Management of cystic echinococcosis in the last two decades: what have we learned?

Velasco‐Tirado, Virginia; Romero‐Alegría, Ángela; Pardo‐Lledías, Javier; Alonso‐Sardón, Montserrat; López-Bernús, Amparo; Sampedro, José Quiñones; Muñoz-Bellvis, Luís; Gómez, Amalia; Muro, Antonio; Bellido, Juan Luis Muñoz; Iglesias-Iglesias, Manuel; Jiménez, Marcelo F.; Belhassen‐García, Moncef

doi:10.1093/trstmh/try050

Cited by 18 publications

(24 citation statements)

References 20 publications

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“…In a recent study performed in a high-endemic area of Spain, only one patient from 491 (0.2%) was treated with the PAIR technique. 10 This fact should emphasize the importance of having well-trained personnel in these techniques; otherwise, the recommendations and guidelines are hard to follow in most of the centers.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in Cystic Echinococcosis Management Among Spanish Centers: Results from a National Survey

Salvador

Calabuig

López‐Vélez³

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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The aim of the study was to evaluate the availability of different procedures, diagnostic tests, and treatments, as well as the procedures and techniques used in the management of cystic echinococcosis (CE) in Spain. This was a cross-sectional study performed from September to December 2018 in Spain. A survey directed to CE-treating clinicians was conducted to collect information regarding the center characteristics and the different protocols of management followed. Thirty-nine centers among 76 contacted centers participated in the survey, most of them belonging to the public health system and attending both adult and children. The median number of patients with CE attended during the last three years per center was 15. Percutaneous techniques were used only in seven centers, and surgery was the most frequently used therapeutic approach. Drugs and duration of treatment (both when administered exclusively or when combined with surgery/puncture, aspiration, injection, and reaspiration) were very variable depending on the centers. There is a high variability in the management of CE among Spanish centers. These results stress the importance of promoting the diffusion of existing knowledge, adapting the WHO recommendations to our setting, and referring patients to referral centers at a national level.

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Section: Discussionmentioning

confidence: 99%

Heterogeneity in Cystic Echinococcosis Management Among Spanish Centers: Results from a National Survey

Salvador

Calabuig

López‐Vélez³

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…In a recent study, this treatment strategy was associated with higher mortality attributable to CE complications. 13 The spontaneous complications of CE have also been commonly referred to in the literature, although their frequency and risk factors involved have not been well established. We aimed to study the spontaneous complications of CE.…”

Section: Discussionmentioning

confidence: 99%

“…11 Complications frequently occur secondary to CE treatment, which is associated with surgical interventions or other therapeutic procedures, such as puncture, aspiration, injection, reaspiration. 12,13 Moreover, primary complications have also been frequently described in the literature because of rupture of the cyst, superinfection, or immunological reactions. Nevertheless, the data on the incidence of these complications and the associated risk factors have not been well defined.…”

Section: Introductionmentioning

confidence: 99%

Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis

Collado-Aliaga

Romero‐Alegría

Alonso‐Sardón

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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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.

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“…These data were not included because we had covered this topic previously. 4 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.…”

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confidence: 99%

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Belhassen‐García

Alonso‐Sardón

Antonio³

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Management of cystic echinococcosis in the last two decades: what have we learned?

Abstract: Complications of CE are one of the most common causes of mortality in CE patients, with size, location, and number of cysts, and the 'watch and wait' treatment strategy being the main factors associated with mortality.

Cited by 18 publications

References 20 publications

Heterogeneity in Cystic Echinococcosis Management Among Spanish Centers: Results from a National Survey

Heterogeneity in Cystic Echinococcosis Management Among Spanish Centers: Results from a National Survey

Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis

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