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Hydatidosis is an important zoonotic parasite disease in several herbivorous mammals. Human cystic echinococcosis (CE) caused by infection with larval stage of Echinococcus granulosus has been frequently reported from different organs. Here, we report the first case of a urinary echinococcosis in Iran with a pain in the lower left abdominal quadrant and severe frequent urination (pollakiuria). We detected a cyst 120 x 15 mm dimensions with heterogeneous mass contain fluid in the back of the urinary bladder neck between the umbilical region and external urethral sphincter. The patient was candidate for open-abdomen surgery and cysts were resected. The isolated cysts from liver and urinary bladder were referred to pathology laboratory, and the tissue sections were stained with Tri-chrome and Hematoxylin/eosin staining methods. Microscopic examination of prepared tissue sections showed protoscoleces of E. granulosus with specific and thick laminated hyaline layer (non-cellular membrane), with covers the thin activate germinal epithelium, which revealed the diagnosis of a hydatid cyst. This rare case illustrates that CE is the necessity of considering in the differential diagnosis from cysts, abscesses, malignant and benignant tumors, especially is essential in endemic areas of CE. [ABSTRACT FROM AUTHOR]

Aim: Hydatid cystic disease is an endemic parasitic disease that is common in the world. We aimed to review the demographic, clinical and laboratory findings, and treatments and outcomes of children with hydatid cyst disease, and to determine the factors affecting treatment response in two pediatric pulmonology centers in the central region of Turkey. Material and Methods: The clinical records of patients aged below 18 years who were followed up between January 2006 and December 2016 because of hydatid cyst disease were reviewed retrospectively. The patients' ages at the time of diagnosis, sexes, living areas (rural / urban), dog contact history, presence of hydatid cyst in other family members, symptoms, organs involved, dimensions of cysts, laboratory results, treatments and post treatment responses, follow-up, and outcomes were noted. Results: In a period of 10 years, 50 pediatric patients were followed up with a diagnosis of hydatid cyst. The mean age was 9.3±0.5 years and 33 (66%) of the patients were male. Fifteen patients were living in a rural area and 35 were living in an urban area. Fifteen patients had a history of contact with a dog and 10% had a positive family history. Thirty-six patients had lung involvement, 25 had liver involvement, 14 (28%) had both lung and liver involvement, and six patients had organ involvement other than lung and liver. The indirect hemagglutination test for hydatid cyst was positive in 24 of 40 patients and Echinococcus granulosus-specific IgE positivity was detected in 8 of 17 patients. Surgery was performed in 31 patients with lung involvement and PAIR was performed in 13 patients who had liver involvement. Cyst excision was performed in two patients who had isolated spinal involvement. All patients were treated with albendazole, and additional praziquantel treatment was given to seven patients. Relapse occurred in seven patients in this period. The relapse frequency was higher in patients who had organ involvement other than in the lung and liver (p<0.05), and these patients' treatment durations were longer compared with the others (p<0.05). Conclusion: Hydatid cysts can involve different organs in children. Patients with organ involvement other than the lung and liver should be followed up carefully in terms of recurrence. [ABSTRACT FROM AUTHOR]

Echinococcus granulosus, first reported by Goeze in 1782, is the causative parasite of cystic echinococcosis (hydatidosis) especially for countries that are endemic areas. Since the 1970s, the incidence of echinococcosis in Greece has been very high. Nevertheless, with the implementation of special prevention measures in the 1980s, a large reduction in the incidence of hydatidosis meant that it reached European levels. Therefore, we analyzed the demographics, multiple organ localizations of the parasite, diagnosis, and conservative and optimal surgical treatment over a total period of 39 years, especially for pulmonary and hepatic echinococcosis in children. The higher incidence of pulmonary echinococcosis compared with other localizations, male predominance, wide range of age, and various cystic sizes were some of the main demographics. Because cystic echinococcosis remains a main public health problem, we advocate a meticulous clinical investigation and treatment methodology to bridge the gap between knowledge and awareness of this important disease. [ABSTRACT FROM AUTHOR]

A quiz related to a case of 62-year old migrant from Western Sahara who presented for chronic back pain, sciatica and positive signs of Lasegue and Bragard signs is presented.

Background: Hydatid cyst disease is a serious health problem in our country, especially in Eastern and Southeastern Anatolia Region and in our province. Hydatid disease is a protozoal disease caused by Echinococcus granulosus and Echinococcus multilocularis. It can produce cysts in the internal organs of humans such as liver, lungs, spleen and brain, leading to undesirable consequences. In this study, we aimed to evaluate our anesthesia experience in patients who underwent surgery for hydatid cyst disease. Methods: In this study; Between August 2015 and August 2018, demographic data, anesthesia method, anaphylaxis and organ involvement were investigated retrospectively in patients operated with pre-diagnosis of hydatid cyst in Harran University Research and Application Hospital operating room. Results: 321 patients who underwent surgical treatment in our hospital with the diagnosis of hydatid cyst were included in the study. 33.33% (n = 107) of the patients were male and 66.66% (n = 214) were female. Of these patients, 25.85% (n = 83) were pediatric patients under the age of 18 and 74.17% (n = 238) were adult patients. Patient's had hydatid cyst organ involvement in liver 55.76% (n = 179), in lungs 36.44% (n = 117), in both lungs and liver 3.11% (n = 10), in kidney 2.18% (n = 7), in heart 1.24% (n = 4), in brain 0.93% (n = 3), and 0.31% (n = 1) of patients had pelvic involvement. Intraoperative allergy and anaphylactic reaction findings were not noted. Conclusion: Anaphylactic reaction is a serious complication in hydatid cyst disease and rarely seen. We think that intraoperative antihistaminic and steroid use in cyst hydatid surgery decreases allergy and anaphylaxis. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis is considered as an emerging zoonosis that can develop asymptomatically for years, clinically nonpathognomic. The disease is of public health importance due to often late, difficult diagnostics, uncertain results of treatment, the need to remove hydatid cysts surgically in advanced cases, and poor prognosis in untreated patients. Six Polish female patients with diagnosed cystic echinococcosis (CE) were examined. DNA extracted from the liver and lung samples served for amplification of mitochondrial nad1 gene fragment. Sequence alignments of 5 isolates showed identity with the pig strain, Echinococcus canadensis G7. One case was in 100% identical with Echinococcus ortleppi G5, the cattle strain. These data demonstrate first report of E. ortleppi, regarded as extinct species, causing human cystic echinococcosis in Poland, where the most frequent causative agent of human CE is E. canadensis. [ABSTRACT FROM AUTHOR]

Intracranial echinococcosis is relatively uncommon and usually occurs in the context of echinococcal lesions elsewhere in the body, mostly liver and lung. Multiple intracranial lesions can result from rupture of an initial single intracranial cyst (in cystic echinococcosis) or from dissemination of systemic disease of the lung, liver or heart (cystic and alveolar echinococcosis). The two main subtypes, cystic and alveolar echinococcosis, present differently and have distinct imaging features in the brain. We discuss the presentation, imaging findings and clinical course of three cases (two cystic and one alveolar) of intracranial echinococcal disease in adults. [ABSTRACT FROM AUTHOR]

Alveolar hydatid disease or alveolar echinococcosis (AE) is caused by the parasite Echinococcus multilocularis and is increasingly seen as an imported disease in non-endemic areas such as the UK. It is rare compared to cystic echinococcosis (CE), but like CE commonly affects the liver. AE does have imaging features that can aid in diagnosis, but is often initially misdiagnosed as liver malignancy. It is usually fatal if untreated, underscoring the importance of early diagnosis. This review highlights the role of imaging in AE diagnosis with the broader objective of increasing radiologists' awareness of this unusual, but increasingly prevalent disease. [ABSTRACT FROM AUTHOR]

Musculoskeletal hydatidosis is a rare but severe disease in central Europe. This case report presents the incidental finding of an osseous hydatidosis after cementless revision total hip arthroplasty in a patient without a preoperative history of hydatidosis or any clinical symptoms. Revision total hip arthroplasty had been necessary due to a septic osteonecrosis of the femoral head 2 years after osteosynthesis of a traumatic proximal femur fracture with a sliding hip screw. The positive sample was taken out of the greater trochanter in the area of the possible former entry point for the lag screw, which was macroscopic inconspicuous. Sero-analysis could afterwards confirm the suspected diagnosis. Postoperative chemotherapy with albendazole was performed for 6 months. A full-body MRI did not reveal any further cysts. This case demonstrates a possible impact of migration on the expected pathogens in revision arthroplasty. This demonstrates that in revision arthroplasty, an infection with this parasite also has to be taken into account, if the patients come from an area endemic for hydatidosis. [ABSTRACT FROM AUTHOR]

Intramuscular cystic echinococcosis is a very rare occurrence. Herein we report a case of a 37-year-old patient who presented with progressive swelling of his left thigh. Ultrasound evaluation showed a multicystic, encapsulated lesion (16 × 3.5 × 8.5 cm) in the M. vastus lateralis, and serology confirmed the diagnosis of Echinococcus granulosus s.l. infection. No additional cysts were detected upon total body CT scan. The patient was treated with albendazole pre-operatively; surgical resection of the mass was then successfully performed. The patient feels well and no signs of residual infestation were seen after 2 years of follow-up. [ABSTRACT FROM AUTHOR]

Abstract Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are highly co-endemic in Sichuan, a part of Qinghai-Tibet Plateau where is a typical Tibetan nomadic community living area. In order to better understand the Echinococcus spp. of human being infected origins in this area, 140 lesions were collected from echinococcosis patients who were received operations during the period of 2014–2016 in different geographic districts in this region. Partial DNA sequences of the mitochondrial cox1 gene were analyzed. The genetic characterization of the isolates from 3 different places including Ganzi, Aba and Liangshan were assessed. Of all the 140 samples, the great majority was identified as Echinococcus granulosus sensu stricto (n = 108). Echinococcus multilocularis was confirmed to be another important pathogen of the human infections (n = 31). Additionally, one Echinococcus canadensis (G6/7) isolate from Ganzi was confirmed. Comparing the clinical diagnosis with the sequencing results, 6.4% (9/140) of the cases were misdiagnosed between AE and CE, and another 8.6% (12/140) were unclassified to sub-type in echinococcosis. Higher rates of misdiagnosis and unclassified diagnosis were found in AE cases (12.9%, 4/31 and 16.1%, 5/31 respectively) compared to CE (4.6%, 5/109 and 6.4%, 7/109 respectively). In E.granulosus s.s., a total of 34 haplotypes were detected, and 4 haplotypes were inferred from E.multilocularis. The haplotype networks of the 2 species exhibited a similar star-shaped feature with a dominant haplotype in the center. Geographically specific haplotypes were observed in Ganzi and Aba respectively. This study provides insight into the current species causing human echinococcosis in the Tibetan districts of Sichuan. E.granulosus s.s. and E.multilocularis are confirmed to be the main causative agents, and the existence of E. canadensis (G6/7) is also observed in the region. Molecular diagnosis was proven to be essential for the confirmation of human echinococcosis in the area. [ABSTRACT FROM AUTHOR]

Abstract Cystic echinococcosis (CE) is a neglected zoonotic disease with a worldwide distribution and is a major public health problem in some areas. Diagnosis of CE is mainly based on clinical symptoms, imaging and serological testing, however, improvement in serodiagnosis is still needed. This study was aimed at detecting circulating Echinococcus antigen in CE patients using a lateral flow dipstick (LFD) assay. Three types of hydatid antigens i.e. hydatid cyst fluid (HCF), native antigen B (nAgB) and recombinant antigen B (rAgB) were prepared and polyclonal rabbit antiserum was raised against each antigen. Purified IgG fractions were prepared and a portion was conjugated to gold nanoparticles. After a series of optimizations, a final antigen detection LFD assay was developed using a combination of anti-nAgB-IgG and gold-conjugated anti−HCF-IgG. Evaluation of the assay showed that 27 out of 35 (77%) serum samples from CE patients gave positive results. Meanwhile, the test showed a diagnostic specificity of 82% when tested with sera from 38 healthy individuals and 13 patients with other parasitic diseases. In conclusion, the antigen detection LFD assay seemed to be useful for diagnosis of CE and possibly for post-treatment follow-up, and merit further evaluation studies. We foresee that it may improve serodiagnosis of CE when used in tandem with an antibody detection test. [ABSTRACT FROM AUTHOR]

Background: Human echinococcosis is a neglected infectious disease affecting more than 1 million people globally. Its diagnosis is expensive and difficult because of lack of adequate resources in low-resource locations, where most cases occur.Methods: A group of volunteers diagnosed with the 2 main types of echinococcosis and corresponding control groups were recruited from hospitals in Tunisia (32 patients with cystic echinococcosis and 43 controls) and Poland (16 patients with alveolar echinococcosis and 8 controls). Breath samples were collected from all patients and analyzed by gas chromatography coupled to mass spectrometry, and a specifically developed electronic nose system.Results: The chemical analysis revealed statistically different concentrations of 2 compounds in the breath of patients with cystic echinococcosis compared to controls, and statistically different concentrations of 7 compounds in the breath of patients with alveolar echinococcosis compared to controls. The discrimination accuracy achieved by the electronic nose system was 100% for cystic echinococcosis and 92.9% for alveolar echinococcosis, while the discrimination accuracy between these 2 patient groups was 92.1%.Conclusion: Here we advocate a noninvasive, fast, easy-to-operate and nonexpensive diagnostic tool for the diagnosis of human echinococcosis disease through exhaled breath analysis, suitable for early diagnosis and population screening. [ABSTRACT FROM AUTHOR]

Cyst hydatid is a parasitic infectious disease caused by Echinococcosis. Even if the liver and lung are mainly affected organs, this cyst can be seen in every organ. Clinical presentation varies depending on the affected organ. We report here an unusual location of hydatid cyst, such as intermuscular septum of left scapular area. Sixty-five years of woman presented a swelling of left-back, and after surgery, her pathological diagnosis was hydatid cyst. Hydatid cyst is a common disease worldwide, and this disease is known to affect usually liver and lungs, but especially in endemic areas, every doctor should be aware when patients come to the clinic for soft tissue swelling of the different body areas. [ABSTRACT FROM AUTHOR]

Hydatid cyst (HC) is a serious health problem in endemic areas. Liver and lung are the most common involved organs while the involvement of muscles, heart, kidney, brain, and spleen is rare. The involvement of these rare locations for HC is mostly in association with infestation of common sites. We report a case of 43-year-old man with a history of surgery of HC in brain and heart who complained from chest pain. In imaging modalities, three cystic lesions were seen in heart and kidney which were confirmed to be recurrence of HC by serologic tests. However, no evidence of involvement of liver and lungs as the most common infected organs of HC was seen in recent and previous imaging mo®dalities. The patient refused another surgery and just accepted anthelmintic drugs. The practical point of this case report is that when we see any cystic lesion in imaging modalities in uncommon sites for HC, while common sites are spare, we should still consider the possibility of HC and not rule out it just because of lack of simultaneous infestation of its common involved organs. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE), a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato (s.l.), is a worldwide public health problem. Echinococcus granulosus sensu stricto (s.s.), associated with G1 and G3 genotypes, is endemic with high prevalence in the Mediterranean basin. The parasite’s life cycle comprises definitive hosts (canids) and intermediate hosts (ruminants) and can occasionally involve humans. The main aim of this research was to confirm the diagnosis of 13 patients suspected of CE who presented different complications and needed the surgical removal of the cysts. We also wanted to understand and clarify more the diagnosis of echinococcosis in humans. For this purpose, the patients first underwent cyst evaluation by ultrasound (US), immunological analysis, and then total pericystectomy, followed by parasitological, histopathological, and molecular biology examinations of the cysts. US stadiated one CE1, one CE2, eight CE3b, one CE4, and two CE5; immunology evidenced nine positives; histopathology confirmed 11 CE cysts, of which 8 fertile presenting protoscoleces were identified as E. granulosus s.s. by molecular biology, genotyped as three G1 and four G3 by neighbor-joining (NJ) phylogenetic tree. In conclusion, the results showed that 11 patients were affected by E. granulosus s.s. G1 orG3, and 2 cystic neoformations were of non-parasitic origin.

Primary hydatid cyst of the rib is very rare. Although the diagnosis of hydatid cyst is usually easy in endemic regions, the diagnosis of isolated rib hydatid cyst can be difficult. In this study, images of a case with isolated rib hydatid cyst mimicking a tumor were presented. [ABSTRACT FROM AUTHOR]

Hydatid cyst disease continues to be an important health problem in regions where animal husbandry is common. Transmission is often by fecal-oral ingestion of eggs excreted in dog feces. Diagnosis and treatment are usually possible in endemic areas without causing serious complications. However, it can sometimes lead to serious clinical situations. In this study, a case of hydatid cyst causing vertebra and rib destruction is presented. [ABSTRACT FROM AUTHOR]

Cardiac manifestations of hydatid cysts are rare and occur in 0.5% to 2% of all cases of human hydatidosis. Behçet's disease is a vasculitis which is often associated with venous thrombosis. An intra‐cardiac mass in a patient with Behçet's disease should raise the suspicion of thrombosis. However, we report a 32‐year‐old gentleman with Behçet's disease and history of multiple episodes of venous thrombosis who was first diagnosed with having an intra‐cardiac thrombus on echocardiogram. Five months later, his echocardiogram revealed a hydatid cyst in the right ventricular apex which was also confirmed by cardiac magnetic resonance. [ABSTRACT FROM AUTHOR]

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Hydatidosis commonly affect the liver and lungs but in rare cases, it can involve heart tissue. A 42-year-old man from urban areas of Khorasan Razavi province, northeastern Iran, was referred to the cardiac clinic with palpitation, and atypical chest pain in 2018. Large pericardial effusion, reduced left ventricle systolic function was found. A cystic-like lesion was also seen in inter-ventricular septum in echocardiography and high-resolution computed tomography (HRCT). Urgent cardiac surgery was done because of echocardiographic evidence of tamponade. Although the serologic analysis was negative for hydatidosis, surgical excision of cyst and the subsequent histopathological findings revealed a hydatid cyst. In endemic areas, hydatidosis should be considered in differential diagnosis of any cystic-like lesions, even if the serological analysis is negative. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the clinical and radiological findings of hepatic alveolar hydatid cyst diagnosed in our clinic. Material and Methods: Records of patient files with histological diagnosis of hepatic alveolar hydatid cyst between March 2013 and February 2018 were retrospectively reviewed. Fifteen cases were included in the study. Nine of the cases were males (60%) and 6 were females (40%). Their ages ranged from 27 to 62 with a mean age of 41 ± 7.3 years. Clinical and laboratory findings and radiological imaging findings of the cases were investigated and recorded. Results: The most common symptoms were right upper quadrant pain (75%), jaundice (24%), fever (13%) and weight loss (12%). The most common finding in physical examinations was hepatomegaly (96%). AST, ALT, and ALP values increased 3-4 times. Bilirubin values were generally increased (0.8-21.2 mg/dL). Abdominal ultrasonography (US) was described as a mass lesion with irregularly border, heterogeneous echogenicity, which consisted of the most solid component. It was located in the right liver lobe (82%). Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) findings supported the US findings. There was no contrast material involvement in the lesion. Diffusion MRI showed mild diffusion restriction somewhere. Conclusions: Alveolar echinococcosis frequently confused with other malignant liver lesions. Early diagnosis of the disease is very important in terms of treatment. Immunologic tests and biopsy are helpful in diagnosis. Radiological findings have an important role and contribution in the diagnosis of the disease. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis (AE) is a prevalent epidemic in the northern hemisphere, especially in central Europe and western China. Serum diagnosis is important for patients with AE, especially during the first screening. The present study purified the recombinant Em18-GST (rEm18-GST), and detected its diagnostic performance in human alveolar echinococcosis patients of Xinjiang, China with immunoblotting (IB) and enzyme-linked immunosorbent assay (ELISA). Serum samples were collected from 50 patients with AE, 222 patients with cystic echinococcosis (CE), 158 patients with other unrelated infections and 106 healthy individuals. The IB results showed that serum samples of 47 patients with AE and 12 patients with CE were rEm18-positive. However, only one sample from patients with cancer showed a cross-reaction with rEm18 in IB. The overall sensitivity was 94%, and the total specificity was 96.58%. For the rEm18 results using ELISA, the sera of 46 patients with AE were positive, and the overall sensitivity was 92%. In conclusion, compared with imaging tools, including computed tomography, magnetic resonance imaging and positron emission tomography, rEm18 has considerable advantages for AE serodiagnosis. [ABSTRACT FROM AUTHOR]

Objective: In this study, we researched the availability of Echinococcus IgG ELISA in pulmonary hydatid cysts. Materials and Methods: Between January 2008 and December 2015, 93 successive cases, which were studied in preoperative Echinococcus IgG and histopathologically found to have pulmonary hydatid cysts, were retrospectively analyzed. Age and sex of the cases and the cyst's location, number, size, spread to other organs outside the lungs, and its condition as intact or ruptured were reviewed. Results: Forty-seven (50.5%) patients were male and 46 (49.5%) patients were female; the mean age was 27.7±19.6 years. While in 56 (60.2%) cases, only lung cysts were detected, 32 (34.4%) cases presented with both lung and liver cysts. While lung cysts were single in 71 (76.3%), they were multiple in 22 (23.6%) cases (between 2 and 20 pieces). In 48 (51.6%) cases, cysts were in the right lung, and in 32 (34.4%) cases, they were in the left. In 13 (14%) cases, cysts presented in both the right and left lungs. The mean diameter of the pulmonary cysts was 6.4 cm (ranging from 2 to 19 cm). In 53 (57%) cases, hydatid cysts were ruptured, whereas in 40 (43%) cases, the cysts were intact. While general Echinococcus IgG was found to be positive in 53 (57%) cases, it was negative in 40 (43%) cases. There were 53 ruptured cases, and 48 (90.6%) of them were test-positive; however, the test was positive in only 5 (12.5%) out of the 40 cases where the cysts were intact (p<0.001). A statistically significant correlation has not been found between IgG and patient age, gender, cyst location, number of cysts, cyst diameter, and extrapulmonary involvement. Conclusion: Our study demonstrated that the most important factor that affects the positivity of Echinococcus IgG is the rupture of cysts. When ruptured cysts become confusing, Echinococcus IgG can contribute toward a diagnosis. [ABSTRACT FROM AUTHOR]

In the article was reviewed results of diagnostic methods and surgical treatment of 33 patients with hydatid cyst of heart. Basic diagnostic technique was echocardiogram and Magnetic Resonance Imaging (MRI). Postoperative lethality was 9,06%. Spontaneous perforation and anaphylactic shock were observed in 6% cases. Among not fatal complication there often were observed heart rhythm disturbance. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE) is one of the most widespread helminthic zoonoses and is caused by the tapeworm Echinococcus granulosus complex. CE diagnosis and monitoring primarily rely on imaging techniques, complemented by serology. This is usually approached by the detection of IgG antibodies against hydatid fluid (HF), but the use of this heterogeneous antigenic mixture results in a variable percentage of false positive and negative results, and has shown to be useless for follow-up due to the long persistence of anti-HF antibodies in cured patients. To improve test performances and standardization, a number of recombinant antigens mainly derived from HF have been described, among them the B2t and 2B2t antigens. The performance of these antigens in the diagnosis and follow up of patients with CE has been so far evaluated on a limited number of samples. Here, we evaluated the performances of tests based on B2t and 2B2t recombinant antigens compared to HF in IgG-ELISA and immunochromatography (IC) for the diagnosis and follow-up of patients with CE in a retrospective cohort study. A total of 721 serum samples were collected: 587 from 253 patients with CE diagnosed by ultrasonography (US), 42 from patients with alveolar echinococcosis and 92 from healthy donors from Salamanca (Spain). The highest overall sensitivity was obtained with HF in ELISA (85.5%), followed by IC containing HF and 2B2t-HF (83.0% and 78.2%, respectively). The lowest sensitivity was obtained with B2t and 2B2t in ELISA (51.8%). The highest specificity was obtained with IC containing 2B2t-HF (100%), and the lowest with HF-ELISA (78.0%). The lowest cross-reactivity with sera from patients with alveolar echinococcosis was detected with the recombinant antigens in ELISA (9.5% - 16.7%) and the highest with the HF-IC (64.3%). The results of B2t and 2B2t-ELISA were influenced by cyst stage, as classified by US according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE), with low sensitivity for inactive (CE4 and CE5) cysts, and by the drug treatment, with higher sensitivity in patients after drug treatment compared with patients not subjected to drug treatment. The two recombinant antigens in ELISA provided promising results for monitoring patients in follow-up, although their use is limited to patients with positive serology against them at the beginning of the follow-up. Potential biological reasons behind the low sensitivity of the recombinant antigens and possible strategies to enhance the performance of CE serology are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentiating it from its mimics. The aim of this study is to assess the findings of pulmonary hydatid cysts on CT and MRI and the additional contribution of MRI in doubtful cases. Materials and Methods: This is a retrospective study of 90 patients with suspected hydatid cysts. CT and MRI findings were noted and role of MRI in diagnosing hydatid cysts and its mimics was studied. Descriptive statistics for CT findings and sensitivity and specificity of MRI were calculated using surgery or histopathology as gold standard. Results: Of the 90 patients with suspected pulmonary hydatid cysts, there were 52 true-positive and 7 false-positive cases on CT. Commonest CT finding was unilocular thick-walled cyst. In the 26 patients who had additional MRI, based on T2-weighted hypointense rim or folded membranes, accurate preoperative differentiation of 14 patients with hydatid cysts from 10 patients with alternate diagnosis was possible. There was one false-positive and one false-negative case on MRI. Conclusion: Although hydatid cyst can be diagnosed on CT on most occasions, sometimes there are challenges with certain mimics and atypical appearances. T2-weighted MRI can act as a problem solving tool to conclusively diagnose hydatid cyst or suggest an alternate diagnosis. [ABSTRACT FROM AUTHOR]

Background: Bile leak is the main cause of morbidity and mortality after surgery for hydatid liver cysts. Aim was to assess the role of prophylactic endoscopic sphincterotomy (ES) in reducing postoperative bile leak in patients undergoing partial cystectomy.Methods: Fifty-four patients with hepatic hydatid cyst met inclusion criteria, 27 were excluded or declined to participate. Twenty-six women and 28 men (mean age 44.6 ± 10.1, range: 22-61 years) were randomly assigned to either group I with ES (n = 27) or group II without ES (n = 27).Results: Demographics and clinical, laboratory, and radiological characteristics of cysts were not statistically different between two groups. Group I had a significant decrease in bile leak rate compared with group II (11.1% versus 40.7%, P = .013), with significantly shorter duration of hospital stay (P < .0001). Biliary fistula in group I had significantly lower daily output (100 mL/day versus 350 mL/day) with gradual reduction till stoppage of leak in 3-4 days without intervention. Biliary fistula in group II had a significantly higher need for biliary intervention through postoperative endoscopic retrograde cholangiopancreatography with ES compared with biliary fistula in group I (FEP = .002), with significantly longer mean time of fistula closure (P = .011) and longer time to drain removal (P < .0001). Nonbiliary complications were comparable between two groups.Conclusion: Prophylactic ES provides significant reduction in postoperative bile leak rate with shorter hospital stay after partial cystectomy of hydatid cyst. Biliary fistula in patients with ES has significantly lower daily output with shorter time of drain removal and shorter time to closure than patients without ES. [ABSTRACT FROM AUTHOR]

A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012-2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in . . . . 21-30 years-old group (24.2%) followed by 41-50 (22.7%), 31-40 (16.2%), 11-20 (13.6%), 51-60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61-70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan. [ABSTRACT FROM AUTHOR]

Purpose: Cystic echinococcosis (CE) is a parasitic disease caused by the tapeworm Echinococcus granulosus sensu lato. Although in Hungary the disease is listed among reportable infections, inadequacies in the reporting practice of CE by clinicians and pathologists have resulted in underscoring of this disease. The aim of this study was to describe the epidemiological and clinical characteristics of CE in Hungary using a datasource other than the official records that are based mainly on serological data.Methods and Results: This retrospective case series study included a total of 45 CE patients confirmed by histopathology in a single Hungarian center between 2000 and 2014.Conclusion:  Although CE is the most prevalent reportable endemic helminthosis in Hungary, to date this is the first study on the clinical epidemiology of the disease in this country. [ABSTRACT FROM AUTHOR]

Hydatic disease has always been the most common in countries where large amount of sheep and cattle is raised, but increased travel and immigration have made this condition a serious worldwide public problem. Cyst hydatid may affect all parts of the human body like the heart, the bone marrow, the eye, the brain, the kidney, and the spermatic cord. Humans can become infested by accidentally ingesting the eggs that are passed in the feces from definitive hosts (usually a canid, such as a wolf, fox, or dog). Even in endemic countries, the primitive pleural hydatid cyst is exceptional, and it is very difficult to distinguish from other pleural and parietal cystic masses especially that in majority of cases the immunologic tests are negative. We report two cases of pleural hydatid cyst discovered in two young patients, with a nonspecific clinical presentation. The interest of this paper is to raise the primordial role of imaging in the positive diagnosis of primary pleural hydatid cyst. [ABSTRACT FROM AUTHOR]

Purpose: The management of hydatid disease (HD) co-occurring with pregnancy remains a challenge for physicians. We aimed to determine factors that were related to fetal and maternal outcomes in HD complicated pregnancies and then develop an approach/treatment algorithm.Method: All patients at the participating hospitals were first analyzed to determine whether they had HD. Only patients diagnosed with HD during the course of their pregnancy were included. Certain cyst-related factors (diameter, localization, increase in size, and viability) and certain pregnancy-related factors (treatments, gestational week, maternal co-morbidities, and delivery type) were investigated. Nonlinear principal component analysis (NPCA) was performed to determine the relationships between the categories of variables.Results: Out of 12,926 pregnancies, 27 cases were diagnosed with HD. In 13 cases, each developed at least one fetal problem. Using Albendazol in first trimester, presence of an active cyst, increased diameter by more than 1 cm during pregnancy and a cyst diagnosed in the second trimester were associated with at least one fetal problem. According to the NPCA results, cyst diameter when first diagnosed was related to fetal outcomes; a cyst greater than 10 cm was associated with "at least one fetal problem". Cysts 5-10 cm in diameter were in a neutral position, while 2-5 cm in diameter were in the "no problems" group.Conclusions: HD mostly affects fetus. If cyst-related and pregnancy-related variables are optimal, close follow-up on a monthly is the best course of action. However, in high-risk conditions, percutaneous interventions or surgery should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentiating it from its mimics. The aim of this study is to assess the findings of pulmonary hydatid cysts on CT and MRI and the additional contribution of MRI in doubtful cases. Materials and Methods: This is a retrospective study of 90 patients with suspected hydatid cysts. CT and MRI findings were noted and role of MRI in diagnosing hydatid cysts and its mimics was studied. Descriptive statistics for CT findings and sensitivity and specificity of MRI were calculated using surgery or histopathology as gold standard. Results: Of the 90 patients with suspected pulmonary hydatid cysts, there were 52 true-positive and 7 false-positive cases on CT. Commonest CT finding was unilocular thick-walled cyst. In the 26 patients who had additional MRI, based on T2-weighted hypointense rim or folded membranes, accurate preoperative differentiation of 14 patients with hydatid cysts from 10 patients with alternate diagnosis was possible. There was one false-positive and one false-negative case on MRI. Conclusion: Although hydatid cyst can be diagnosed on CT on most occasions, sometimes there are challenges with certain mimics and atypical appearances. T2-weighted MRI can act as a problem solving tool to conclusively diagnose hydatid cyst or suggest an alternate diagnosis. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis (AE) is a parasitic disease, due to Echinococcus multilocularis . Often compared to liver cancer, it develops by infiltration from its primary site to the surrounding tissue, and can then metastasize to other organs. Detection of circulating cell-free DNA (ccfDNA) is a useful analytical tool in oncology, for diagnosis, prognosis, and therapy monitoring. This study sought to investigate the presence of ccfDNA in patients with AE, and its potential usefulness for the evaluation of treatment efficiency. To achieve these aims, a quantitative PCR and a droplet digital PCR were developed to detect E. multilocularis ccfDNA. An AE animal model identified, for the first time, the presence of large quantities of ccfDNA. Samples from patients with AE (n = 31) were then analyzed twice, at diagnosis, and after three months of chemotherapy: about 25% were positive, almost always with very low concentrations of ccfDNA. These results confirmed that E. multilocularis produces ccfDNA, as solid tumors do, but detection may not yet be sufficient for AE diagnosis nor for the evaluation of treatment efficiency, due to the low levels of ccfDNA detected in patient serum. [ABSTRACT FROM AUTHOR]

Background: Several tools have been proposed for serodiagnosis of cystic echinococcosis (CE), but none seems promising for cyst viability assessment. Antigens with stage-specific diagnostic value have been described, but few studies with well-characterized antigens and human serum samples have been performed. Antigen B (AgB) proteoforms hold promise as markers of viability, due to their differential stage-related expression and immunoreactivity. Methods: Four AgB subunits (AgB1, AgB2, AgB3, AgB4) were synthesized and structurally characterized. Based on the preliminary evaluation of the subunits by western immunoblotting and enzyme-linked immunosorbent assay (ELISA), AgB1 and AgB2 were further tested in two ELISA setups and extensively validated on 422 human serum samples. Results: All subunits showed a high degree of spontaneous oligomerization. Interacting residues within oligomers were identified, showing that both the N-terminal and C-terminal of each subunit are involved in homo-oligomer contact interfaces. No hetero-oligomer was identified. AgB1 and AgB2 ELISAs revealed different sensitivities relative to cyst stage. Of note, besides high specificity (97.2%), AgB1 revealed a higher sensitivity for active-transitional cysts (100% for CE1, 77.8% for CE2, 81.5% for CE3a, and 86.3% for CE3b) than for inactive cysts (41.7% for CE4 and 11.1% for CE5) and postsurgical patients (44%). Interestingly, 19 of 20 patients with spontaneously inactive cysts and 6 of 9 treated with albendazole >5 years earlier were negative on the AgB1 assay. Conclusions: The structural characterization of subunits provides insights into the synthetic antigen conformation. The stage-related sensitivity of synthetic AgB1 holds promise as part of a multiantigen setting and deserves further longitudinal evaluation as marker of cyst viability. [ABSTRACT FROM AUTHOR]

The present preliminary study intends to evaluate the in vitro use of hydatid antigen and their antibodies once labeled with iodine 125(I 125 ) and characterized from viewpoint of radiochemical purity and immunoreactivity. Radiolabelled molecules gave satisfactory purity of 94% and 96%–98%, for hydatid antigen and IgG respectively. As regards, the specific activity of these latter, varied between 4.79 and 5.97 μCi/μg. The specificity test of radiolabelled IgG against the hydatid membranes showed a significant recognition that increased proportionally according to the contact surface. Likewise this immunoreactivity test performed with a simple binding assay, using human hydatid fluid antigen (HHF-Ag), previously fixed on a solid phase, gave satisfactory fixation rate of the order of 356 ± 48.08cpm, 2539 ± 550.12cpm and 6558 ± 712.76cpm for the concentrations of 0.1 μg/ml, 2 μg/ml and 25 μg/ml respectively. Statistical study of 88 sera, carried out with radiolabelled antigen ( 125 I-HHF-Ag) in competitive radioimmunoassay test (CRIA) showed highly significant difference (p < 0.0001) in the binding capacity of antigens from patients sera with hydatid disease (65.63 ± 9.12) compared to the negative sera (19.25 ± 14.84). No cross reaction was observed using sera from patients with toxoplasmosis (33, 07 ± 13, 07) and the difference was highly significant (p < 0.0001) compared to E granulosus infected patient sera. Furthermore, this test seemed to be sensitive since among the 43 sera tested, only 37 (86%) were found to be positive by passive hemagglutination (HAP), while the totality (100%) responded positively by CRIA. Our findings are encouraging, suggesting that these radiolabeled molecules could be useful for advancing toward new diagnostic and therapeutic modalities. [ABSTRACT FROM AUTHOR]

A total of 2100 sheep, slaughtered or spontaneously dead, from various areas of Kashmir valley were screened for the presence of hydatidosis. Out of 2100 cases, 85 were positive for hydatidosis. Histopathologicallly, the cyst wall consisted of the inner germinal, middle lamellated, and outer fibrous layer. Inflammatory reaction around the cyst was variable and was characterized by an inner zone of loosely arranged fibroblasts infiltrated with mononuclear cells and densely packed fibroblasts mixed with mononuclear cells; and an outer layer of concentrically packed fibrous connective tissue. Mast cell reaction was observed mainly in the bronchiolar, peribronchiolar, and inflammatory zones in the lungs; while in the liver, mast cells were noted in portal triads and bile ducts and were least evident in the vicinity of the cysts. Qualitative increase was observed for acid mucopolysaccharides in fibroblasts, inflammatory cells, and bronchial epithelium, especially hyperplastic epithelial cells. Masson’s trichrome revealed intense formation of collagen fibers in the pericystic connective tissue. The calcareous corpuscles of the protoscolices were distinct when stained with combined Alcian blue PAS and toluidine stains but were not visible when stained with H & E and Masson’s trichrome stains. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumor (SFT) is a rare spindle cell tumor of the orbit of mesenchymal origin. Though these tumors are mostly solid, partial or complete cystic changes can rarely occur. Only six such previous cases of cystic fibrous tumor of the orbit have been mentioned in the literature. We report a case of an elderly male who presented with a huge left sided medial orbital mass. Magnetic resonance imaging showed a predominant cystic orbital mass separated by septae and suggested a diagnosis of Hydatid cyst. The patient underwent complete excision of the mass and histopathology and immunohistochemistry were suggestive of cystic SFT. Cystic degeneration in SFT is extremely rare and can be a harbinger of malignancy, and pose risk of recurrence. Close follow up and monitoring is required for all such cases. [ABSTRACT FROM PUBLISHER]

Background: Cystic echinococcosis (CE) is a human and animal health problem in many endemic areas worldwide. It is considered a neglected zoonotic disease caused by the larval form (hydatid cyst) of Echinococcus spp. tapeworm. There are limited studies on echinococcosis in Pakistan. Methods: A cross-sectional survey was conducted to find out recent knowledge, attitudes and practices on the occurrence of cystic echinococcosis in butchers and dog owners in both urban and rural areas of Rawalpindi/Islamabad regions, Pakistan. The quantitative data was collected in the form of questionnaires to investigate the knowledge and awareness of CE among community members and their routine practices that were behind the factors involved in hydatid cyst infection. The practices and infrastructure of abattoirs/butcher shops and their role in transmission of cystic echinococcosis were also evaluated in the present study. Results: The participants involved in the study were dog owners and people who kept animals. A total of 400 people were interviewed and 289 questionnaires were received. The results showed that only 4.1% of people have heard about the disease, and 58.1% were closely associated with dogs. Sixty-three percent of dogs in study area were consuming uncooked organs (e.g. liver, lung, etc.) of slaughtered animals, while 100% of dogs at butcher shops were consuming uncooked organs. Home slaughtering was common in 20.06%. Among butchers, 32.3% had heard about zoonoses and 7.61% knew about CE. The statistical analysis showed that there was highly significant difference (P < 0.05) among most of the practices that were associated with the prevalence of CE. Conclusions: It was concluded from the present study that, the knowledge and awareness of CE among people of Rawalpindi/Islamabad were low. Because of dogs and poor knowledge of CE among community members and butchers, the transmission of echinococcosis is facilitated. Therefore, there is urgent need to strengthen awareness and health education among people, as well as proper practices related to the CE not only in the study area, but also in other areas of Pakistan. [ABSTRACT FROM AUTHOR]

Human echinococcus is caused by tapeworm, Echinococcus granulosus, which forms larval cysts in the human tissue. Incidence in the cerebral form is only 1–2%. This localization can be associated with the involvement of other organs such as liver or lung or may be an isolated infestation of the brain or spinal column. Surgical removal of the intact and unruptured cyst is advised to prevent local recurrence that may require further surgery and long-term treatment with parasiticidal agents. We report three cases who presented with headache, vomiting, hemiparesis with decreased visual acuity, and convulsions. MRI showed a giant hydatid cyst in all three cases which was removed surgically and the patient was successfully discharged. Successful treatment of hydatid cyst requires preoperative diagnosis and meticulous surgical technique for complete excision of cyst without rupture under perioperative coverage of albendazole to avoid recurrence and anaphylaxis. [ABSTRACT FROM AUTHOR]

Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. Peritoneum, omentum, and mesentery are among these unusual locations, which can cause diagnostic challenge and treatment delay. This review provides information on the reported cases of the peritoneal, omental, and mesenteric hydatid cyst in the world during the last 20 years. During the last 20 years, there have been 49 published cases of hydatid cysts in the peritoneum, mesentery, and omentum. Among the reported cases in the English literature, the most common presenting symptom has been chronic abdominal pain and the method of primary diagnosis has been ELISA and ultrasonography. The best treatment modalities have been surgical excision, with and without adjuvant therapy, with albendazole and scolicidal agents. The published follow-up studies showed a low recurrence rate. [ABSTRACT FROM AUTHOR]

There are no routine, reliable diagnostic methods for detection of Echinococcus granulosus infection, the causative agent of cystic echinococcosis in human and domestic animals. Two recombinant proteins EgAg5-38 sub-unit and P-29 of E. granulosus were expressed in prokaryotic expression vectors. The diagnostic potential of these two recombinant proteins was evaluated in the detection of cystic echinococcosis in buffaloes in IgG-ELISA. The EgAg5-38 sub-unit and P-29 recombinant protein reacted fairly with the hydatid infected buffaloes with EgAg5-38 sub-unit showing sensitivity and specificity of 67.9 and 78.8%, respectively. However, the recombinant P-29 protein showed a higher sensitivity of 82.1% but a low specificity of 43.9% in the detection of hydatid infection in buffaloes. Cross-reactivity of these recombinant antigens in buffaloes naturally infected with several gastrointestinal trematodes and Sarcocystis was studied. The results showed that both these antigens cross-reacted with most of these parasites of buffaloes. Present study is the first report on the evaluation of diagnostic potential of E. granulosus recombinant EgAg5-38 sub-unit and P-29 antigens in buffaloes. [ABSTRACT FROM AUTHOR]

Cystic hydatid disease is responsible for the loss of 1 to 3 million disability-adjusted life years every year. Infestation of the heart, though rare, can result in serious complications if left untreated. We retrospectively collected information on 19 patients with cardiac hydatid cyst admitted at the Center for Cardiac Surgery of Ibn Al-Bitar Hospital in Baghdad from July 2007 to July 2011 who were either in need of a cardiac surgery for treating hydatid cysts or presented with emergency conditions. Nine (47%) patients presented with left-sided heart failure and mitral valve dysfunction, 5 (26%) patients had hydatid cysts in the pericardium, 3 (16%) patients had hydatid cyst in the right ventricle and presented with right-sided heart failure, and 2 (11%) patients who presented with cardiac arrhythmias had infestation in the interventricular septum. Removal of cysts following open-heart surgery was successful and was followed by the use of mebendazole or albendazole for 5 years. We conclude that cardiac hydatid cyst that leads to various cardiac symptoms can be successfully managed and should be considered as a diagnostic possibility in patients with cardiac symptoms in endemic areas. [ABSTRACT FROM AUTHOR]

Echinococcosis is a neglected zoonotic disease affecting over 1 million people worldwide at any given time. It is the leading cause of hospital admissions for parasitic diseases in Chile. We conducted a retrospective investigation of hospitalized cases to describe the epidemiological trends of echinococcosis in Chile. We also examined the potential environmental risk factors for echinococcosis hospitalization rates. Through nation-wide hospital discharge data, a total of 11,516 hospitalized patients with cystic echinococcosis were identified between January 2001 and December 2012. The mean age of hospitalization was 40 years, with notable gender difference in pediatric patients. The hospitalization rate was found to be overall steadily decreasing from 2001 (7.02 per 100,000) to 2012 (4.53 per 100,000) with a 5% decrease per year (rate ratio = 0.95 [95% CI: 0.94, 0.96]). The hospitalization rate was higher in the south of Chile compared to the north. Goat density and intermediate precipitation were found to be significantly positively associated with the hospitalization rate while annual average temperature was found to be significantly negatively associated with the hospitalization rate. Findings of this study indicate that echinococcosis is still an important public health burden in Chile related to interaction with livestock and climate. Efforts should be placed on targeted prevention measures for farmers and raising awareness of echinococcosis among health care workers. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE) is a neglected zoonotic disease, diagnosed through clinical findings, imaging techniques, and serology, for which many serological tests are available. Here we report a rapid unit assay, the immunochromatographic VIRapid® HYDATIDOSIS test (Vircell, Granada, Spain), potentially suitable for laboratories in low-prevalence or poorly equipped areas. This test was evaluated with a large retrospective cohort (224 sera), including patients suffering from CE or from other parasitic or liver diseases. The test was also assessed in routine conditions with a prospective cohort (115 sera) in areas where both cystic and alveolar echinococcoses have been diagnosed. Its performance (in terms of sensitivity, specificity, and both positive and negative likelihood ratios) was similar to an ELISA based on a crude antigen. Our study shows that this test performs adequately in the diagnostic process, when used with caution, especially regarding cross-reactivity with other parasitic diseases. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis is a common parasitic disease in some areas and involves different organs with different presentations. Rural areas in our country are endemic with this disease. We present a case of echinococcal aortic involvement that was diagnosed incidentally by a routine chest radiogram as a mediastinal mass. Cystic echinococcosis was established as final diagnosis after magnetic resonance imaging (MRI) and ELISA studies. The patient was treated surgically through a thoracotomy and her aortic defect was repaired during the operation. She has been asymptomatic and complication free in physical examination and imaging study in follow up periods after two years. Awareness of various presentations of the disease is necessary for physicians who are occupied in endemic areas. It is rational to treat echinococcal cysts adjacent to the great vessels with the cooperation of a vascular surgeon. [ABSTRACT FROM AUTHOR]

Objective. We aim to determine the efficiency of CT in identification of cystic echinococcosis in sheep. Methods. Fifty-three sheep with liver cysts confirmed by ultrasonography were subject to CT scan to evaluate the number, size, and type of the cysts in liver and lung, confirmed using necropsy. The correlation of numbers between liver cysts and lung cysts was calculated using Pearson analysis. Results. Necropsy indicated a 98% consensus on size, location, number, and activity compared with CT scan. The viable cysts were 53.1% and 50.6% in the liver and lung, respectively. Among the cysts in liver, 35.5%, 9.5%, 5.7%, 10.2%, and 39.1% were Types CE1, CE2, CE3, CE4, and CE5, respectively. The cysts in the lungs, 17.4%, 26.9%, 12.1%, 11.6%, and 32.1%, were Types CE1, CE2, CE3, CE4, and CE5, respectively. A significant correlation was noticed between the number of cysts in liver and those in lung (R=0.770, P<0.001). Conclusions. CT scan is a suitable tool in determining the size and type of cystic hydatid cysts in both liver and lung of sheep. A significant correlation was noticed between the numbers in liver and lung, indicating that lung infection was likely due to the expansion of liver cyst burden pressure. [ABSTRACT FROM AUTHOR]

Introduction: Echinococcosis or hydatid cyst disease is one of the most common infectious diseases between animals and humans (zoonosis) that is endemic in all the countries of the Mediterranean region, including Iran. Pelvic involvement is rare, and the involvement of the uterus is very rare. Case Report: 26-year-old female patient complained of limb paresis, ataxia and progressive headaches diagnosed with hydatid cyst of the brain was undergone surgery. The pain and slight swelling in the area of the wrist occurred, one year later and with the same diagnosis, surgery was performed again. Abdominal ultrasound showed two cystic lesions in the suprapubic region with a diagnosis of hydatid cyst of the uterus, 3 years later, surgery was performed. In all cases, the diagnosis was confirmed by pathology. Discussion: Follow-up of patients with radiologic and serologic methods is necessary. Conclusion: In patients with any clinical manifestation of endemic areas, particularly if there is a previous history of hydatidosis, hydatid cyst should be considered in terms of risk. [ABSTRACT FROM AUTHOR]

Objective of the present review is to describe in a systematic way potential uses of ultrasonographic examination in diagnosis of parasitic diseases of sheep and to comment upon its potential usefulness in the health management of flocks. The technique has been primarily employed for diagnosis of hydatid disease in live sheep, by imaging lesions in the liver and/or the lungs of affected animals; this can be of potential value in health management of flocks, as other methods used to diagnose the disease may not have increased diagnostic accuracy. Further, the technique has been used for diagnosis of Fasciola infection, during the ductal phase, as well as for diagnosis of coenurosis. It is concluded that sonoparasitology should be considered as a diagnostic possibility of valuable potential for application in sheep. [ABSTRACT FROM AUTHOR]

Background: The reservoir and intermediate hosts of Echinococcus granulsus and human hydatidosis are more prevalent in the Alborz and Zagros Mountains slop due to rich pastures for sheep raising. Many cases of hydatid cysts operate in local hospitals annually. The present study aimed to review the epidemiologic characteristics of the hydatidosis patients. Methods: In this descriptive study, the medical files of 182 hydatidosis patients from main public and private hospitals in Hamadan Province, western Iran from 2006 to 2013 were reviewed. The data collected from eight general hospitals including demographic data, clinical and diagnostic measures, surgical approaches, and outcome were entered into the prepared checklist and analyzed by descriptive statistics. Results: All patients were diagnosed and operated giving an average of 26 cases per year, or 1.5 cases per 100000 inhabitants. The site of cysts was as follows: liver 70.9%, lung 24.7%, and in both these organs 2.2%. The ratio of male and female patients was approximately 1:1. Mean age of patients was 44.5±21.5 yr at range of 3 to 91 yr. The majority the patients were illiterate (32.2%) and resided in the rural areas (61.7%), and their occupations were housewives (36.8%). Almost 90% of patients diagnosed by imaging methods and 8% had history of surgery for cyst. Conclusion: Hydatidosis is a major health problem still in this region and more extensive epidemiological investigations of CE is necessary to better determine the prevalence, economic impact and risk factors for the disease control. [ABSTRACT FROM AUTHOR]