Cystic echinococcosis in sub-Saharan Africa

Wahlers, Kerstin; Menezes, Colin; Wong, Michelle; Zeyhle, E.; Ahmed, Mohammed E; Ocaido, Michael; Stijnis, Cornelis; Römig, Thomas; Kern, Peter; Grobusch, Martin P.

doi:10.1016/s1473-3099(12)70155-x

Cited by 78 publications

(60 citation statements)

References 87 publications

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“…PAIR (puncture, aspiration, injection and re-aspiration) is a safe and effective alternative to surgery, and has partly replaced surgery as the treatment of choice. 9 Anthelmintic chemotherapy (albendazole preferred to mebendazole) has shown improvement in most patients, albeit a very small (29%) cure rate. 8 Currently, chemotherapy has been restricted to pre and post operative use to prevent recurrence and as sole therapy for inoperable cases.…”

Section: Discussionmentioning

confidence: 99%

Primary Subcutaneous Hydatid Cyst in supraclavicular region diagnosed by fine needle aspiration cytology: A Rare Case Report

Brahmachari¹,

Saha²,

Bhattacharya³

et al. 2015

Sri Lankan J Infec Dis

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Abstract:Hydatid cyst is not an uncommon disease, primarily affecting the liver, lungs and other viscera. In case of disseminated disease, cysts may be found in uncommon locations like muscle and subcutaneous tissue. However, the presence of a hydatid cyst in subcutaneous tissue only, without being present in liver or lungs is an extremely rare entity. Here we report such a rare case of solitary primary subcutaneous hydatid cyst, misdiagnosed previously as a cold abscess until aspiration clinched the diagnosis.A 46 year old female patient presented with a gradually progressive swelling in the right supraclavicular region. Imaging studies favoured a cold abscess. Haematoxylin and Eosin stained aspirated fluid from the swelling showed the presence of scolices with hooklets. This finding conclusively proved the swelling to be a hydatid cyst. Serological tests were negative. No other organ involvement was found. The case was finally diagnosed to be an extremely rare case of primary solitary subcutaneous hydatid cyst in the supraclavicular region. The cyst was surgically removed.This case points to the fact that although hydatid cyst is a rare possibility, it should be considered in the differential diagnosis of any cystic lesion. Without the correct diagnosis, proper therapy can be missed and might lead to recurrence of the disease.

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Section: Discussionmentioning

confidence: 99%

Primary Subcutaneous Hydatid Cyst in supraclavicular region diagnosed by fine needle aspiration cytology: A Rare Case Report

Brahmachari¹,

Saha²,

Bhattacharya³

et al. 2015

Sri Lankan J Infec Dis

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“…[1] In SA, the disease is prevalent in Limpopo, Eastern Cape, North West and Northern Cape provinces. [2] Retrospective National Health Laboratory Service information system results for serology, microscopy and histopathology from eight provinces (excluding KwaZulu-Natal) gave an overall positivity rate in submitted diagnostic samples of 17.0% (1 056/6 211), with Eastern Cape leading at 30.4%, North West 19.0% and Northern Cape 18.0%. [3,4] The life cycle of the Echinococcus worm begins with the host animal shedding, via its faeces, a mature segment full of eggs.…”

Section: Discussionmentioning

confidence: 99%

The different faces of pulmonary hydatid disease

2016

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Hydatid disease is responsible for causing cystic disease. In children, it classically involves the liver, lung and brain but can involve almost any organ or numerous organs simultaneously. The lung is the most common target organ in children, while in adults hepatic involvement is more common. We present three case reports of children who presented with hydatid disease with varying clinical manifestations of pulmonary hydatidosis and complications, and their related management. S Afr Case presentations Case 1The first case is an 11-year-old boy referred to our hospital for the assessment of ring lesions seen on X-ray. He was from a rural area of KwaZulu-Natal Province. He had a 3-month history of cough, fever and loss of appetite. He had no history of tuberculosis (TB) contact. On examination he was wasted, had tachypnoea and had bilateral crackles in both lung fields. The rest of the system examination was normal. His chest X-rays showed bilateral well-circumscribed round lesions (Fig. 1). The enzyme-linked immunosorbent assay (ELISA) HIV test was negative and sputum microscopy sensitivity and culture revealed no pathogens. The hydatid indirect haemagglutinin assay was positive and the full blood count smear showed eosinophilia. A diagnosis of bilateral diffuse echinococcosis was made. The thoracic surgeons were consulted; however, because of the extent of the disease, with multiple lesions bilaterally, the agreed therapeutic option was a trial of medical treatment, as the lesions were inoperable. Medical management was then instituted with albendazole 400 mg/day for 6 months. The follow-up X-rays showed dramatic improvement of the lesions and good resolution. Case 2A 5-year-old boy was referred from rural Eastern Cape Province for assessment of a suspected non-resolving pleural effusion. The parents gave a history of progressively worsening symptoms of a tight chest and breathlessness on exertion over the past 3 years. He had been diagnosed with asthma by numerous general practitioners but the symptoms had not improved on treatment. On clinical examination, he had respiratory distress with tachypnoea, bilateral wheezes over both lung fields and decreased air entry. The remaining systems were normal. The chest X-ray revealed an almost complete white-out of the right hemithorax with an air-fluid level (Fig. 2). He had been suspected of having a pleural effusion/empyema at the referral hospital and this had been drained, with clear blood-tinged fluid aspirated. The full blood count smear showed eosinophilia. The hydatid indirect haemagglutination assay was highly positive. Computed tomography (CT) scan confirmed the presence of a large cystic lesion with a thick wall and air-fluid levels (Fig. 3). Ultrasound did not show any lesions in the liver. The child was referred to cardiothoracic surgeons, the lesion operated and a cyst removed (Fig. 4).

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“…29,30 In humans, CE cysts develop predominantly in the liver (60-70%) and lungs (20-30%). On average, 60-75% of infected patients with hepatic CE are asymptomatic.…”

Section: Focused Assessment With Sonography For Echinococcosismentioning

confidence: 99%

Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

Bélard¹,

Tamarozzi²,

Bustinduy³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. The development of good quality and affordable ultrasound machines has led to the establishment and implementation of numerous point-of-care ultrasound (POCUS) protocols in various medical disciplines. POCUS for major infectious diseases endemic in tropical regions has received less attention, despite its likely even more pronounced benefit for populations with limited access to imaging infrastructure. Focused assessment with sonography for HIV-associated TB (FASH) and echinococcosis (FASE) are the only two POCUS protocols for tropical infectious diseases, which have been formally investigated and which have been implemented in routine patient care today. This review collates the available evidence for FASH and FASE, and discusses sonographic experiences reported for urinary and intestinal schistosomiasis, lymphatic filariasis, viral hemorrhagic fevers, amebic liver abscess, and visceral leishmaniasis. Potential POCUS protocols are suggested and technical as well as training aspects in the context of resourcelimited settings are reviewed. Using the focused approach for tropical infectious diseases will make ultrasound diagnosis available to patients who would otherwise have very limited or no access to medical imaging.

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Cystic echinococcosis in sub-Saharan Africa

Cited by 78 publications

References 87 publications

Primary Subcutaneous Hydatid Cyst in supraclavicular region diagnosed by fine needle aspiration cytology: A Rare Case Report

Primary Subcutaneous Hydatid Cyst in supraclavicular region diagnosed by fine needle aspiration cytology: A Rare Case Report

The different faces of pulmonary hydatid disease

Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

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