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Almomani MM, Al-Shaikhly FF, Oduibat RT, Al-Adwan AJ, Al-Tarawneh LM. Total Cystectomy in the Management of Primary Retroperitoneal Echinococcal Cysts: Current Evidence and Future Directions. Cureus 2024; 16:e57218. [PMID: 38686260 PMCID: PMC11056284 DOI: 10.7759/cureus.57218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
Echinococcal cysts (ECs) are a significant public health concern globally, particularly in endemic regions. Among these, primary retroperitoneal echinococcal cysts (PRECs) present unique challenges due to their location and complex presentations. Total cystectomy, involving complete removal of the EC and surrounding tissue, is a surgical option for managing PRECs. However, evidence regarding its efficacy and safety is limited. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the role of total cystectomy in managing PRECs. A comprehensive search of databases yielded four relevant studies. These studies reported favorable outcomes following total cystectomy, including low recurrence rates and minimal postoperative complications. However, challenges such as technical complexity and proximity to vital structures were noted. Future research should focus on evaluating minimally invasive approaches, exploring adjuvant therapies, identifying predictors of recurrence, and assessing cost-effectiveness. This systematic review underscores the need for further investigation to optimize the management of PRECs and improve patient outcomes.
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Affiliation(s)
| | | | - Rahaf T Oduibat
- Medicine and Surgery, Jordan University Hospital, Amman, JOR
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Santucciu C, Ferrari PA, Grimaldi G, Murenu A, Nemolato S, Bonelli P, Masala G, Porcu GS, Cherchi R. Environmental Influence on the Occurrence of Multi-Organ Cystic Echinococcosis Infection in a Patient from Sardinia, Italy. Diseases 2023; 11:90. [PMID: 37489442 PMCID: PMC10366914 DOI: 10.3390/diseases11030090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023] Open
Abstract
An uncommon clinical case of an adult woman who was referred to the hospital with severe symptoms attributable to cystic echinococcosis (CE) is described in this report. According to a questionnaire, the subject was exposed to a high risk of infection since she was employed on a farm about 20 years before diagnosis. She lived close to several animal species and handled vegetables in inadequate hygienic conditions. Medical and laboratory investigations confirmed the presence of massive echinococcal cystic lesions in each lung and in the liver. Given the peculiarity of the case, pharmacological and surgical treatments were the only conceivable option. The association of pharmacological treatment, surgery, and interventional radiology procedure represented a reliable and effective way to handle a complex case of human hydatidosis. A multi-disciplinary approach was mandatory, resulting in a clear and conclusive diagnosis of CE caused by the zoonotic parasite E. granulosus sensu stricto of the G1 genotype.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Paolo Albino Ferrari
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Giulia Grimaldi
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Alessandro Murenu
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Sonia Nemolato
- Department of Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Piero Bonelli
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Giuseppe Salvatore Porcu
- Department of Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Roberto Cherchi
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
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Peters L, Burkert S, Hagemann JB, Albes R, Klemptner J, Birkle J, Schwaibold E, Siefermann S, Grüner B. Initial Risk Assessment in Patients with Alveolar Echinococcosis—Results from a Retrospective Cohort Study. Pathogens 2022; 11:pathogens11050557. [PMID: 35631078 PMCID: PMC9144025 DOI: 10.3390/pathogens11050557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Alveolar echinococcosis (AE) is a potentially lethal parasitosis with a broad spectrum of disease dynamics in affected patients. To guide clinical management, we assessed initial prognostic factors for both progressive and controlled AE based on initial staging. Methods: A retrospective cohort study was conducted, examining 279 patients assigned to different clinical groups: cured, stable with and without the need for benzimidazole treatment, and progressive disease. Univariate analysis compared demographic and clinical variables. Significant variables were subsequently entered into two separate logistic regression models for progressive and controlled disease. Results: Based on the multivariate analysis, a large AE lesion (OR = 1.02 per millimetre in size; 95%CI 1.004–1.029), PNM staging (OR = 2.86; 95%CI 1.384–5.911) and especially the involvement of neighbouring organs (OR = 3.70; 95%CI 1.173–11.653) remained significant risk factors for progressive disease. A negative Em2+ IgG (OR = 0.25; 95%CI 0.072–0.835) and a small AE lesion (OR = 0.97; 95%CI 0.949–0.996) were significant protective factors. Conclusions: Patients with large lesions and advanced stages should be monitored closely and most likely require long-term treatment with benzimidazoles if curative resection is not feasible. Patients with small lesions and negative Em2+ IgG seem able to control the disease to a certain extent and a less strict treatment regimen might suffice.
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Affiliation(s)
- Lynn Peters
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
- Correspondence:
| | - Sanne Burkert
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | | | - Rasmus Albes
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | - Jonas Klemptner
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | - Jessica Birkle
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | - Elias Schwaibold
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | - Sofia Siefermann
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
| | - Beate Grüner
- Department of Internal Medicine III, Division of Infectious Diseases, Ulm University Hospital, 89081 Ulm, Germany; (S.B.); (R.A.); (J.K.); (J.B.); (E.S.); (S.S.); (B.G.)
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Sioutis S, Reppas L, Bekos A, Soulioti E, Saranteas T, Koulalis D, Sapkas G, Mavrogenis AF. Echinococcosis of the spine. EFORT Open Rev 2021; 6:288-296. [PMID: 34040806 PMCID: PMC8142696 DOI: 10.1302/2058-5241.6.200130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Echinococcosis or hydatid disease affecting the spine is an uncommon manifestation of Echinococcus granulosus infection of the spine.More commonly found in endemic areas, it causes significant morbidity and mortality as it grows slowly and produces symptoms mainly by compressing the spinal cord.As diagnostic methods are non-specific, diagnosis and management are usually delayed until the disease is advanced, thereby therapy is usually unlikely.Treatment is usually surgical, aiming at cyst excision, spinal cord decompression and spinal stabilization.This article summarizes the clinical findings of echinococcosis of the spine, discusses the specific laboratory and diagnostic findings, lists the current treatment options, and reviews the patients' outcomes.The aim is to prompt clinicians to be aware of the possibility of echinococcosis as a possible diagnosis in endemic areas. Cite this article: EFORT Open Rev 2021;6:288-296. DOI: 10.1302/2058-5241.6.200130.
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Affiliation(s)
- Spyridon Sioutis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Lampros Reppas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Achilles Bekos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Eleftheria Soulioti
- Second Department of Anaesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Theodosis Saranteas
- Second Department of Anaesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Sapkas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas F. Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Superinfection of a Dead Hepatic Echinococcal Cyst with a Cutaneous Fistulization. Case Rep Radiol 2017; 2017:9393462. [PMID: 29181218 PMCID: PMC5664247 DOI: 10.1155/2017/9393462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/06/2017] [Accepted: 09/26/2017] [Indexed: 12/28/2022] Open
Abstract
Cystic echinococcosis (CE), also known as "hydatid disease" (HD), is a zoonotic infection caused by the larval stage of Echinococcus granulosus, which infects humans as intermediate hosts through the orofecal route. Carried by the intestinal venous blood, the embryos released by the eggs of the tapeworms can reach every organ, especially the liver, turning into a hydatid cyst. Usually asymptomatic, the cysts can be incidentally detected through radiological examinations performed for other reasons. We show an unusual case of superinfection of a hydatid cyst with typical radiological features of inactivity (WHO-type CE5) with an even rarer skin fistulization passing through a subcutaneous-abdominal abscess involving the right iliac muscle.
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Echinococcus multilocularis infection in the field vole (Microtus agrestis): an ecological model for studies on transmission dynamics. Parasitol Res 2015; 114:1703-9. [DOI: 10.1007/s00436-015-4355-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/22/2015] [Indexed: 12/11/2022]
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