Polycystic hydatid disease<i>(Echinococcus vogeli).</i>Treatment with albendazole

Meneghelli, U. G.; Martinelli, A.L.C.; Bellucci, Ângela Delete; Villanova, Márcia G.; Velludo, Maria Angeles Sanches Llorach; Magro, Jose E.

doi:10.1080/00034983.1992.11812645

Cited by 17 publications

(14 citation statements)

References 13 publications

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“…Typically, polycystic structures can be detected by ultrasonography or computed tomography of the liver and abdomen or by X-ray examination of the chest. Antibodies against Echinococcus antigen could be detected in 12 of 16 patients by the indirect hemagglutination test (32,138), but this test does not discriminate between Echinococcus species. In one study, discrimination between PE and CE was achieved by using a purified antigen of E. vogeli in the ELISA (85).…”

Section: Polycystic Echinococcosis In Humansmentioning

confidence: 97%

“…The main clinical manifestations include abdominal pain, palpable abdominal masses, loss of weight, jaundice, hepatomegaly, anaemia, fever, hemoptysis (in cases of lung involvement), and, in about 25% of patients, signs of portal hypertension and biliary obstruction. In some cases laboratory tests revealed high serum levels of blirubin, gamma-globulin, and liver enzymes, eosinophilia, and low levels of albumin (32,65,138,139,146). In advanced cases, mortality is high.…”

Section: Polycystic Echinococcosis In Humansmentioning

confidence: 99%

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Biological, Epidemiological, and Clinical Aspects of Echinococcosis, a Zoonosis of Increasing Concern

2004

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Echinococcosis in humans is a zoonotic infection caused by larval stages (metacestodes) of cestode species of the genus Echinococcus. Cystic echinococcosis (CE) is caused by Echinococcus granulosus, alveolar echinococcosis (AE) is caused by E. multilocularis, and polycystic forms are caused by either E. vogeli or E. oligarthrus. In untreated cases, AE has a high mortality rate. Although control is essentially feasible, CE remains a considerable health problem in many regions of the northern and southern hemispheres. AE is restricted to the northern hemisphere regions of North America and Eurasia. Recent studies have shown that E. multilocularis, the causative agent of AE, is more widely distributed than previously thought. There are also some hints of an increasing significance of polycystic forms of the disease, which are restricted to Central and South America. Various aspects of human echinococcosis are discussed in this review, including data on the infectivity of genetic variants of E. granulosus to humans, the increasing invasion of cities in Europe and Japan by red foxes, the main definitive hosts of E. multilocularis, and the first demonstration of urban cycles of the parasite. Examples of emergence or reemergence of CE are presented, and the question of potential spreading of E. multilocularis is critically assessed. Furthermore, information is presented on new and improved tools for diagnosing the infection in final hosts (dogs, foxes, and cats) by coproantigen or DNA detection and the application of molecular techniques to epidemiological studies. In the clinical field, the available methods for diagnosing human CE and AE are described and the treatment options are summarized. The development of new chemotherapeutic options for all forms of human echinococcosis remains an urgent requirement. A new option for the control of E. granulosus in the intermediate host population (mainly sheep and cattle) is vaccination. Attempts are made to reduce the prevalence of E. multilocualaris in fox populations by regular baiting with an anthelmintic (praziquantel). Recent data have shown that this control option may be used in restricted areas, for example in cities, with the aim of reducing the infection risk for humans

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Section: Polycystic Echinococcosis In Humansmentioning

confidence: 97%

Section: Polycystic Echinococcosis In Humansmentioning

confidence: 99%

Biological, Epidemiological, and Clinical Aspects of Echinococcosis, a Zoonosis of Increasing Concern

2004

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“…All were treated with albendazole. One was considered cured after surgery and a second after two years of albendazole treatment alone (44).…”

Section: Clinical Characteristics Of Polycystic Echinococcosis (E Vomentioning

confidence: 99%

“…The only five patients that seem to have been cured were treated surgically with the additional chemotherapy with albendazole. CT scan and US, performed after treatment was terminated, were negative (10,29,42,44,49,53).…”

Section: Consequences Of Medical Treatmentmentioning

confidence: 99%

“…When the invasion by the metacestode involves essential organs or especially vulnerable parts of organs, the judgment of the surgeon must determine whether to leave portions of the metacestode and continue therapy with albendazole or, in the future, perhaps to administer other drugs that reduce the invasiveness or are parasitocidal for the metacestode. Liver transplant has also been considered as a possibility (44).…”

Section: Consequences Of Medical Treatmentmentioning

confidence: 99%

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New Aspects of Neotropical Polycystic ( Echinococcus vogeli ) and Unicystic ( Echinococcus oligarthrus ) Echinococcosis

2008

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SUMMARY Of the four species of the genus Echinococcus (Cestoda) distinguished by biological and morphological characteristics, two species, E. vogeli and E. oligarthrus, occur widely in the Neotropics. Approximately 200 cases of polycystic echinococcosis (PE) have been recorded from 12 countries in South America. Following early proliferation of E. vogeli in the human host, typically in the liver, the metacestode usually spreads in the peritoneal and pleural cavities, and numerous organs may be invaded. The clinical characteristics of PE in 81 patients with sufficient information are reviewed. Type I disease consists of polycysts in the liver and abdominal cavity (37% of the patients had this characteristic); type II is similar to type I but also includes hepatic insufficiency (26%); type III consists of cysts in liver and chest (14%); type IV consists of cysts only in the mesenteries (16%); and type V consists of cysts calcified in liver and lung (4%). The percentage of patients with polycysts in the liver was 81%, and the percentage of patients with polycysts in the chest was 14%. PE is most ready diagnosed by geographic origin of the patient and by means of ultrasound or computerized tomography scanning showing cysts and calcifications. The highest mortality was for patients with type II disease, due to hepatic failure and its complications. There were five patients who died due to surgical accidents, whereas 35 cases had uncomplicated surgery. Twenty-three patients died of PE, making the total mortality 29% (23 of 78 cases). None of the 13 patients treated only with albendazole, the most efficacious treatment, was completely cured. PE represents a severe medical problem in South America. A reevaluation of the characteristics of the metacestode of E. oligarthrus indicated that it is unicystic. Only three human cases are known (two with infection in the orbit and one with infection in the heart). The metacestode of E. oligarthrus, in contrast with that of E. vogeli, consists of a spherical, fluid-filled vesicle that enlarges concentrically and is not known to undergo exogenous proliferation.

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