Very Prolonged Treatment with Albendazole of a Case of Disseminated Abdominal Cystic Echinococcosis

Abstract

Cystic echinococcosis is a zoonosis caused by the ingestion of food or water contaminated by Echinococcus eggs. E. granulosus is the most common causative agent of cystic echinococcosis that still has a relevant incidence in Italy, especially on the islands of Sicily and Sardinia. We report the case of a 64-year-old man with disseminated abdominal cystic echinococcosis (liver, spleen, peritoneum). The patient was asymptomatic and non-eligible for surgical treatment. Treatment with albendazole 400 mg/twice daily was started in 2012 for 15 cycles (each cycle consisted of three 28-day treatments at 14-day intervals) over 10 years for a total of 1260 days of treatment. Serum anti-Echinococcus antibody titers and imaging (echography, TC) were evaluated to monitor the evolution of the disease. Imaging techniques documented the regression of all cyst lesions, but it was less evident for the peritoneal localizations that still are in follow-up. In this case, the prolonged treatment with albendazole was effective, safe and free of side effects. Until today, the patient displays a good clinical condition.

Enhancing Giardicidal Activity and Aqueous Solubility through the Development of “RetroABZ”, a Regioisomer of Albendazole: In Vitro, In Vivo, and In Silico Studies

“…RetroABZ exhibited 2.4 times greater in vitro activity against G. lamblia than albendazole, and the in vivo results exhibited a good correlation with the in vitro studies. It is worth noting that only a few adverse events related to albendazole treatment have been reported; however, most of these are associated with the use of high doses in systemic infections [29,30]. The notable improvement in the water solubility of Retro-ABZ creates opportunities for investigating new derivatives that can effectively target invasive parasites, addressing significant limitations associated with albendazole's poor water solubility.…”

Laparoscopic Management of Multiple Liver, Omental, Mesenteric, Peritoneal, and Round Ligament Hydatid Cysts—A Rare Report of a Case and a Systematic Literature Review

“…For such therapy to be effective, it requires prolonged treatment, high costs, and management of adverse reactions, especially hepatotoxicity. Combining albendazole as adjuvant or neoadjuvant therapy with Puncture, Aspiration, Instillation, Reaspiration (PAIR), Modified Catheterisation Technique (MoCAT), or surgery represents the most optimal option in terms of cyst inactivation and low recurrence [10][11][12][13].…”

“…To achieve a unified management of this condition, an algorithm has been developed that establishes a therapeutic sequence based on the imaging classification of the hydatid cyst and its dimensions (Figure 1). Modified Catheterisation Technique (MoCAT), or surgery represents the most optimal option in terms of cyst inactivation and low recurrence [10][11][12][13].…”