Search

An 8-y-old Labrador Retriever was presented to a small animal practice in northern Virginia with a history of recent lethargy. Physical examination findings were unremarkable. Ultrasound revealed several large hepatic masses and multiple smaller masses involving the pancreas. Cytologic findings on fine-needle aspirates of the hepatic masses included inflammation and necrosis with eosinophilic, membranous oval structures consistent with cestode infection. Histopathologic findings for biopsies of these masses included extensive necrosis, inflammation, and PAS-positive hyaline-like membranous material interpreted as metacestode cyst wall. A PCR product was generated from aspirate material using primers specific for Echinococcus multilocularis. Subsequent sequence data were 100% homologous to E. multilocularis NADH dehydrogenase subunit I gene sequences. The dog received daily oral albendazole (10 mg/kg) treatment, but its condition deteriorated, and the dog was euthanized. The dog, born in Mississippi, was brought as a puppy to Virginia with no other travel history. To our knowledge, alveolar echinococcosis has not been reported previously in a dog in the United States; E. multilocularis infection was apparently acquired in the mid-Atlantic region of the United States. [ABSTRACT FROM AUTHOR]

Alveolar and cystic echinococcosis are emerging and reemerging in Europe, Africa, and Asia. The expansion of Echinococcus spp. tapeworms in wildlife host reservoirs appears to be driving this emergence in some areas. Recent studies suggest a similar phenomenon may be occurring in North America. We describe the context of Echinococcus spp. research in North America, with a specific focus on the contiguous United States. Although studies were conducted in the United States throughout the 1900s on various sylvatic and domestic Echinococcus spp. tapeworm cycles, data are lacking for the past ≈30 years. We review previous research, provide analysis of more recent focal studies, and suggest that Echinococcus spp. tapeworms, in particular E. canadensis, may be underrecognized. As a result, we suggest that additional research and surveillance be conducted for these tapeworms in wildlife host reservoirs across the United States. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease is a serious public health problem in endemic areas. Percutaneous treatment is an effective alternative to surgical and medical therapy in hydatid liver disease (HLD). Objective: To present clinical and radiological results of percutaneous treatment of HLD in children. Materials and methods: Twenty-five children (16 males; age range, 5-15 years; mean age, 9.6 years) with a total of 30 hydatid cysts of the liver underwent ultrasound US guided percutaneous treatment using hypertonic saline as the scolicidal agent. Results: The percutaneous procedure was successful in all patients. All children were asymptomatic at follow-up. A hypersensitivity reaction occurred in one child (4%) during the procedure. No other complications occurred. The reduction in cyst volume was 14-100% (mean, 64%) at follow-up (mean 13.8 months). On US at follow-up, the treated cysts were semisolid with a heterogeneous echo pattern ( n = 17), solid hypoechoic ( n = 10) or solid with calcification ( n = 2). One treated cyst disappeared sonographically. Conclusion: Percutaneous treatment of HLD is effective, safe and well-tolerated in children. [ABSTRACT FROM AUTHOR]

Echinococcosis is a disease which is commonly seen in certain parts of the world and uncommonly seen in the United States. Recognition of this disease is important for appropriate surgical management with the least amount of morbidity and mortality. Proper history taking and awareness of this disease will decrease the chance of misdiagnosis. Two cases are presented here, and the salient features of this disease are reviewed, in order to reacquaint the physician. [ABSTRACT FROM AUTHOR]

Echinococcal or hydatid cyst is not commonly seen in the United States; however, two cases were seen within a 6-month period at a southern teaching hospital, and it is endemic in many areas of the world. The causative organism, Echinococcus granulosus, is a tapeworm of dogs; the normal intermediate hosts are hoofed animals. When man becomes infected enlarging cysts in the liver, lung, nervous system, or peritoneum may cause considerable morbidity. While surgery traditionally has been the treatment of choice, in the past few years the usage of high doses of mebendazole has been suggested as a possible alternative. This review describes two cases and the recent literature regarding the use of mebendazole as therapy for hydatid disease. [ABSTRACT FROM AUTHOR]

The authors reflect on the medical treatment of hydatid cyst disease in the U.S. They argues that the sufficiency of chemotherapy is not appropriate for all patients and surgical treatment remains an option. They cite the meta-analysis conducted by Smego and colleagues on the different outcomes of surgical management of the disease using several scolicidal agents. They also mention the puncture, aspiration, injection, and re-aspiration (PAIR) as an effective factor use in surgical treatment.