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Cystic hydatid disease or cystic echinococcosis (CE) is a globally endemic zoonosis caused by the larval cyst stage of the tapeworm Echinococcus granulosus. Concomitant presence of CE and hepatocellular carcinoma (HCC) is a rare clinical scenario. A 70-year-old male patient presented with acute abdominal pain to the surgical outpatient department. On evaluation, a cystic lesion with solid components and free fluid in the abdomen was observed, which led to multiple differentials in the working diagnosis. A CT showed the mass to have a delayed enhancement. Surgical exploration revealed a partially ruptured hydatid cyst with daughter cysts in the abdominal cavity and a solid-component mass lesion. We proceeded with a right partial hepatectomy. Pathological evaluation revealed a pale mass lesion with a large collapsed cyst. HCC with unusual dense fibrillar fibrosis and cystic interface with normal parenchyma was observed. This case connects the multimodal assessment of radiology, surgery and pathology.

This case study is a rare example of cardiac hydatidosis in a high-income country, where a middle-aged man presented with a ruptured right ventricular cyst causing anaphylaxis, pulmonary emboli and dissemination ofEchinococcusthroughout the lung. He survived the cyst rupture and underwent cardiac surgery but had incomplete resection and experienced progressive cardiopulmonary hydatidosis despite antihelminthic therapy. As a result, he experienced an array of cardiopulmonary sequelae over his lifespan. This case report highlights rare clinical manifestations of hydatid disease and potential complications of its treatment.

Background: To compare the efficacy, safety, and long-term results of laparoscopic and open approaches in patients undergoing surgery for renal hydatid cyst. Materials and Methods: The files of 36 ...

Hydatid disease or echinococcosis is a tapeworm infection that spreads by contact with animal contaminated faeces. Dogs, sheep, wolves and jackals are definitive hosts passing the eggs of these parasites in their faeces. Humans are accidental, intermediate hosts and become infected after ingesting

Echinococcosis or human hydatid disease is a helminthic infection is caused by Echinococcus species. Classically, cystic echinococcosis is caused by Echinococcus granulosus sensu stricto, E. equinus, E. ortleppi and E. canadensis, though several other species have been implicated in hydatid disease. Echinococcus infection may lead to cystic disease of the liver, lungs and potentially other organs. Here we present a patient who had cystic disease of the lungs and liver. The patient initially experienced right upper quadrant pain and nausea, and later went on to develop a fever, cough and dyspnoea in the setting of hydropneumothorax. CT scan of the chest and abdomen revealed a large fluid collection at the left lung base and a large lobular complex fluid mass within the right lobe of the liver. Echinococcus titres were positive. The patient was commenced on albendazole; however, experienced significant derangement of liver enzymes within the following month. In light of this, the albendazole was ceased, and a hemi-hepatectomy was performed. During the hemi-hepatectomy there was some cyst content spillage, and subsequently a washout with hypertonic saline 3% was performed. This was followed by a course of praziquantel 1200 mg two times per day for 14 days. Repeat CT 6 months later demonstrated no evidence of recurrence.

Echinococcosis is a zoonotic parasitic disease that is highly endemic to the Qinghai province of China. Limited data are available on the prevalence of the causal pathogen, Echinococcus spp., in definitive hosts in this region. Thus, the aim of this study was to evaluate the prevalence of Echinococcus spp. in wild foxes and stray dogs in Qinghai province. Five hundred and twenty-eight feces from wild foxes and 277 from stray dogs were collected from 11 counties in the Golog, Yushu, and Haixi prefectures and screened for Echinococcus spp. using copro-DNA polymerase chain reaction (PCR). In total, 5.5% of wild foxes and 15.2% of stray dogs tested positive for Echinococcus spp. The prevalence rates of Echinococcus spp. in wild foxes in Golog, Yushu, and Haixi were 7.3%, 5.2%, and 1.9%, respectively. In stray dogs, these rates were 13.3%, 17.3%, and 0%, respectively. Sequencing analysis determined that Echinococcus multilocularis was the most prevalent species, occurring in 4.0% and 12.6% of wild foxes and stray dogs, respectively. Echinococcus shiquicus was observed in 1.5% of wild foxes and 0.7% of stray dogs. Echinococcus granulosus was observed only in wild dogs, with a prevalence rate of 1.8%. To our knowledge, this is the first report on the prevalence of E. shiquicus in dogs in Qinghai province. The current results improve our understanding of the transmission and dissemination of human echinococcosis and suggest that exposure to the eggs of E. multilocularis harbored by wild foxes and stray dogs may pose a great risk of alveolar echinococcosis to humans in Qinghai province.

Background: Human cystic echinococcosis (CE), most commonly caused by echinococcosis granulosis, is the most common presentation of hydatid disease of the liver and is considered endemic in the Mid...

Oromaxillofacial hydatid cysts are rare, even in countries where echinococcosis is endemic. This study aimed to describe an isolated oromaxillofacial hydatid cyst and to discuss the epidemiology, clinical features, and treatment thereof. The authors report the case of a 12 year-old boy who presented with a 2 week history of an enlarging hydatid cyst in the parapharyngeal space extending to the neck, with no pulmonary or hepatic involvement. We present our clinical findings, diagnostic techniques, and treatment and review the relevant literature. Forty-one cases, with a male:female ratio of 1.21:1, have been reported, mostly in patients aged 20 to 40 years (both sexes). Oromaxillofacial hydatid cysts are most commonly located in the parotid gland (19.51%, n = 8), submandibular region including the submandibular gland (17.07%, n = 7), and infratemporal fossa (14.63%, n = 6). Only 2 (4.88%) cases of hydatid cysts in the parapharyngeal space have been reported before. Although isolated parapharyngeal space hydatid cysts are rare, oromaxillofacial surgeons should consider relevant diagnostic and therapeutic procedures to ensure complete resection.

Background: Cystic echinococcosis is a parasitic disease that develops in endemic areas due to the transmission of Echinococcus granulosus. The liver is the organ most affected. The most frequent s...

Based on the official statistics the situation of parasitic diseases in the Russian Federation is still quite unfavorable. The issues of soil contamination with Echinococcus granulosus eggs are understudied that’s why the objective of the research was to study canine echinococcosis which poses a threat to animal and human disease freedom in the North Caucasian countries. Helminthological tests of the guardian dog feces were performed in seven North Caucasian Subjects: the Stavropol Krai, the Karachay-Cherkessia Republic, the Kabardino-Balkaria Republic, Republic of North Ossetia −Alania, Republic of Ingushetia, the Chechen Republic, and the Republic of Dagestan. As a result, it was determined that the average frequency index of echinococcosis occurrence was 85.07%. The moderate fecal egg count in 1,400 samples was 22.73 ± 1.49 eggs per 10 grams of dog feces. The data obtained are indicative of the disease unfavourable situation in the Subjects and the zoonosis spread at the regional level. Helminthological tests of 14,000 soil samples from near-village pastures for contamination with tapeworm eggs, including Echinococcus granulosus, showed that the invasion rate in the Stavropol Krai was 65.80%, in Karachay-Cherkessia republic − 79.00%, in Kabardino-Balkaria − 82.60%, in North Ossetia − Alania − 74.65%, in Ingushetia − 88.20%, in Chechnya − 83.75%, in Dagestan − 79.85%. The results obtained testify to the high level of soil contamination with the infective eggs. It was demonstrated that there is a relationship between the distribution of viable Echinococcus granulosus eggs in pasture soils and ecological characteristics of the Subject: the largest number of viable Echinococcus granulosus eggs was observed in submountain areas, fewer eggs were observed in flatlands, and the least number of eggs – in the mountain areas. The number of eggs detected in the soil samples from pastures is indicative of the disease persistence in humans and animals. Results of the helminthological tests of 7,500 soil samples from 119 cattle-driving routes of the North Caucasus demonstrate 100% contamination with parasitic agents which poses a threat of epidemiological and epizootological situation of echinococcosis in the Subject.

Background Cystic echinococcosis (CE), caused by the larval stage of the complex Echinococcus granulosus sensu lato (s.l.), is a zoonotic parasitic disease with a high social burden in China. E. ortleppi is a species (formerly genotype 5 of E. granulosus s.l.) with unique epidemic areas (tropical areas), transmission patterns (mainly cattle origin), and pathological characteristics (large and small hook lengths) compared to other species that cause CE. A 19-year-old female patient in an area with no history of echinococcosis in Guizhou Province, China, was diagnosed with E. ortleppi infection in 2019. This study is to understand the source of this human E.ortleppi infection. Methods We performed computer tomography (CT) scans, surgical operation, morphological sectioning, molecular diagnosis, phylogenetic analyses, and epidemiological investigation in Anshun City, Guizhou Province, China in 2019. Results The patient presented with intermittent distension and pain in the upper abdomen without other abnormal symptoms. Routine blood examination results were normal. However, abdominal CT revealed a fertile cyst with a diameter of approximately 8 cm, uniform density, and a clear boundary, but without an evident cyst wall in the right lobe of the liver. The cyst was fertile, and phylogenetic analyses revealed that the isolates represented a new E. ortleppi genus haplotype. A result of 10‒14 years incubation period with indigenous infection was considered available for the case through the epidemiological survey. Conclusions CE due to E. ortleppi infection can be confused with other diseases causing liver cysts, resulting in misdiagnosis. A transmission chain of E. ortleppi may exist or existed in the past in the previously considered non-endemic areas of echinococcosis in southwestern China. Graphic abstract

BACKGROUND Neurohydatidosis is a rare zoonotic disease in nonendemic areas and a differential diagnosis of intracerebral cysts workup. Appropriate imaging modalities with serology are required for proper diagnosis. The gold standard surgical intervention is the Dowling-Orlando technique. METHOD We provide a detailed description, with key surgical steps, for total excision of hydatid cysts with intact capsules by hydrodissection. We also describe the relevant surgical anatomy, with indications, limitations, and possible complications. CONCLUSION Hydrodissection allows safe resection of hydatid cysts without further damage to the surrounding parenchyma and reduces the risk of cystic wall rupture.

BACKGROUND When Echinococcus multilocularis infects humans as a false intermediate host, alveolar echinococcosis (AE) usually manifests primarily intrahepatically and is initially asymptomatic. If the disease remains undiagnosed and untreated, progressive growth occurs, reminiscent of malignant tumours. The only curative therapy is complete resection, which is limited to localised stages, and palliative drug therapy is used otherwise. Consequently, early diagnosis and reliable detection of AE lesions are important. For this reason, abdominal ultrasonography, as the most common primary imaging for AE, relies on classification systems. AIM To investigate how hepatic AE lesion sonomorphology changes over time in the Echinococcosis Multilocularis Ulm Classification (EMUC)-ultrasound (US) classification. METHODS Based on data from Germany’s national echinococcosis database, we evaluated clinical and US imaging data for 59 patients according to the AE case definition in our preliminary retrospective longitudinal study. There had to be at least two liver sonographies ≥ 6 mo apart, ≥ 1 hepatic AE lesion, and complete documentation in all US examinations. The minimum interval between two separately evaluated US examinations was 4 wk. The AE reference lesion was the largest hepatic AE lesion at the time of the first US examination. To classify the sonomorphologic pattern, we used EMUC-US. In addition to classifying the findings of the original US examiner, all reference lesions at each examination time point were assigned EMUC-US patterns in a blinded fashion by two investigators experienced in US diagnosis. Statistical analysis was performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, United Stated). P values < 0.05 were considered statistically significant. RESULTS The preliminary study included 59 patients, 38 (64.5%) women and 21 (35.6%) men. The mean age at initial diagnosis was 59.9 ± 16.9 years. At the time of initial ultrasonography, a hailstorm pattern was present in 42.4% (25/59) of cases, a hemangioma-like pattern in 16.9% (10/59), a pseudocystic pattern in 15.3% (9/59), and a metastasis-like pattern in 25.4% (15/59). For the hailstorm pattern, the average lesion size was 67.4 ± 26.3 mm. The average lesion size was 113.7 ± 40.8 mm with the pseudocystic pattern and 83.5 ± 27.3 mm with the hemangioma-like pattern. An average lesion size of 21.7 ± 11.0 mm was determined for the metastasis-like pattern. Although the sonomorphologic pattern remained unchanged in 84.7% (50/59) of AE reference lesions, 15.3% (9/59) showed a change over time. A change in pattern was seen exclusively for AE lesions initially classified as hemangioma-like or pseudocystic. A total of 70% (7/10) of AE lesions initially classified as hemangioma-like showed a relevant change in pattern over time, and 85.7% (6/7) of these were secondarily classified as having a hailstorm pattern, with the remainder (1/7; 14.3%) classified as having a pseudocystic pattern. A total of 22.2% (2/9) of AE lesions initially classified as pseudocystic showed a relevant change in pattern over time and were classified as having a hailstorm pattern. For AE lesions initially classified as having a hailstorm or metastatic pattern, no pattern change was evident. All patients with pattern change were on continuous drug therapy with albendazole. CONCLUSION The sonomorphology of hepatic AE lesions may change over time. The hemangioma-like and pseudocystic patterns are affected.

У статті наведено результати огляду літератури щодо епідеміології та діагностики кістозного ехінококозу в дітей та описаний клінічний випадок легеневого ехінококозу в дівчинки 8 років. Останніми роками збільшилася кількість хворих на ехінококоз не тільки в загальновизнаних ендемічних вогнищах, але також і серед жителів європейських країн. Через зростаючу кількість людей, які емігрують до Центральної Європи з країн із високою частотою виникнення кістозного ехінококозу, дана хвороба стала важливою при диференційній діагностиці кістозних уражень. У 2014 році запущений Європейський регістр кістозного ехінококозу (ERCE) в контексті проекту HERACLES. Описаний клінічний випадок являє безперечний інтерес як приклад пізньої діагностики кістозного ехінококозу, що призвело до розвитку ускладнень та потребувало оперативного лікування.

Background Tapeworm infections are among the tropical neglected parasitic diseases endemically occurring in Ethiopia. This systematic review and meta-analysis aims at estimating the pooled prevalence and distribution of Taenia and Echinococcus infections in humans and animals from reports from Ethiopia. Methods The systematic search was conducted in four bibliographic databases (PubMed, Google Scholar, Africa Journal Online and Science Direct). Additional data were retrieved from grey literature. Studies that met the inclusion criteria were considered for the systematic review and meta-analysis. The meta-analysis was conducted using MetaXL add-in for Microsoft Excel. Heterogeneity and inconsistency were evaluated using Cochran’s Q and I2 statistics, respectively. Results The study provides a country-based database of Taenia and Echinococcus infections consisting of 311 datasets from 201 publications which were mostly abattoir surveys; of these, 251 datasets were subjected to meta-analysis. Most of the studies were from Oromia (32.8%) followed by Amhara (22.9%) regional states. The pooled prevalence of cystic echinococcosis in intermediate and accidental hosts was calculated as 22% (95% CI 18–26%) and high study variability (Q = 24,420.65, I2 = 100%, P = 0.000). Moreover, a pooled prevalence of Echinococcus infections in final hosts was calculated as 33% (95% CI 20–48%) and low study variability (Q = 17.24, I2 = 65%, P = 0.001). Similarly, study subjects (human, cattle, sheep, goat and wolf) were infected by Taenia spp. with pooled prevalence of 3% (95% CI 2–4%) and moderate study variability (Q = 279.07, I2 = 89, P = 0.000). Meanwhile, the pooled prevalence of Taenia hydatigena, T. ovis and T. multiceps infections in intermediate hosts were calculated as 38%, 14% and 5%, respectively. The random effect meta-analysis of bovine cysticercosis showed a pooled prevalence of 7% (95% CI 5–9%) and high study variability was of (Q = 4458.76; I2 = 99%, P = 0.000). Significant differences in prevalence of Taenia and Echinococcus infections between study sites or different livestock origins have been reported. Conclusion The study evidenced a comprehensive dataset on the prevalence and distribution of Taenia and Echinococcus infections at different interfaces by regions and hosts and hence can aid in the design of more effective control strategies. Graphical Abstract

Preoperative assessment of an echinococcal liver cyst with surrounding tissue structures is extremely important for planning the course of surgical intervention. The paper presents the first experience of treating a patient with a parasitic cyst using three-dimensional reconstruction of the liver affected by echinococcus at the preoperative stage. The use of this approach made it possible to avoid the development of intraoperative complications and get a good treatment result.

Spinal hydatid is an uncommon entity that may cause paraplegia due to extensive cord compression. Often, the lesion may be misdiagnosed as spinal tuberculosis, especially in endemic countries. We report such a case of a young female with primary vertebral hydatid disease, who had been on antitubercular treatment for a long time due to misdiagnosis. We discuss the distinguishing diagnostic imaging features of this entity, which would beware radiologists of misdiagnosing this rare but serious condition.

The article provides data on the current epidemiological situation on the incidence of echinococcosis in residents of Bishkek, Kyrgyz Republic (KR). The long-term dynamics of the incidence of echinococcosis for the period 2000 - 2020 has been analyzed. According to official data, the incidence has decreased, if in 2000 the PI was 15,1, then in 2020 – 3,6. 2000 to 2020 the average long-term intensive indicator was 7,350 per 10 thousand population, the minimum – 3,6 per 10 thousand population (2020) and the maximum – 15,10 per 10 thousand population (2000). Key words: echinococcosis, alveococcosis (multi-chamber echinococcosis), retrospective analysis, epidemiological situation, morbidity, invasion, damage, Bishkek.

Graphical abstract, Highlights • Multimodality imaging plays a crucial role in confirming cardiac echinococcosis. • Speckle-tracking echocardiography gives information about regional myocardial function. • Cyst rupture often causes life-threatening anaphylactic shock. • We present an unusual case of cyst rupture, with chest pain as the only symptom. • Complete surgical removal is the treatment of choice for cardiac echinococcosis.

In recent years, there has been an increase in patients with thyroid pathology around the world, which is associated with iodine deficiency and often these diseases are combined with other pathologies that require surgical treatment. The aim of our work was to evaluate the effectiveness of simultaneous operations in nodular goiter. Material and methods . The article presents the results of simultaneous operations that were performed in 19 patients with nodular goiter. Echinococcosis of the liver was found in 8 of them, cholelithiasis in 11 (chronic calculous cholecystitis – 7 and recurrent choledocholithiasis – 4). All operations were performed under endotracheal anesthesia from two approaches, and thyroidectomy and resection of the thyroid gland in combination with cholecystectomy (choledochotomy) were performed in 11 and in 8 with echinococcectomy. In addition to conventional examination methods, a fine-needle aspiration biopsy of the thyroid gland was performed in all patients with nodular goiter to exclude proliferative growth and identify the contents of the cyst. Postoperative complications and long-term results were studied (from 3 months to 3.5 years). Results . In the immediate postoperative period, complications arose in 3 cases each (wound suppuration, infiltration and pleurisy). 18 patients were examined up to 3 and 6 months, 15 patients – from one to 2 years, 13 patients – from 2 to 3.5 years; recurrence of goiter and associated diseases (gallstone disease and echinococcosis of the liver) were not found. Conclusion . Simultaneous operations can be performed in cases of nodular goiter combination with echinococcosis and gallstone disease, but under the condition of strict adherence to the rules of the principle of aparasiticity and antiparasiticity in echinococcectomy. When performing simultaneous operations, it is necessary to fully examine the patient, determine the indications and contraindications, the volume of the planned operation, and also pay attention to the preoperative preparation and management of the postoperative period.

Background Cystic echinococcosis (CE) is a worldwide parasitic zoonosis caused by the larval stage of Echinococcus granulosus sensu lato affecting livestock, particularly sheep and goats. However, often this parasitosis is underestimated. For this reason, this study aimed to evaluate the epidemiological features and spatial distribution of CE in sheep and goats slaughtered in a hyperendemic Mediterranean area. Methods A survey was conducted in the Basilicata region (southern Italy) from 2014 to 2019. A total of 1454 animals (1265 sheep and 189 goats) from 824 farms were examined for hydatid cyst detection by visual inspection, palpation and incision of target organs. All the CE cysts were counted and classified into five morphostructural types (unilocular, multiseptate, calcified, caseous and hyperlaminated). Molecular analysis was performed on 353 cysts. For spatial analysis, a kriging interpolation method was used to create risk maps, while clustering was assessed by Moran’s I test. Results CE prevalence of 72.2% (595/824) and 58.4% (849/1454) was observed at the farm and animal levels, respectively, with higher values in sheep (62.9%) than goats (28.0%). The liver and lungs were the most frequently infected organs in both sheep and goats. Most of recovered cysts were of the calcified and multiseptate morphotypes. All the isolates were identified as E. granulosus sensu stricto (genotypes G1–G3). Spatial distribution showed a moderate clustering of positive animals. Conclusion The findings of this study can be used to better understand the eco-epidemiology of echinococcosis and to improve CE surveillance and prevention programs in regions highly endemic for CE. Graphical abstract

Hydatid cyst disease is a parasitic infection caused by larval stage of Echinococcus granulosusaffecting mainly the liver. Diagnosis of hepatic hydatidosis depends on clinical presentations, serologicalassays and radiological findings. The present study included 40 patients suffered fromhepatic hydatid cysts. They were classified into 4 groups according to therapeutic protocols theyreceived. All cases were subjected to serological assay, radiological examination to categorizecysts and open surgical intervention for treatment. Samples of hydatid fluid and cysts were examinedregarding parasitological, morphometric and histopathological aspects. Viability of cystcontents was assessed using eosin stain. All samples were cultivated for microbiological assessment.Viability was 95-100% in GI (no previous treatment), 50-85% in GII, 25-45% in GIII(single PAIR technique and single Albendazole course) and 0-10% in GIV (repeated PAIR andmedical treatment). Enterococci and Staphylococcus aureus were detected in one samplein GI and 8 samples in GIV respectively.

Objective. To improve the results of treatment of patients with liver echinococcosis and carry out a comparative assessment of techniques of surgical treatment depending on the nature of postoperative complications, hospital stay and antirecurrent efficacy. Materials and methods. The experience of complex examination and treatment of 65 patients with liver echinococcosis for the period of 1999-2019 was analyzed. Open echinococectomy was performed in 21 patients, atypical liver resection in 18 patients, anatomical liver resection in 14 patients, pericystectomy in 10, laparoscopic echinococectomy in 1, percutaneous puncture of an echinococcal cyst under ultrasound control in 1 patient. Results. The time of inpatient treatment of patients after open echinococectomy was 23.5 4.3 days, after pericystectomy 19.8 1.4 days, after liver resection 14.4 2.7 days, after laparoscopic echinococcectomy 6, after percutaneous puncture echinococcal cyst 7 days. Postoperative complications were observed in 52.4 % of patients who underwent open echinococectomy, in 20 % of patients after pericystectomy, and in 15.6 % after liver resection. There were no relapses of liver echinococcosis in all the groups. Mortality was 1.5 % and was recorded after open echinococectomy. Conclusions. The most effective techniques for preventing postoperative complications are pericystectomy and liver resection. The duration of surgery and the average length of hospital stay with minimally invasive methods of treatment are shorter. However, the use of these methods of treatment remains controversial due to the possibility of intra-abdominal spread of the parasite. Patients with parasitic liver cysts after surgical treatment are subjected to dynamic follow-up observation (ultrasound examination of the liver, enzyme-linked immunosorbent assay, computed tomography of the abdominal organs) after 3-6 months for at least 5 years.

The aim of this study was to develop a synthesis of the evidence available regarding verified E. granulosus sensu lato (s.l.) genotypes in different species worldwide. A systematic review was performed including studies concerning genotypes of E. granulosus s.l. without language or genotyped method restriction, published between 1990 and 2020. A systematic search was carried out in Trip Database, BIREME, SciELO, LILACS, IBECS, PAHO-WHO, EMBASE, PubMed, Scopus, and WoS. Variables of interest were year of publication, country, number of samples, and hosts; genotypes, molecular marker, haplotypes and molecular biology techniques used. Descriptive statistics were applied. 2411 articles were analyzed, however 135 met the selection criteria, representing 8643 liver and lung samples. Of the samples selected 24% were human, the remaining samples pertained to non-human animal hosts; cattle and sheep prevailed with 28.6% and 26.6% of the studied samples, respectively. The reported evidence is mainly from Iran, Turkey, Argentina, China and Chile; with 50, 11, 6, 6 and 5 studies, respectively, published between 1992 and 2020 [most frequently during 2015–2020 (76/135 studies; 56.3%)]. The mitochondrial gene cox1 was generally sequenced and informative (91.8%). Genotypes most frequently identified were E. granulosus sensu stricto (s.s.) (83.2%). Based on this overall evidence, it can be concluded that publications related to genotypes of E. granulosus s.l. are heterogeneous. E. granulosus ss accounts for the vast majority of the global burden of E. granulosus s.l. worldwide. Further studies including larger number of cases and adequate internal validity are required to specify the distribution of genotypes in various host species. PROSPERO CRD42018099827.

Liver transplantation is the final treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The large gap between the growing list of patients awaiting liver transplantation and the scarcity of donor organs has fueled efforts to maximize the existing donor pool and identify new avenues. We treated a 13-year-old boy who had acute liver failure, due to Wilson's disease, with transplantation of a liver from a deceased liver donor with a calcified hydatid cyst. After 3 years of follow-up, liver function tests remained normal, hydatid cyst serology was negative, and no hydatid cyst or other problems were observed.

Background: Echinococcosis caused by Echinococcus granulosus is a zoonotic disease of public health significance, but there have been few studies of the infection in dogs in Nigeria. This study aimed to establish the seroprevalence of E. granulosus in dogs in four Local Government Area of Plateau State, Nigeria.Methods: A total of 179 dog sera were examined for the presence of E. granulosus antibody using an ELISA kit between May to October 2017.Results: Eleven of the sera (6.1%) were seropositive with a prevalence of 7.4% and 2.3% for dogs less than 2 years and those above 2 years of age respectively. More male dogs (7.5%) than females (4.1%) were seropositive. Seroprevalence was associated with 2 years dogs (OR=3.33, p=0.46) and male than female dogs (OR=1.90, p=0.53) but association were not significant. Dogs from Bassa had the highest seroprevalence (15.2%), followed by Mangu (5.9%), Kanke (4.8%) and Jos South (2.0%). Odds ratio showed an association which was not significant between Bassa (OR=3.3), Kanke (OR=2.50).Conclusion: This study shows that E. granulosus infection is present in dogs in some parts of Plateau State. More studies should be done to ascertain echinococcus infection in dogs in Nigeria to aid the formulation of control programmes to forestall its public health impacts. Annals of Medical Laboratory Science (2021) 1(2), 9 - 17

We observed liver failure with a presumed etiology of echinococcosis in an 89-year-old woman. Our patient had been born and then resided on Rebun Island until she was 12 years old. At 46 years old, she had been referred to our hospital due to right abdominal pain. Ultrasound had revealed multilocular cysts in the right lobe of the liver. At 84 years old, the hepatic cyst occupied nearly the entire liver with ring-shaped calcification along the cyst wall. The patient was diagnosed with decompensated cirrhosis and hepatic hydatid disease based on typical imaging and the long-term natural clinical course.

Cystic echinococcosis (CE) is a zoonotic disease, caused by parasite known as Echinococcus granulosus sensu lato complex, leading to substantial economic losses in rural areas with public health problems. This study was carried out to understand the haplotypic profiles of the partial mitochondrial cytochrome c oxidase (mt-CO1) gene of cattle lung hydatid cyst samples which were obtained from two provinces in Turkey. In this study, forty (n = 40) hydatid cyst samples from the lungs of slaughtered cattle were obtained. The germinal layers were taken separately for each individual cyst then stored in 70% ethanol. From each individual cyst sample, total genomic DNA was extracted. Amplification of the partial mt-CO1 gene (875 bp) was performed using a specific primer set by PCR, and then, the amplicons were sequenced. All sequences were analyzed individually, followed by alignment, and haplotype and phylogenetic analyses were then performed. By the sequence alignment process, 39 out of the 40 sequences were characterized as E. granulosus sensu stricto. However, one of them was matched with E. canadensis (G6/G7). The haplotype analyses of the E. granulosus s.s. isolates were arranged in a star-like orientation with a main haplotype, which was separated from other haplotypes by 1–10 mutation steps, and 26 haplotypes were identified. In the mt-CO1 sequences, 29 polymorphic sites were determined, and 34.5% (10/29) of them were parsimony informative. The findings of this study provide the first report of E. canadensis (G6/G7 genotype) among cattle in Turkey.

Background. An increase in the incidence of hepatic echinococcosis is noted annually, surgery remaining its main treatment option. Objective. To analyze the treatment structure and evaluate the treatment outcomes of the patients operated for hepatic echinococcosis in the Surgical department №2 of SAHI "KCEH named after M.A. Podgorbunsky" over the period of 2016 - 2020. Material and methods. The analyzed group included treatment outcomes of 58 patients (22 men (38%), 36 women (62%)), who underwent 76 surgical interventions for liver echinococcosis in the Surgical department №2 on the basis of SAHI "KCEH named after M.A. Podgorbunsky". The difference between the number of operations performed and that of actual patients is explained by the use of staged surgery in a number of cases. Results. The majority of the 76 operations performed over the period of 2016 - 2020 were open resections - 50 (65.8%) cases. Of these, extensive anatomic segmental hepatic resections were performed in 22 cases (44%). In 14 (24%) of all patients staged surgery was used, making it possible to exclude a number of patients from the category of "non-resectable" and to perform surgery with good outcomes. A fatal outcome was noted in one case. Conclusions. The use of various surgical techniques including staged minimally invasive and laparoscopic ones in a specialized surgical department allows achieving good treatment outcomes.

Echinococcus spp. are zoonotic cestode parasites with a worldwide distribution and a complex, two-host life cycle involving carnivore definitive hosts and small mammal or ungulate intermediate hosts. Surveillance for Echinococcus spp. in the Midwestern United States (USA) is rare. Using a mixed-methods approach, we examined Echinococcus infection risks in wildlife and domestic dogs in four Minnesota Tribal Nations. We hypothesized that the spillover of Echinococcus spp. into domestic dogs would vary with the presence or absence of suspected wildlife host species and certain behaviors associated with domestic dog ownership, like feeding wildlife host carcasses or frequency of veterinary care. Among 83 dogs tested, three (3.6%) were positive for Echinococcus spp. Despite low prevalence, pet owner survey and focus group findings indicated that dogs encounter peri-domestic wildlife most often when they roam freely or consume wildlife carcasses. This study demonstrates a need for further research into spillover potential of endemic zoonotic Echinococcus spp. in the Midwest USA.

Background Hydatid disease is an infectious disease that affects several organs. Isolated renal involvement is very rare. The treatment for renal hydatid cyst ranges from minimally invasive percutaneous aspiration techniques to laparoscopic and open techniques. We describe five cases of isolated renal hydatidosis with varied presentations who were treated successfully by various methods. Case presentation The presenting symptoms included flank pain (n = 5), mass abdomen (n = 2), and hydaturia (n = 1). In 4 patients, the diagnosis of a hydatid cyst was known preoperatively, but one patient with a preoperative diagnosis of a simple cyst was found to harbor hydatidosis intra-operatively. Eosinophilia as a marker for the active disease was present in 60% (3/5), while echinococcal serology was positive in only 25% (1/4). Two cases were approached laparoscopically, while three required an open approach. Two patients were treated with nephrectomy due to the high bulk of the disease, while the other three underwent renal preserving cyst excision. Conclusions The presence of eosinophilia in the preoperative workup may indicate an infective/active hydatid disease. Echinococcal serology is representative of past hydatid infection but cannot reveal about current disease status. Cysts with varied attenuations and residence in an endemic region may support a renal hydatid cyst diagnosis. A holistic approach including clinical history, laboratory parameters, and imaging is needed for diagnosis. Surgical treatment requires cyst excision, along with precautions to prevent spilling. Nephrectomy may be preferred in cases with minimal residual function.

Several strategies exist to prevent and control echinococcosis, a global parasitic disease. However, most treatments are ineffective and adverse effects are common. Therefore, we aimed to screen protoscolex antigen molecules of Echinococcus granulosus to identify a diagnostic biomarker for hydatid disease. Published E. granulosus transcriptome sequencing data were analyzed to screen for antigen molecules that are highly expressed in protoscoleces but not in oncospheres. The membrane protein EG-06283 (annotated as Frizzled-4) was selected from 16 antigens, and its gene fragment was subjected to codon optimization and synthesis. rEG-06283 expression was induced in the pET-24a/EG-06283/BL21 strain; subsequently, the protein was purified and subcutaneously injected into ICR mice at weeks 0, 2, 4, and 6. Blood sampling occurred periodically to quantify serum immunoglobulin G (IgG) levels via enzyme-linked immunosorbent assays (ELISA). Immunogenicity was determined by western blot assays using sera from normal mice and mice with secondary hydatid infections. The antigen’s immune reactivity and diagnostic value were validated using sera of patients with hydatid disease. ELISA results confirmed that the antigen molecule induced specific IgG production in mice, resulting in significantly higher levels than those in the adjuvant and control groups (P

We analyzed data reflected in the records of the epidemiological screening of cases with echinococcosis in 2019 in some constituent entities of the Russian Federation. It was noted that both rural people and urban residents suffered from the disease equally, while women suffered a little more than men (54.4%). It is found that the most common localization of echinococcal cysts, both in men and women, is the liver (79.5%), and the lesion of the lungs caused by echinococcal cysts (9.1) is in the second place. We presented multiple localization of echinococcal cysts affecting several organs simultaneously to a lesser extent. Two cases of hydatidosis and two cases of multilocular hydatid cyst in the liver were accompanied by a fatal outcome. In some territories, alveococcosis was diagnosed in 14 (8.75%) cases. Contacts with dogs, work on livestock farms, caring for pets, picking wild berries or mushrooms in the forest and eating them without thermal treatment, use of raw river water in housekeeping, eating unwashed vegetables and berries, activities in natural environment, hunting and dressing of wild animals, or failure to observe the rules of personal hygiene have great importance in the spread of this disease among the population, according to epidemiological records.

This article provides data on the research work carried out to identify echinococcosis among small cattle of different age groups in the Republic of Tajikistan. Echinococcosis of farm animals with a high intensity of invasion is recorded in all areas studied by us, in the valley, foothill and mountain zones. Thus, out of the examined 23 364 organs from slaughtered sheep, 17 850 animals, or 76.40%, were affected by echinococcus. In the farms of the valley zone with distant-pasture sheep breeding, the average prevalence was 72.4%, in the foothill zone with distant-pasture sheep breeding – 90.4%, and in the mountain zone – 59.3%. Slaughtered livestock has a high prevalence not only in the context of zones and districts, but also within farms of the same district, depending on the conditions of keeping the sheep and the number of dogs in the flocks. Thus, in farms with distant-pasture sheep breeding in the valley zone of the same district, the infection rate reached 75.0%, while in the mountain zone only 54.2%. The study for echinococcosis of cattle of different sex and age groups found the same pattern as in sheep, i.e. the prevalence increased with age: from 12% in animals under 2 years old to 39.4% in animals of 3–4 years old and 41.6% in animals older than 5 years.

Echinococcosis, caused by larval stage of the genus Echinococcus, is one of the most important zoonotic diseases worldwide. The purpose of this study was to determine the presence and prevalence of Echinococcus species in stray dogs of Erzurum, a highly endemic region for cystic echinococcosis (CE) and alveolar echinococcosis (AE) in Turkey. The study samples consisted of 446 stray dog faecal specimens collected from an animal shelter in Erzurum, Turkey, between October 2015 and February 2016. The faecal samples were collected from individual dogs for the isolation of taeniid eggs using the sequential sieving and flotation method (SSFM). Molecular analyses and sequencing revealed the prevalence of Echinococcus spp. as 14.13% (63/446) in faecal samples. The stray dogs harboured five different Echinococcus spp.: E. granulosus s.s. (G1/G3) (n = 41), E. equinus (G4) (n = 3), E. ortleppi (G5) (n = 1), E. canadensis (G6/G7) (n = 3) and E. multilocularis (n = 16). E. granulosus s.s. was the most abundant species. Surprisingly, the occurrence of E. multilocularis in dogs was revealed for the first time in Turkey. E. ortleppi was also reported for the first time in Turkey. These findings highlight a significant public health risk for human AE and CE, presenting useful baseline data on Echinococcus spp. infection in dogs for designing control strategies.

Presented clinical case is a rare case of poorly differentiated squamous cell non-keratinizing cancer of the right lung with ingrowth into the diaphragm and liver, metastatic liver damage in combination with recurrent echinococcosis of the liver. Taking into account the epidemiological history, the surgery, the features of radiation imaging and the results of serology in the preoperative period, the diagnosis of “echinococcosis of the liver with spread to the lungs” was made, which turned out to be incorrect. The diagnosis during the surgical operation was changed, but also turned out to be incorrect. The final diagnosis was made only on the basis of histological and immunohistochemical studies.The reasons of diagnostic errors are analyzed, the emphasis is made on the criteria of differential diagnosis. Typical features of visualization of liver echinococcosis, lung cancer with local and distant spread are presented.

Objective. Alveolar echinococcosis (AE) is a zoonosis caused by the larval stage of the metacestode Echinococcosis multilocularis with a tumor-like behavior in the targeted organ, especially in the liver. Surgery with albendazole is first-line modality for AE. Drug discontinuation is usually based upon the parasitic viability shown by the positron emission tomography (PET) scan. However, as a demanding and expensive method, it is not widely practiced in majority of the endemic regions. Further understanding on the cytokine and chemokine response profiles in AE patients may provide an interesting insight for potential markers in viability assessment. Methods. Mice were inoculated with Echinococcus multilocularis intrahepatically to develop the hepatic AE murine model. Oral albendazole administration was then applied for three months after the first inoculation, and peripheral and regional immune cells including type 1 T helper cells (Th), Th2, Th17, regulatory T (Treg) cells, related cytokines, and chemokines were examined. Results. The hepatic AE lesion was confirmed by ultrasound examination resulting in a successful rate of 70%. Among the 17 cytokines and chemokines detected, plasma levels of IL-23 were significantly higher in E. multilocularis-infected mice when compared to the control group; furthermore, more obvious increasing levels were found after albendazole treatment ( p < 0.05 ). All chemokine levels other than eotaxin and MCP-3 were slightly higher in E. multilocularis-infected mice compared to the control group ( p > 0.05 ). Eotaxin levels were significantly decreased in mice with E. multilocularis infection followed by albendazole treatment ( p < 0.05 ). Both IL-17A and IL-23 expressions in hepatic AE lesions were significantly higher and related with disease activity. Conclusion. Albendazole administration influenced the balance of immune response and promotes the secretion of proinflammatory factors which is beneficial to parasite clearance. IL-23 seems to be associated with the successful albendazole treatment in mice with E. multilocularis infection; such a change could be translated into clinical application in the near future.

BackgroundTo explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosisMethodsTwenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4–60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3–6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years.ResultsFor the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected withEchinococcus granulosus(including 2 cases of spinal cord echinococcosis), and 6 cases were infected withEchinococcus alveolaris.ConclusionThe diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

Cardiac echinococcosis is a rare manifestation of Echinococcus infection, affecting 0.5-2% of the patients. Since it may be a life-threatening condition, surgical treatment should be always considered. Herein, here we present a case of a 66-year-old male with chest pain. Subsequent exams confirmed the diagnosis of multiple cardiac hydatic cysts. The patient initiated treatment with albendazole and was submitted to a surgical resection with cardiopulmonary bypass. A complete surgical resection was achieved, and patient remains asymptomatic without disease signs of recurrence on imaging exams. We highlight the necessity of cardiac screening in echinococcosis cases and the surgical management in this case.

Resumen Introducción: La echinococcosis esplénica (EE), suele ser una enfermedad asintomática cuyo diagnóstico se plantea de forma incidental. Objetivo: Determinar morbilidad post-operatoria (MPO) y recurrencia en pacientes intervenidos quirúrgicamente por EE. Material y Método: Serie de casos con seguimiento, de pacientes con EE intervenidos de forma consecutiva, entre 2000 y 2018. Las variables resultado fueron MPO y recurrencia. Otras variables de interés fueron: diámetro y localización del quiste, tipo de cirugía, tiempo quirúrgico, estancia hospitalaria, y mortalidad. Los pacientes fueron seguidos de forma clínica y con imágenes por un mínimo de 18 meses. Se utilizó estadística descriptiva, con medidas de tendencia central y dispersión. Resultados: Se intervinieron 26 pacientes (53,8% hombres), con una mediana de edad de 41,5 años. Las medianas del diámetro de los quistes, el tiempo quirúrgico y el tiempo de hospitalización fueron 14,5 cm; 65 minutos y 4,5 días, respectivamente. La MPO fue 11,5% (3 casos). No hubo mortalidad. Con una mediana de seguimiento de 94 meses, se verificó una recurrencia de 3,8%. Conclusión: Los resultados verificados, en términos de MPO, mortalidad y recurrencia son apropiados en comparación a otras series publicadas.

Background: Echinococcosis (hydatid disease) is a parasitic infection that, in humans, mostly affects the liver and lungs. Pelvic and ovarian involvement with hydatid cysts is commonly secondary to...

Purpose The aim of the present study is to describe the cavity-reducing internal capitonnage technique that we used for the surgical therapy of liver hydatid cyst, and contribute to the literature by presenting the short- and long-term outcomes of the patients who were operated on with this technique. Methods A drainage and internal capitonnage technique was performed on 12 cases due to liver hydatid cyst in our clinic between January 2016 and December 2019. Results The mean age of cases was 36.25 ± 12.5 years, with 7 females and 5 males. All cases had pain in the right upper quadrant, and a sense of fullness in 5 cases. None of the cases had ruptured cysts, jaundice, or other clinical manifestations. The preoperative laboratory findings were normal in 8 cases. Intraoperative biliary-cyst communication was demonstrated in 8 cases (66.7%). Cases were followed up for a mean duration of 38.1 months (range, 24-88 months). Conclusion The drainage/internal capitonnage with/without selective bile duct repair is a technique that can be performed with very low morbidity and mortality rates in experienced hands, especially for centrally located hydatid cysts.

Background. Alveolar echinococcus (AE) is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. The study was designed to illustrate the multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) features of extrahepatic AE.Methods. A cohort of 33 patients who suffered from extrahepatic AE was enrolled consecutively from January 2012 to December 2017. The MSCT and MRI features of extrahepatic AE were recorded and analyzed by experienced radiologists. The MSCT and MRI agreements for detecting imaging features of extrahepatic AE were calculated using kappa statistics.Results. All cases secondary to hepatic AE, except two primary extrahepatic AE, were found in this study. Locations of extrahepatic AE included 19 (57.6%) lung, 10 (30.3%) adrenal gland, 9 (27.3%) brain, 5 (15.2%) peritoneal cavity, 5 (15.2%) spleen, 4 (12.1%) diaphragm, 3 (9.1%) kidney, 3 (9.1%) retroperitoneal, and 2 (6.1%) vertebra; Involvement of 1 (3.0%) heart, 1 (3.0%) mediastinum, 1 (3.0%) muscle, and 1 (3.0%) pancreas was rare. AE of the lung usually appeared as irregular and scattered nodules with small vacuoles or cavities inside and peripheral distribution. Multiple cerebral nodules with calcification and surrounding edema were the most common features seen in brain AE. Adrenal gland AE presented as plaques containing different sizes of hypodense areas and different amounts of calcification. Injection of contrast medium showed no enhancement of lesions except in the brain. Very good agreements were seen between MSCT and MR for detecting number (κ=0.841, p=0.000), border (κ=0.911, p=0.000) and size (κ=0.864, p=0.000) of extrahepatic AE.Conclusions. MSCT and MRI are reliable imaging methods for the diagnosis of extrahepatic AE. When one AE patient is clinically confirmed, MSCT scan from the head to pelvis should be performed to exclude other organs AE.

We present a case of immune thrombocytopenic purpura (ITP), which leads to the diagnosis of severe cystic echinococcosis. Our patient presented with platelets of 5 × 109/L, and investigations uncovered multiple large echinococcal hepatic cysts, the largest of which measured 19.4 × 15 × 12 cm, and peritoneal implants. While initially refractory to prednisone and immunoglobulins, the ITP responded to dexamethasone. The echinococcosis was treated with albendazole followed by surgical resection of all lesions. Our patient's disease course has evolved favorable since his initial treatment with an isolated episode of recurrent thrombocytopenia 2 years later, and has remained in remission for the past 2 years. While a causal association between echinococcosis and ITP cannot be confirmed, this case is a reminder of the importance of remaining inquisitive for atypical potential triggers of ITP. We also present a review of the limited literature on the association of parasitic infections and ITP.

OBJECTIVE: To identify risk factors to pre-surgical complications in patients with cystic echinococcosis (CE) in endemic areas of Peru. MATERIALS AND METHODS: Study of cases (n=43) and controls (n=127) not paired was designed, with a case-control ratio of 1:3 based on a secondary source. The case was defined as the patient with CE who presented with pre-surgical complications related or not with the disease and the control without pre-surgical complication. The response variable was preoperative complication and the exposition ones were age, gender, degree of instruction, occupation, number, size (diameter in centimeters) and location of the cyst. To identify the risk factors, a bivariate logistic regression analysis was performed to obtain the crude odds ratios (cOR) and then the variables with significant association were adjusted by a multivariate logistic regression analysis using the Stata® version 14 software, obtaining theadjusted odds ratios (aOR). RESULTS: Fifty eight point eight percent (24/43) of the cases were women and the median age was 35 years and 59.1% (75/127) of the controls correspond to the female gender and the median age was 27 years. The multivariate logistic regression analysis found that being over 56 years old has an aOR 2.91 (95% confidence interval [CI]: 1.007-8.433) and having ≥3 cysts has an aOR 4.26 (95% CI: 1.62-11.22) for present pre-surgical complications in patients with CE. CONCLUSION: It was identified that being over 56 years old and having ≥3 cysts are risk factors for presenting pre-surgical complications in CE Objetivo: Identificar los factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística (EC) en áreas endémicas del Perú. Materiales y métodos: Se diseñó un estudio de casos (n = 43) y controles (n = 127), sin emparejamiento, de fuente secundaria con una relación de caso-control de 1:3. Se definió como «caso» al paciente con EC que presentó complicaciones prequirúrgicas relacionadas o no con la enfermedad y el control sin complicación prequirúrgica. La variable respuesta fue complicación prequirúrgica y las de exposición fueron edad, género, grado de instrucción, ocupación, número de quistes, tamaño (diámetro en centímetros) y localización del quiste. Para identificar los factores de riesgo, primero se calcularon los odds ratio crudos (ORc) mediante regresión logística; luego las variables que mostraron asociación significativa se ajustaron mediante análisis multivariado de regresión logística utilizando Stata® versión 14, y se obtuvieron los odds ratio ajustados (ORa). Resultados: El 55,8% (24/43) de los casos fueron mujeres y la mediana de edad fue 35 años. Entre los controles, el 59,1% (75/127) fueron mujeres y la mediana de edad fue 27 años. En el análisis de regresión logística multivariado, se encontró que tener más de 56 años tiene un ORa de 2,91 (intervalo de confianza [IC] 95%: 1,01-8,43) y tener ≥3 quistes tiene un ORa de 4,26 (IC 95%: 1,62-11,22) para presentar complicaciones prequirúrgicas en pacientes con EQ. Conclusión: Los factores asociados para presentar complicaciones prequirúrgicas en EQ fueron el tener más de 56 años y el tener ≥3 quistes

Aspergillosis covers a wide range of diseases caused by the genus Aspergillus fungi. Aspergillus saprophytic mold is widespread in the environment; its spores are easily inhaled. However, despite the fact that most people inhale aspergillus spores daily, aspergillosis develops mainly in immunocompromised individuals (due to illness or during immunosuppressive therapy).the lungs are affected most often, being the portal for the fungus penetration, but the naso-orbital sinus is also involved in the process. There are few reports on extrapulmonary aspergillosis. Even rarer in the literature are publications about the co-infection of a saprophytic fungus and a hydatid cyst. Only single clinical observations of the coexistence of aspergillosis and echinococcosis in the lungs have been described. No literature data are available on the coexistence of these two pathogens in the liver. The authors present a clinical case of a 54-year-old woman with two echinococcal cysts in the liver and Aspergillus revealed in their structure. The co-infection of liver echinococcosis and aspergillosis is extremely rare. Preoperative verification of the presence of local aspergillosis in this case is practically impossible. However, early diagnosis and treatment are vital, preventing possible complications from becoming infected with these two pathogens. Treatment is based on an early morphological diagnosis and the detection of both pathogens.

Aim. Improving outcomes of diagnosis and treatment of patients with liver echinococcosis and its complications. Materials and methods. A comparative analysis of the results of surgical treatment of liver echinococcosis and its complications with traditional laparotomy access surgery (control group) and minimally invasive interventions (main group) was performed.Results. The study included 300 patients (170 in the control and 130 in the main group). In the main group, 37 (28.4%) cases performed open echinococcectomy from various mini-accesses, and 27 (20.7%) performed twostage operations using minimally invasive technology. Laparoscopic echinococcectomy was performed in 23 (17.7%) patients, laparoscopic pericystectomy 12 (9.2%) and laparoscopic liver resection in 10 (7.7%) patients. The frequency of postoperative complications in the main group was 17.7%, in the control 51.8%, postoperative mortality decreased from 2.3% to 0.8%.Conclusion. Minimally invasive technologies in the surgical treatment of liver echinococcosis show the better immediate results compared to traditional open surgical methods.