Thompson RCA, McManus DP, 2002. Towards a taxonomic revision of the genus Echinococcus. Trends Parasitol 18: 452–457.
Cappello E, Cacopardo B, Caltabiano E, Li Volsi S, Chiara R, Sapienza M, Nigro L, 2013. Epidemiology and clinical features of cystic hydatidosis in western Sicily: a ten-year review. World J Gastroenterol 19: 9351–9358.
Carmena D, Sánchez-Serrano LP, Barbero-Martínez I, 2008. Echinococcus granulosus infection in Spain. Zoonoses Public Health 55: 156–165.
Rojo-Vazquez FA, Pardo-Lledias J, Francos-Von Hunefeld M, Cordero-Sánchez M, Alamo-Sanz R, Hernandez-Gonzalez A, Brunetti E, Siles-Lucas M, 2011. Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe. PLoS Negl Trop Dis 5: e893.
Hidalgo Pascual M, Barquet Esteve N, 1987. Hepatic hydatidosis. Study of a series of 7,435 cases. I: general aspects, epidemiology and diagnosis. Rev Esp Enferm Apar Dig 71: 1–6.
Pozo F, Fernández MJ, Suárez TV, Tojo S, Lamamie E, Rodrigo LR, 1987. Epidemiologic study of human hydatidosis in Asturias (1975–1984). Med Clín (Barc) 89: 773–777.
Romig T, Zeyhle E, Macpherson CN, Rees PH, Were JB, 1986. Cyst growth and spontaneous cure in hydatid disease. Lancet 1: 861.
Armiñanzas C, Gutiérrez-Cuadra M, Fariñas MC, 2015. Hydatidosis: epidemiological, clinical, diagnostic and therapeutic aspects. Rev Esp Quimioter 28: 116–124.
Velasco-Tirado V et al. 2017. Recurrence of cystic echinococcosis in an endemic area: a retrospective study. BMC Infect Dis 17: 455.
Schenone H, 1989. Cysticercosis and hydatidosis do not always bring about detectable pathology in humans. Bol Chil Parasitol 44: 63–65.
Belhassen Garcia M et al. 2014. Study of hydatidosis-attributed mortality in endemic area. PLoS One 9: e91342.
Akhan O, Salik AE, Ciftci T, Akinci D, Islim F, Akpinar B, 2017. Comparison of long-term results of percutaneous treatment techniques for hepatic cystic echinococcosis types 2 and 3b. AJR Am J Roentgenol 208: 878–884.
Velasco-Tirado V et al. 2018. Management of cystic echinococcosis in the last two decades: what have we learned? Trans R Soc Trop Med Hyg 112: 207–215.
Lopez-Bernus A, Belhassen Garcia M, Alonso-Sardón M, Carpio-Perez A, Velasco-Tirado V, Romero-Alegria A, Muro A, Cordero-Sánchez M, Pardo-Lledias J, 2015. Surveillance of human echinococcosis in Castilla-Leon (Spain) between 2000–2012. PLoS Negl Trop Dis 9: e0004154.
Stamm B, Fejgl M, Hueber C, 2008. Satellite cysts and biliary fistulas in hydatid liver disease. A retrospective study of 17 liver resections. Hum Pathol 39: 231–235.
Köksal N, Müftüoglu T, Günerhan Y, Uzun MA, Kurt R, 2001. Management of intrabiliary ruptured hydatid disease of the liver. Hepatogastroenterology 48: 1094–1096.
Paksoy M, Karahasanoglu T, Carkman S, Giray S, Senturk H, Ozcelik F, Ergüney S, 1998. Rupture of the hydatid disease of the liver into the biliary tracts. Dig Surg 15: 25–29.
Yilmaz M, Akbulut S, Kahraman A, Yilmaz S, 2012. Liver hydatid cyst rupture into the peritoneal cavity after abdominal trauma: case report and literature review. Int Surg 97: 239–244.
Oraha AY, Faqe DA, Kadoura M, Kakamad FH, Yaldo FF, Aziz SQ, 2018. Cardiac hydatid cysts; presentation and management. A case series. Ann Med Surg (Lond) 30: 18–21.
Nourbakhsh A, Vannemreddy P, Minagar A, Toledo EG, Palacios E, Nanda A, 2010. Hydatid disease of the central nervous system: a review of literature with an emphasis on Latin American countries. Neurol Res 32: 245–251.
Kirmizi S, Kayaalp C, Yilmaz S, 2016. Hydatid liver cyst causing portal vein thrombosis and cavernous transformation: a case report and literature review. Gastroenterol Hepatol Bed Bench 9: 331–335.
Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS, 2000. Hydatid disease: radiologic and pathologic features and complications. Radiographics 20: 795–817.
Symeonidis N, Pavlidis T, Baltatzis M, Ballas K, Psarras K, Marakis G, Sakantamis A, 2013. Complicated liver echinococcosis: 30 years of experience from an endemic area. Scand J Surg 102: 171–177.
Alexiou K, Mitsos S, Fotopoulos A, Karanikas I, Tavernaraki K, Konstantinidis F, Antonopoulos P, Ekonomou N, 2012. Complications of hydatid cysts of the liver: spiral computed tomography findings. Gastroenterology Res 5: 139–143.
García MB, Lledías JP, Pérez IG, Tirado VV, Pardo LF, Bellvís LM, Varela G, Sánchez MC, 2010. Primary super-infection of hydatid cyst—clinical setting and microbiology in 37 cases. Am J Trop Med Hyg 82: 376–378.
Koçer NE, Kibar Y, Güldür ME, Deniz H, Bakir K, 2008. A retrospective study on the coexistence of hydatid cyst and aspergillosis. Int J Infect Dis 12: 248–251.
Vuitton DA, 2004. Echinococcosis and allergy. Clin Rev Allergy Immunol 26: 93–104.
Perrigone R, Fontana L, De Carolis C, Ottaviani P, 1980. Activation of alternative complement pathway by fluid from hydatid cysts. N Engl J Med 302: 808–809.
Diáz A, Ferreira AM, Nieto A, 1995. Echinococcus granulosus: interactions with host complement in secondary infection in mice. Exp Parasitol 80: 473–482.
Hamilton RG, Wagner E, April M, Winkelstein JA, Sobotka AK, Bleeker E, Adkinson NF, 1986. Dirofilaria immitis: diethylcarbamazine-induced anaphylactoid reactions in infected dogs. Exp Parasitol 61: 405–420.
Ortona E, Margutti P, Vaccari S, Riganò R, Profumo E, Buttari B, Chersi A, Teggi A, Siracusano A, 2001. Elongation factor 1 beta/delta of Echinococcus granulosus and allergic manifestations in human cystic echinococcosis. Clin Exp Immunol 125: 110–116.
Riganò R, Profumo E, Teggi A, Siracusano A, 1996. Production of IL-5 and IL-6 by peripheral blood mononuclear cells (PBMC) from patients with Echinococcus granulosus infection. Clin Exp Immunol 105: 456–459.
Torcal J, Navarro-Zorraquino M, Lozano R, Larrad L, Salinas JC, Ferrer J, Roman J, Pastor C, 1996. Immune response and in vivo production of cytokines in patients with liver hydatidosis. Clin Exp Immunol 106: 317–322.
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Cystic echinococcosis (CE) is a chronic, complex, and overlooked zoonotic disease caused by Echinococcus granulosus. In humans, it may result in a wide spectrum of clinical manifestations depending on the type of complications, ranging from asymptomatic infection to fatal disease. The primary complications and risk factors associated with CE are not well defined. We performed a retrospective, observational study of inpatients diagnosed with CE from January 1998 to December 2017 in the public health-care system of western Spain. Five hundred and six cases were analyzed. More than half of the patients (302 [59.7%]) were asymptomatic, and the diagnoses were made incidentally. A total of 204 (40.3%) patients had complications associated with CE; 97 (47.5%) were mechanical, 62 (30.4%) were infectious, 15 (7.3%) were immunoallergic, and 30 (14.7%) involved a combination of complications. Mortality was higher in patients with mechanical complications (9.4%) than in patients with infectious complications (5.6%) and in patients with allergic complications (0%) (odds ratio = 19.7, 95% CI, 4.3–89.1, P < 0.001). In summary, CE frequently results in complications, especially in the liver in younger patients and, regardless of other variables, such as size or stage of cyst. Mechanical problems and superinfection are the most frequent complications. CE is an obligatory diagnosis in patients with urticarial or anaphylactoid reactions of unknown cause in endemic areas.
Authors’ addresses: Javier Collado-Aliaga, Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), E-mail: humanoide123@hotmail.com. Ángela Romero-Alegría, Servicio de Medicina Interna, CAUSA, Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain, E-mail: aralegria82@hotmail.com. Montserrat Alonso-Sardón, Área de Medicina Preventiva y Salud Pública, IBSAL, CIETUS, Universidad de Salamanca, Salamanca, Spain, E-mail: sardonm@usal.es. Antonio Muro, Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain, E-mail: ama@usal.es. Amparo López-Bernus, Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Salamanca, Spain, E-mail: albernus@hotmail.com. Virginia Velasco-Tirado, Servicio de Dermatología, CAUSA, IBSAL, CIETUS, Salamanca, Spain, E-mail: virvela@yahoo.es. Juan Luis Muñoz Bellido, Servicio de Microbiología CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Salamanca, Spain, E-mail: jlmubel@usal.es. Javier Pardo-Lledias, Servicio de Medicina Interna, General Hospital of Palencia “Río Carrión”, C/ Donantes de Sangre, Palencia, Spain, E-mail: javipard2@hotmail.com. Moncef Belhassen-García, Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain, E-mail: mbelhassen@hotmail.com.
Thompson RCA, McManus DP, 2002. Towards a taxonomic revision of the genus Echinococcus. Trends Parasitol 18: 452–457.
Cappello E, Cacopardo B, Caltabiano E, Li Volsi S, Chiara R, Sapienza M, Nigro L, 2013. Epidemiology and clinical features of cystic hydatidosis in western Sicily: a ten-year review. World J Gastroenterol 19: 9351–9358.
Carmena D, Sánchez-Serrano LP, Barbero-Martínez I, 2008. Echinococcus granulosus infection in Spain. Zoonoses Public Health 55: 156–165.
Rojo-Vazquez FA, Pardo-Lledias J, Francos-Von Hunefeld M, Cordero-Sánchez M, Alamo-Sanz R, Hernandez-Gonzalez A, Brunetti E, Siles-Lucas M, 2011. Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe. PLoS Negl Trop Dis 5: e893.
Hidalgo Pascual M, Barquet Esteve N, 1987. Hepatic hydatidosis. Study of a series of 7,435 cases. I: general aspects, epidemiology and diagnosis. Rev Esp Enferm Apar Dig 71: 1–6.
Pozo F, Fernández MJ, Suárez TV, Tojo S, Lamamie E, Rodrigo LR, 1987. Epidemiologic study of human hydatidosis in Asturias (1975–1984). Med Clín (Barc) 89: 773–777.
Romig T, Zeyhle E, Macpherson CN, Rees PH, Were JB, 1986. Cyst growth and spontaneous cure in hydatid disease. Lancet 1: 861.
Armiñanzas C, Gutiérrez-Cuadra M, Fariñas MC, 2015. Hydatidosis: epidemiological, clinical, diagnostic and therapeutic aspects. Rev Esp Quimioter 28: 116–124.
Velasco-Tirado V et al. 2017. Recurrence of cystic echinococcosis in an endemic area: a retrospective study. BMC Infect Dis 17: 455.
Schenone H, 1989. Cysticercosis and hydatidosis do not always bring about detectable pathology in humans. Bol Chil Parasitol 44: 63–65.
Belhassen Garcia M et al. 2014. Study of hydatidosis-attributed mortality in endemic area. PLoS One 9: e91342.
Akhan O, Salik AE, Ciftci T, Akinci D, Islim F, Akpinar B, 2017. Comparison of long-term results of percutaneous treatment techniques for hepatic cystic echinococcosis types 2 and 3b. AJR Am J Roentgenol 208: 878–884.
Velasco-Tirado V et al. 2018. Management of cystic echinococcosis in the last two decades: what have we learned? Trans R Soc Trop Med Hyg 112: 207–215.
Lopez-Bernus A, Belhassen Garcia M, Alonso-Sardón M, Carpio-Perez A, Velasco-Tirado V, Romero-Alegria A, Muro A, Cordero-Sánchez M, Pardo-Lledias J, 2015. Surveillance of human echinococcosis in Castilla-Leon (Spain) between 2000–2012. PLoS Negl Trop Dis 9: e0004154.
Stamm B, Fejgl M, Hueber C, 2008. Satellite cysts and biliary fistulas in hydatid liver disease. A retrospective study of 17 liver resections. Hum Pathol 39: 231–235.
Köksal N, Müftüoglu T, Günerhan Y, Uzun MA, Kurt R, 2001. Management of intrabiliary ruptured hydatid disease of the liver. Hepatogastroenterology 48: 1094–1096.
Paksoy M, Karahasanoglu T, Carkman S, Giray S, Senturk H, Ozcelik F, Ergüney S, 1998. Rupture of the hydatid disease of the liver into the biliary tracts. Dig Surg 15: 25–29.
Yilmaz M, Akbulut S, Kahraman A, Yilmaz S, 2012. Liver hydatid cyst rupture into the peritoneal cavity after abdominal trauma: case report and literature review. Int Surg 97: 239–244.
Oraha AY, Faqe DA, Kadoura M, Kakamad FH, Yaldo FF, Aziz SQ, 2018. Cardiac hydatid cysts; presentation and management. A case series. Ann Med Surg (Lond) 30: 18–21.
Nourbakhsh A, Vannemreddy P, Minagar A, Toledo EG, Palacios E, Nanda A, 2010. Hydatid disease of the central nervous system: a review of literature with an emphasis on Latin American countries. Neurol Res 32: 245–251.
Kirmizi S, Kayaalp C, Yilmaz S, 2016. Hydatid liver cyst causing portal vein thrombosis and cavernous transformation: a case report and literature review. Gastroenterol Hepatol Bed Bench 9: 331–335.
Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS, 2000. Hydatid disease: radiologic and pathologic features and complications. Radiographics 20: 795–817.
Symeonidis N, Pavlidis T, Baltatzis M, Ballas K, Psarras K, Marakis G, Sakantamis A, 2013. Complicated liver echinococcosis: 30 years of experience from an endemic area. Scand J Surg 102: 171–177.
Alexiou K, Mitsos S, Fotopoulos A, Karanikas I, Tavernaraki K, Konstantinidis F, Antonopoulos P, Ekonomou N, 2012. Complications of hydatid cysts of the liver: spiral computed tomography findings. Gastroenterology Res 5: 139–143.
García MB, Lledías JP, Pérez IG, Tirado VV, Pardo LF, Bellvís LM, Varela G, Sánchez MC, 2010. Primary super-infection of hydatid cyst—clinical setting and microbiology in 37 cases. Am J Trop Med Hyg 82: 376–378.
Koçer NE, Kibar Y, Güldür ME, Deniz H, Bakir K, 2008. A retrospective study on the coexistence of hydatid cyst and aspergillosis. Int J Infect Dis 12: 248–251.
Vuitton DA, 2004. Echinococcosis and allergy. Clin Rev Allergy Immunol 26: 93–104.
Perrigone R, Fontana L, De Carolis C, Ottaviani P, 1980. Activation of alternative complement pathway by fluid from hydatid cysts. N Engl J Med 302: 808–809.
Diáz A, Ferreira AM, Nieto A, 1995. Echinococcus granulosus: interactions with host complement in secondary infection in mice. Exp Parasitol 80: 473–482.
Hamilton RG, Wagner E, April M, Winkelstein JA, Sobotka AK, Bleeker E, Adkinson NF, 1986. Dirofilaria immitis: diethylcarbamazine-induced anaphylactoid reactions in infected dogs. Exp Parasitol 61: 405–420.
Ortona E, Margutti P, Vaccari S, Riganò R, Profumo E, Buttari B, Chersi A, Teggi A, Siracusano A, 2001. Elongation factor 1 beta/delta of Echinococcus granulosus and allergic manifestations in human cystic echinococcosis. Clin Exp Immunol 125: 110–116.
Riganò R, Profumo E, Teggi A, Siracusano A, 1996. Production of IL-5 and IL-6 by peripheral blood mononuclear cells (PBMC) from patients with Echinococcus granulosus infection. Clin Exp Immunol 105: 456–459.
Torcal J, Navarro-Zorraquino M, Lozano R, Larrad L, Salinas JC, Ferrer J, Roman J, Pastor C, 1996. Immune response and in vivo production of cytokines in patients with liver hydatidosis. Clin Exp Immunol 106: 317–322.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 797 | 722 | 15 |
Full Text Views | 543 | 9 | 1 |
PDF Downloads | 194 | 7 | 1 |