applied in repurposing drugs against AE. Genome-wide identification and homology-based modeling were used for predicting drug targets. RNAi, enzyme assay, and RNA-Seq analyses were utilized for investigating the roles in parasite survival and validations for the drug target. Findings: We identified nelfinavir as the most effective HIV protease inhibitor against larval E. multilocularis. Once-daily oral administration of nelfinavir for 28 days resulted in a remarkable reduction in parasite infection in either immune-competent or immunocompromised mice. E. multilocularis DNA damage-inducible 1 protein (EmuDdi1) is predicted as a target candidate for nelfinavir. We proved that EmuDdi1 is essential for parasite survival and protein excretion and acts as a functionally active protease for this helminth. We found nelfinavir is able to inhibit the proteolytic activity of recombinant EmuDdi1 and block the EmuDdi1-related pathways for protein export. With other evidence of drug efficacy comparison, our results suggest that inhibition of EmuDdi1 is a mechanism by which this HIV proteinase inhibitor mediates its antiparasitic action on echinococcosis. Interpretation: This study demonstrates that nelfinavir is a promising candidate for treating echinococcosis. This drug repurposing study proves that the widely prescribed drug for AIDS treatment is potent in combating E. multilocularis infection and thus provides valuable insights into the development of single-drug therapy for highly prevalent co-infection between HIV and helminth diseases. Funding: This work was supported by the National Natural Science Foundation of China (31802179), the Natural Science Foundation of Gansu Province, China (No. 21JR7RA027), and the State Key Laboratory of Veterinary Etiological Biology (No. SKLVEB2021YQRC01).

AbstractBackground To the best of our knowledge, the association of inflammatory parameters with hepatic hydatid disease (HD) has not been investigated in a single study. We aimed to evaluate the potential value of inflammatory indices in this disorder.Methods The retrospective study including 114 patients was performed from January 2016 to November 2019. Clinical characteristics and laboratory data for all participants were collected and analysed. The levels of inflammatory parameters were compared in the patient and control group, the predictive value of these inflammatory parameters was assessed by the logistic regression analysis and receiver operating characteristic curve, and differences between pre- and post-surgical operations were compared by pair tests.Results Significantly higher levels of platelet distribution width (PDW), eosinophil percentage (EOS %), neutrophil to lymphocyte ratio (NLR), gamma-glutamyl transpeptidase to platelet ratio (GPR) and alkaline phosphatase to platelet ratio (APPR) and lower levels of platelet (PLT) and prognostic nutritional index (PNI) were observed in patients than in controls. Multivariate analyses showed that hydatid could induce the abnormal levels of these parameters, of which APPR and PNI had more obvious changes as compared to other parameters. The levels of PDW and APPR significantly decreased after surgical treatment.Conclusions Inflammatory parameters closely associated with the hepatic HD could be used in the evaluation of treatment as assistant indexes.KEY MESSAGEHydatid disease (HD) seriously endangers public health and economic development.Inflammatory parameters that are readily available and acceptable in routine clinical practice could be closely associated with HD.Inflammatory parameters could be used in the evaluation of disease development by combing with histological and radiological results in future studies.

Abstract Background Hydatid cyst is rarely located in soft tissues. This case of a hydatid cyst over the plantar surface of our patient’s foot is one of the rarest presentations. Case presentation This is a case report of a 22-year-old Somali who presented with a lump over the plantar surface of his foot of 1-year duration. The diagnosis of hydatid cyst was made intraoperatively from the typical appearance of a hydatid cyst. The cyst was completely excised. No local recurrence has been detected to date. Conclusions The rare location and uncommon incidence made the initial diagnosis of hydatid cyst of the foot difficult. Detection of the typical germinal membrane can guide the diagnosis of hydatid cyst in rare locations that are found incidentally.

Objective. To compare the performance of polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for diagnosing Echinococcus granulosus in dog feces among national reference laboratories in Argentina, Chile, Peru, and Uruguay. Methods. National laboratories affiliated with the Ministry of Health/Agriculture of each country exchanged panels of 10 positive/negative samples obtained from their regular national surveillance programs in November 2015 – November 2016. All laboratories applied PCR; two also applied ELISA techniques. Sensitivity and specificity were determined for each laboratory and concordance of results among the laboratories was evaluated by Cohen Kappa coefficient. Results. Poor concordance (3 of 10 paired comparisons had values of Kappa > 0.4), low sensitivity and specificity across all laboratories, and poor performance of both techniques in detecting E. granulosus in canine feces was demonstrated in this study. An ex-post comparison of the laboratories’ test protocols showed substantial heterogeneity that could partially explain poor concordance of results. Conclusion. The results underscore the heterogeneity of canine echinococcosis diagnosis across the region and indicate possible sources of variability. Efforts to standardize canine echinococcosis testing must be included in the plan of action for the Regional Initiative for the Control of Cystic Echinococcosis. Future comparisons with fecal samples of known parasite load are needed.

Echinococcosis is a zoonotic disease caused by Echinococcus species. The life cycle involves a definitive host (dogs, wolves, jackals, and foxes) and an intermediate host. It is not transmitted from human to human. The most frequent agents are Echinococcus granulosus (E. granulosus) and Echinococcus multiloculoris (E. multiloculoris). Echinococcus vogeli (E. vogeli), and Echinococcus oligarthus (E. oligarthus) are more rarely seen. The disease is more widespread in rural areas in which animal husbandry and uncontrolled slaughter are common. The infection can remain asymptomatic for extended periods. E. multiloculoris infection has a greater probability of being symptomatic, and of mortality. It most frequently settles in the liver and lungs. Single organ involvement and cyst are detected in the majority of patients. Diagnosis is based on clinical, serological, imaging, and pathological findings. It is a preventable and treatable public health problem. Education and animal control are very important.

Abstract Hydatidosis is an anthropozoonosis mainly encountered in pastoral areas. It mostly affects the liver, lung, and rarely the bone and the soft tissues. Skeletal involvement is usually secondary to visceral hydatidosis. We report a case of a 49‐year‐old man presenting with one‐year history of a progressive left hip pain. On local examination, there was tenderness in the left gluteal region with reduction in the hip range of motion. Pelvic X‐ray revealed an expansive bone destruction involving the left hemi pelvis without periosteal reaction. A magnetic resonance imaging showed multiple cystic lesions extending from pelvic bones to the gluteal region. The possibility of hydatid disease was raised, and hydatid serology test was positive. No visceral involvement was found by additional examinations investigations revealed visceral hydatidosis. Thus, the diagnosis of a primary bone hydatid disease was established. No surgical excision was possible, and the patient was put on Albendazole. Echinococcosis should be ruled out while dealing with progressive expansive bony lesions. Surgical management remains a challenge especially if the involvement is very extensive.

Aim: Diagnosis of echinococcosis is based on clinical symptoms, imaging techniques and particularly on the detection of specific antibodies in serum specimens of patients. The aim of this study is retrospective evaluation of seropositivity from patients who is diagnosed as Cystic echinococcosis. Materials and Methods: In this study, the blood serum samples of patients, which were sent to the Medical Microbiology Laboratory from several clinics of the Selcuk University Medical Faculty Hospital between 01 January 2015- 01 July 2020, were evaluated in terms of Cystic echinococcosis by using indirect hemaglutination test. The results were evaluated with a cut off titer ≥160 of as recommended by the manufacturer. Results were evaluated by gender and ages. Results: Cystic echinococcosis (CE) was determined to be seropositive 332 (21.6%) of 1543 patient samples. Seropositivity was found in 226 (14,7%) of 933 female patients and in 106 (6,9%) of 610 male patients. Seropositivity was mostly seen in 21-40 age group. Conclusion: While there have been a number of animal studies, little information is available about the prevalence of Cystic echinococcosis in humans in Turkey. Cystic echinococcosis continues to be a majör public health problem in the Konya province. Large scale prevention and control programs should be implemented against this disease.

Introduction Cystic echinococcosis (CE) is a zoonotic infection caused Echinococcus granulosus with worldwide distribution. As one of the problems that can be encountered after treating CE patients is the risk of postsurgical relapses or treatment failure, a long-term clinical and serological follow-up is required to evaluate the success and failure of therapy. Materials and Methods We used extract protoscolex antigen from fresh sheep hydatid cyst collect from slaughtered in Ahvaz. Overall we tested 180 serum samples comprising: 41 sera from post surgically confirmed CE from 6 month to 20 years after surgery, 69 sera from patients with symptomatic CE and 50 sera from non CE patients and 20 heterologous sera were evaluated with SDS-PAGE gel electrophoresis and western blotting. Results The sensitive of the 38 KDa PSC Antigen was 67 % pre and 83 % after surgery and 100% specify. All hepatic CE and 66.6 % of pulmonary CE sera was reacted with PSC Antigen. Conclusion The results indicate that the hydatid specific antibodies of IgG, IgG1 and IgG4 are the most important antibodies for the serological diagnosis of CE during the active stage of the disease and Ig G, particularly sub-class Ig G4 was more suitable for postoperative follow up.

Objective: The purpose of this study was to identify cases of human echinococcosis in the Bayan-Ulgii, Khovd provinces, to determine their WHO classification by ultrasound and to identify the haplotype in surgically cysts removed. Methods: A total of 1063 people participated in ultrasound screening. Patients who had a positive echinococcosis by ultrasound underwent serologic testing for detection of antibodies for echinococcosis. Results: Ninety people were positive for the liver cystic lesions by ultrasound screening of which 12 cases were newly diagnosed cystic echinococcosis. Four were cystic echinococcosis stages 1-2, five were stage 3, while three were cystic echinococcosis stage 4. Thirty-three patients with previously known echinococcosis stage 2 and alveolar echinococcosis stage 4 were also examined. Out of 29 cystic echinococcosis cases, 24 underwent treatment. Of 24 who underwent treatment, only one was cured. The haplotypes E. canadensis G6/7 and E. granulossus s.s. G1 were confirmed by evaluating the cytochrome c oxidase subunit I gene of mitochondrial DNA in two patients in Bayan-Ulgii. Conclusion: Ninety people were positive for cystic echinococcosis in western Mongolia of which 12 cases were newly diagnosed cases. Of the 12 new cystic echinococcosis cases, 4 were stages 1-2, 5 were stage 3 and 3 were stage 4 by WHO classification. The haplotype in Bayan-Ulgii population were E. canadensis and s.s.

Introduction There is an academic debate over surgical treatments of liver hydatid cyst disease. In this study, a systematic review and meta-analysis were carried out in order to evaluate the pros and cons of both PAIR (Puncture, Aspiration, Injection, Respiration) and laparoscopic techniques by considering the outcomes of liver hydatid cysts. Material and methods We designed descriptive Boolean queries to search two databases, PubMed and Scopus, to derive the articles published in the period of January 2000 to December 2016 in order to evaluate the outcomes of these research articles. The outcomes of laparoscopic and PAIR procedures include the rates of cure, postoperative complications, recurrences, and mortality, which were extracted, assessed, and used as their corresponding effect sizes. Results Fifty-seven studies including a total of 2832 patients (PAIR group n = 1650 and laparoscopic group = 1182) were analyzed. In this meta-analysis study, a random effect model of correlations of outcomes (postoperative complications, mortalities, recurrences, and cure rates) of PAIR and laparoscopy procedures was used. The meta-analysis and the forest plots of the two procedures show that the PAIR approach is superior in terms of cure, complication, and mortality rates compared with the laparoscopy technique. However, the recurrence rate is low in laparoscopic approaches. Moreover, Egger’s tests for determining publication bias and heterogeneity tests were also performed. Conclusions This study shows promising trends toward an advantage of PAIR procedures in treatment of liver hydatid cyst in comparison with laparoscopic procedures. The PAIR procedure is superior to laparoscopy due to having a higher cure rate and lower complication and mortality rates; however, the latter has a lower recurrence rate.

Background: Hydatid cyst is a zoonotic infection caused by . Primary single-intramuscular hydatid disease is rare, even in endemic regions of the world. Here we report the case of exceptional thigh mass due to a hydatid cyst in an Iranian man.Case presentation: An 86-year-old man, initially presented to Velayat teaching hospital surgery clinic in May 2017 with a single right-thigh mass, but physical examinations of other organs were unremarkable. Based on sonographic findings, the differential diagnosis was hydatid cyst. He underwent surgical resection of the cyst. Histopathological results confirmed the diagnosis. There was no evidence of recurrence of the lesion during the 23-month follow-up. Conclusion: Increase thigh mass due to a hydatid cyst is a rare event. In endemic regions with the presence of hydatid cysts, especially physicians of surgical clinics have to consider differential diagnosis of hydatid cysts in unusual locations in case of such a lesion.

Background Echinococcosis caused by larval of Echinococcus is prevalent all over the world. Although clinical experience showed that the presence of tapeworms could not be found in liver lesions, the repeated infection and aggravation of lesions still occur in the host. Here, this study constructed a multifactor-driven disease-related dysfunction network to explore the potential molecular pathogenesis mechanism in different hosts after E.multilocularis infection. Method First, iTRAQ sequencing was performed on human liver infected with E.multilocularis. Second, obtained microRNAs(miRNAs) expression profiles of humans and canine infected with Echinococcus from the GEO database. In addition, we also performed differential expression analysis, protein interaction network analysis, enrichment analysis, and crosstalk analysis to obtain genes and modules related to E.multilocularis infection. Pivot analysis is used to calculate the potential regulatory effects of multiple factors on the module and identify related non-coding RNAs(ncRNAs) and transcription factors(TFs). Finally, we screened the target genes of miRNAs of Echinococcus to further explore its infection mechanism. Results A total of 267 differentially expressed proteins from humans and 3,635 differentially expressed genes from canine were obtained. They participated in 16 human-related dysfunction modules and five canine-related dysfunction modules, respectively. Both human and canine dysfunction modules are significantly involved in BMP signaling pathway and TGF-beta signaling pathway. In addition, pivot analysis found that 1,129 ncRNAs and 110 TFs significantly regulated human dysfunction modules, 158 ncRNAs and nine TFs significantly regulated canine dysfunction modules. Surprisingly, the Echinococcus miR-184 plays a role in the pathogenicity regulation by targeting nine TFs and one ncRNA in humans. Similarly, miR-184 can also cause physiological dysfunction by regulating two transcription factors in canine. Conclusion The results show that the miRNA-184 of Echinococcus can regulate the pathogenic process through various biological functions and pathways. The results laid a solid theoretical foundation for biologists to further explore the pathogenic mechanism of Echinococcosis.

Hydatid disease is a zoonotic infestation caused by the genus Echinococcus. It is still widespread in agricultural communities. It is common in temperate and sheep raising countries of the world where it causes a significant public health problem. It is a chronic disease and cyst can be presented in different organs. In humans, hydatid cyst develops most often in the liver (65%) and lungs (25%). Other organs affected occasionally include the brain, muscle, kidney, heart, pancreas, adrenal, and thyroid gland. Involvement of the thyroid gland by hydatid cyst is rare. It is most often asymptomatic or present with anterior neck swelling or rarely dysphagia or dyspnoea. This case report explains our experience with a patient suffering from hydatid cyst in the thyroid.