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Gastrointestinal Infections
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Echinococcus granulosus causes cystic echinococcus and E. multilocularis causes alveolar echinococcus. Cysts can occur anywhere, but the liver (around two-thirds) and lung (around one-quarter) are the most common sites. Cystic echinococcus can be asymptomatic, particularly in early disease, and can have a long latent period. Infection occurs by ingestion of parasite eggs after excretion by tapeworm-infected animals, for example, dogs (definitive host). It is present in the Middle East, South America, Eastern Mediterranean and sub-Saharan Africa, particularly among rural/farming communities. Diagnosis is based on serology and typical imaging appearances on ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). The WHO classification grades cystic echinococcus from grade 1 to grade 5 based on size and type, for example active, degenerating and inactive. There is a risk of anaphylaxis or secondary echinococcosis if cysts rupture or spill. Treatment depends on staging and can include surgery (if complicated or size >10 cm with risk of rupture), with adjunctive drug therapy with albendazole (15 mg/kg orally twice daily; usual adult dose is 400 mg twice daily; liver function should be monitored.) Puncture Aspiration Injection Re-aspiration (PAIR) is an option for some cysts. For cystic echinococcus stages 4 and 5 (degenerated cysts and solid) or inoperable, monitoring with ultrasound every 6 months is recommended.
The Surgical Treatment of Pulmonary Echinococcosis
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Gillian Alex, Christopher W. Seder, Ozuru Ukoha
Echinococcosis is a zoonotic disease caused by the tapeworm Echinococcus. It is found throughout the world but is concentrated in Europe, the Middle East, and Asia. It carries a large societal and socioeconomic burden in the developing world and has been recently listed as a neglected treatable disease (NTD) by the World Health Organization (WHO) [1]. The following is a report of a young female who presented to a large urban county hospital in the United States with pulmonary cystic Echinococcosis.
Laboratory Diagnostic Tests in the Evaluation of Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Intradermal tests have been used for the diagnosis of schistosomiasis, fascioliasis, fi-lariasis, ascariasis, and leishmaniasis. The Casoni test for echinococcosis is characterized by low sensitivity and lifelong positivity. In general, serologic tests are preferred for such diseases.
Diagnosis of echinococcosis by detecting circulating cell-free DNA and miRNA
Published in Expert Review of Molecular Diagnostics, 2023
Mahboubeh Hadipour, Majid Fasihi Harandi, Hossein Mirhendi, Hossein Yousofi Darani
Echinococcosis is a chronic zoonotic infection causing a significant public health problem that affects many people around the world. World health organization (WHO) has considered echinococcosis as a major neglected disease [1-3]. This disease is classified into cystic echinococcosis (CE) and alveolar echinococcosis (AE), which are caused by the larvae stages of the tapeworms Echinococcus granulosus sensu lato and Echinococcus multilocularis, respectively [4]. Humans as the accidental intermediate host can be infected with the larval stage of the Echinococcus granulosus known as hydatid cyst. Canines are the definitive hosts for both species. CE is mainly perpetuated in a dog-livestock cycle, whereas AE is maintained in foxes and rodents [5]. The fluid-filled hydatid cysts mostly develop in the liver and lungs [6]. AE generally affects people in the northern hemisphere while CE has a higher prevalence across the world, especially in western China, Central Asia, the Middle East, Africa, South America, and Mediterranean countries [7,8].
Risk factors for post-endoscopic retrograde cholangiopancreatography cholangitis in patients with hepatic alveolar echinococcosis—an observational study
Published in Annals of Medicine, 2022
Fei Du, Wenhao Yu, Zhixin Wang, Zhi Xie, Li Ren
All examinations are performed by an experienced chief surgeon (over 20 years in endoscopy and over 600 ERCP cases per year). Side-viewing duodenoscopes (Pentax EPK-i5000; HOYA Corporation, Nishi-shiniuku, Shinjuku-ku Tokyo, Japan) were used to examine all the patients. All patients were treated intraoperatively with anti-inflammatory therapy (gentamicin added to the contrast medium) and postoperatively (using ceftriaxone). This study included the following inclusion criteria: (a) patients with a malignant obstruction caused by compression of the hilar bile duct; (b) patients with a biliary fistula who required endoscopic intervention; (c) patients who required endoscopic nasobiliary drainage to provide radiography before hepatectomy; and (d) patients with a hilar bile duct stricture after hepatectomy. Exclusion criteria: (a) patients with jaundice due to liver injury caused by AE but without biliary obstruction; (b) patients with combined hepatic cystic echinococcosis.
Echinococcosis in a non-endemic country – 20-years’ surgical experience from a Norwegian tertiary referral Centre
Published in Scandinavian Journal of Gastroenterology, 2022
Sheraz Yaqub, Mogens Jensenius, Ole Einar Heieren, Anders Drolsum, Frank O. Pettersen, Knut Jørgen Labori
This is a retrospective review of all patients admitted to OUH with echinococcosis between January 2000 and December 2020. The hospital database was screened to identify all cases with International Classification of Diseases 10 (ICD‐10) codes B67.0-B67.9. All medical records were reviewed concerning the following parameters: age, gender, country of origin, clinical presentation, location and type of cysts diagnosed by radiologic imaging, treatment, postoperative morbidity, hospital stay, and outcomes. The diagnosis of echinococcosis was in most cases confirmed by positive serology (Swedish Institute for Infectious Disease Control, Stockholm, Sweden), by microscopy and/or PCR of cyst fluid, or by histological examination of the surgical specimen. Radiologic workup included ultrasonography, computed tomography (CT) or magnetic resonance imaging (MRI). Surgery, medical treatment, and PAIR were all available treatment options for CE in this time-period. All patients were initially evaluated by infectious disease specialists followed by an interdisciplinary discussion with interventional radiologists and hepatobiliary surgeons. The Hospital Review Board approved the study (20/09690) according to the general guidelines provided by the Regional Ethics Committee.