1
|
Abudouaini H, Zhang X, Dai Y, Meng Y, Lu Q, Ren Q, Sun H, Ma Y, He B, Wang S. Activating the iNOS regulatory pathway by arginine deprivation targets energy metabolism to induce autophagy-dependent apoptosis against spinal echinococcosis. Biochem Pharmacol 2024; 227:116453. [PMID: 39059773 DOI: 10.1016/j.bcp.2024.116453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
Spinal echinococcosis is one of the most overlooked zoonotic parasitic diseases worldwide. There is currently no safe and effective treatment to eradicate it, and research based on the physiological-metabolic signature of the disease is lacking. Herein, we repurposed agrimol B as a potent anti-hydatid compound and validated its pharmacological mechanism based on arginine uptake as a target through multi-omics sequencing. This herbal component suppressed energy metabolism and activated ROS aggregation by inducing mitochondrial membrane potential depolarization, which subsequently triggered autophagy-dependent apoptosis leading to parasite death. Moreover, we discovered that arginine deprivation induced metabolic changes led to a shift from ornithine to nitrogen oxide synthesis, thus boosting the iNOS enzyme-regulated dominant metabolic pathway. The excess NO targeted the mitochondrial respiratory chain complex IV to disrupt energy metabolic homeostasis and induced a downstream pathological waterfall effect to kill the hydatid. A novel metabolic regulatory mechanism targeting mitochondrial damage for arginine starvation therapy was discovered. Finally, arginine depletion was found to be superior to the anti-spinal echinococcosis effect of albendazole and accompanied by the potential for disc protection. This study unveils the role of arginine in the physiological metabolism of Echinococcus granulosus and reveals the value of targeting arginine metabolism as a potential therapy. In addition, agrimol B is proposed as a promising therapeutic strategy for spinal echinococcosis to block arginine uptake and break this parasite's metabolic balance.
Collapse
Affiliation(s)
- Haimiti Abudouaini
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China
| | - Xuefang Zhang
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China
| | - Yi Dai
- The First Affiliated Hospital of Shihezi University, Xinjiang Uygur Autonomous Region, Shihezi City, 832000, China
| | - Yibin Meng
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China
| | - Qing Lu
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China
| | - Qian Ren
- The First Affiliated Hospital of Shihezi University, Xinjiang Uygur Autonomous Region, Shihezi City, 832000, China
| | - Haohao Sun
- The First Affiliated Hospital of Shihezi University, Xinjiang Uygur Autonomous Region, Shihezi City, 832000, China
| | - Yibo Ma
- The First Affiliated Hospital of Shihezi University, Xinjiang Uygur Autonomous Region, Shihezi City, 832000, China
| | - Baorong He
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China.
| | - Sibo Wang
- Department of Spine Surgery, Xi'an Jiaotong University Affiliated HongHui Hospital, Beilin District, Xi'an, Shanxi Province, 710000, China.
| |
Collapse
|
2
|
Fernández Vecilla D, Roche Matheus MP, Nieto Toboso MC, Mongil Escudero R, Miguel Martínez V, Lombide Aguirre I, Baraia-Etxaburu Artetxe JM, Díez Renovales F, Rosselló Soria J, Díaz de Tuesta Del Arco JL. Secondary lumbosacral echinococcosis as presumptive sequelae of other primary locationses. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:199-202. [PMID: 38394350 PMCID: PMC10945099 DOI: 10.37201/req/148.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/15/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Affiliation(s)
- D Fernández Vecilla
- Domingo Fernández Vecilla, Microbiology Service. University Hospital Marqués de Valdecilla. Marqués de Valdecilla Research Institute (IDIVAL). Cantabria, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Weber TF, Mokry T, Stojkovic M. Echinococcoses - A Primer for Radiologists. ROFO-FORTSCHR RONTG 2023; 195:1106-1121. [PMID: 37467780 DOI: 10.1055/a-2114-1980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Cystic (CE) and alveolar (AE) echinococcoses are zoonotic parasitoses that may pose diagnostic problems due to their relative rarity in Middle Europe. METHODS Based on a recent literature search and the observation of casuistics from a national echinococcosis treatment center, epidemiological, radiological, and therapeutic fundamentals are presented and important differences between AE and CE are discussed. RESULTS AND CONCLUSION AE and CE must be regarded as completely different diseases, which differ from each other in every significant aspect. This applies not only to the epidemiological background of the patients but also to the biology of the diseases and their respective imaging features. KEY POINTS · AE and CE are very distinct from one another and must be considered separately.. · AE is endemic in Middle Europe and is known as malignant parasitosis due to its destructive growth form.. · CE is primarily seen in Middle Europe in individuals with migration background and has a rather benign character.. CITATION FORMAT · Weber TF, Mokry T, Stojkovic M. Die Echinokokkosen - Einblicke aus Sicht der Radiologie. Fortschr Röntgenstr 2023; 195: 1106 - 1121.
Collapse
Affiliation(s)
- Tim Frederik Weber
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Theresa Mokry
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
- Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Marija Stojkovic
- Tropical Medicine, Department of Infectiology, University Hospital Heidelberg, Germany
| |
Collapse
|
4
|
Lao X, Hu D, Ji L, Zhan T, Li T, Luo S, Xu X, Zhang C, Chen M. Magnetic resonance imaging and next-generation sequencing for the diagnosis of cystic echinococcosis in the intradural spine: a case report. J Med Case Rep 2023; 17:466. [PMID: 37946273 PMCID: PMC10636940 DOI: 10.1186/s13256-023-04197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/02/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a parasitic zoonotic disease caused by the larval stage of Echinococcus granulosus. The liver and lungs are the most common sites for infection. Infection of the intradural spine is rare. CASE PRESENTATION A 45-year-old woman of Han ethnicity presented with a chronic history of recurrent lumbar pain. Magnetic resonance imaging of the lumbar spine revealed the classical characteristic of multiple cystic lesions of variable sizes, manifesting a "bunch of grapes" appearance, localized within the spinal canal at the L4-L5 vertebral level. In the meanwhile, metagenomic next-generation sequencing identified Echinococcosis granulosa. The patient underwent surgery to remove the cyst entirely and subsequently took albendazole 400 mg orally twice daily for 6 months. CONCLUSION Spinal CE should be suspected in patients with multiple spinal cystic lesions and zoonotic exposure. metagenomic next-generation sequencing serves as a robust diagnostic tool for atypical pathogens, particularly when conventional tests are inconclusive. Prompt and aggressive treatment for spinal cystic echinococcosis is imperative, and further research is warranted for improved diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Xiaojie Lao
- Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Diefei Hu
- Department of Infectious Diseases, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Lei Ji
- Department of Infectious Diseases, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Tingzheng Zhan
- Department of Parasitology, Guangxi Medical University, Nanning, Guangxi, China
| | - Tiantian Li
- Department of Infectious Diseases, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Shuming Luo
- Department of Infectious Diseases, Guangxi Medical University First Affiliated Hospital, Nanning, China
| | - Xianli Xu
- Department of Infectious Diseases, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Chunlan Zhang
- Department of Infectious Diseases, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Maowei Chen
- Department of Infectious Diseases, Wuming Hospital of Guangxi Medical University, Nanning, China.
| |
Collapse
|
5
|
Meng Y, Ren Q, Xiao J, Sun H, Huang Y, Liu Y, Wang S, Wang S. Progress of research on the diagnosis and treatment of bone cystic echinococcosis. Front Microbiol 2023; 14:1273870. [PMID: 37920269 PMCID: PMC10618348 DOI: 10.3389/fmicb.2023.1273870] [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] [Received: 08/07/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Abstract
Bone cystic echinococcosis (CE) is one of the most complex and dangerous of all echinococcoses. The lack of typical imaging features and clinical manifestations makes diagnosis and treatment of this disease difficult. X-ray and computed tomography (CT) images of bone CE are similar to those of bone cysts, giant-cell bone tumors, and bone metastases, but magnetic resonance imaging (MRI) shows good diagnostic value due to excellent soft-tissue imaging features. Serological tests cannot be used as a definitive diagnostic method for bone CE due to cross-reactivity, which can lead to false-positive or false-negative results. The development of novel antigens can open new frontiers in the diagnosis of the disease. Currently, views conflict on how to diagnose and treat bone CE. Both surgical and pharmacological treatments can be used, but determining which is appropriate is difficult due to the different sites and clinical manifestations of bone CE. Radical resection is not indicated for large-bone injuries, and Pharmacotherapy becomes important. This article reviews the progress of research into the pathogenesis and clinical manifestations of, and diagnostic strategies and treatment options for, bone CE. We aimed to provide a reference for clinical diagnosis and -treatment options.
Collapse
Affiliation(s)
- Yibin Meng
- Department of Spine Surgery, Xi’an Jiaotong University Affiliated HongHui Hospital, Xi’an, China
| | - Qian Ren
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Jun Xiao
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Haohao Sun
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Yiping Huang
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Yaqing Liu
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Shan Wang
- Laboratory of Translational Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Sibo Wang
- Department of Spine Surgery, Xi’an Jiaotong University Affiliated HongHui Hospital, Xi’an, China
| |
Collapse
|
6
|
Monge-Maillo B, Lopez-Velez R. Cystic echinococcosis of the bone. Curr Opin Infect Dis 2023; 36:341-347. [PMID: 37593962 DOI: 10.1097/qco.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW Cystic echinococcosis (CE) has a wide world distribution causing important morbidity. Osseous involvement is present in less than 4% of the CE cases. Its diagnosis and therapeutic management is full of challenges and low grade of evidence. RECENT FINDINGS The study summarizes literature evidence on the management of osseous CE with particular emphasis on new data regarding diagnosis and treatment. SUMMARY Clinical presentation of osseous CE depends on the skeletal area affected. Diagnosis is mostly based on radiological findings and serology. Recent advances with qPCR on osseous tissue samples seem to be a good option for diagnosis confirmation. Complete resection of the cystic lesion is the only curative option, but it is usually not possible performing palliative surgery and prolonged albendazole intake in most cases. Radiotherapy could be an option, but experience to date is only based on clinical cases.
Collapse
Affiliation(s)
- Begoña Monge-Maillo
- National Reference Unit for Tropical Diseases. Infectious Diseases Department, Ramón y Cajal University Hospital. IRICYS. CIBERINFEC. Madrid, Spain
| | | |
Collapse
|
7
|
Pour-Rashidi A, Turgut M, Fallahpour M, Mohammadi E, Hanaei S, Rezaei N. Central nervous system hydatidosis around the world: a systematic review. J Neurosurg Sci 2023; 67:653-663. [PMID: 36800683 DOI: 10.23736/s0390-5616.22.05817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Echinococcosis is a chronic disease caused by Echinococcus species. The central nervous system (CNS) hydatidosis is still a major concern, especially in endemic countries, due to non-specific features and late diagnosis and treatment. This study aimed to provide a systematic review to elucidate the epidemiology and clinical characteristics of CNS hydatidosis worldwide over the past decades. EVIDENCE ACQUISITION PubMed, Scopus, EMBASE, Web of Science, Ovid, and Google Scholar were systematically searched. The gray literature and the references of included studies were searched as well. EVIDENCE SYNTHESIS Our results showed that the CNS hydatid cyst was more prevalent in the male gender, and it is known as a recurrent disease with a rate of 26.5%. CNS hydatidosis was more common in the supratentorial region and was also significantly common in developing countries, including Türkiye and Iran. CONCLUSIONS It was demonstrated that the disease would be more prevalent in developing countries. Also, there would be a trend toward a male predominance of CNS hydatid cyst, younger age involvement, and the recurrence rate of 25% in general. There is no consensus about chemotherapy unless in recurrent disease and the patients who experienced cyst rupture intraoperatively, recommended for a wide range of 3 to 12 months.
Collapse
Affiliation(s)
- Ahmad Pour-Rashidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mehmet Turgut
- Department of Neurosurgery, Faculty of Medicine, Aydın Adnan Menderes University, Efeler, Türkiye
- Department of Histology and Embryology, Aydın Adnan Menderes University Health Sciences Institute, Efeler, Türkiye
| | - Mahshid Fallahpour
- Department of Public Health, San Diego State University (SDSU), - University of California San Diego (UCSD), San Diego, CA, USA
| | - Esmaeil Mohammadi
- Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Hanaei
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran -
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
8
|
Belloumi N, Habouria C, Fidha S, Bachouch I, Ben Abdallah FC, Fenniche S. Non-resectable pulmonary alveolar echinococcosis with multi-stage vertebral location. Respir Med Case Rep 2023; 44:101886. [PMID: 37388238 PMCID: PMC10302124 DOI: 10.1016/j.rmcr.2023.101886] [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] [Received: 01/11/2023] [Revised: 04/19/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023] Open
Abstract
Alveolar echinococcosis (also known as Hydatid cyst or Hydatydosis) is a zoonosis with a high degree of disability and morbidity. Bone echinococcosis is a rare presentation. Authors are always defending a personalized approach taking account of the particularities of the cyst location. Recognition of this syndrome is crucial because advances in medical and surgical management strategies have controlled and relieved symptoms in numerous cases. We report, hereby, a case of a patient with a thoracic spine alveolar echinococcosis of an unusual extension. We discussed the outcome of the treatment after fifteen years of follow-up.
Collapse
Affiliation(s)
- N. Belloumi
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| | - C. Habouria
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| | - S. Fidha
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| | - I. Bachouch
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| | - F. Chermiti Ben Abdallah
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| | - S. Fenniche
- Pulmonology department Pavilion 4, Abderrahmen Mami hospital, Ariana, Tunisia
- Faculty of medicine of Tunis, University of Tunis el manar, Tunisia
| |
Collapse
|
9
|
Zali A, Shahmohammadi M, Biazar BH, Masoumi N, Samieefar N, Akhlaghdoust M. Spinal hydatid cyst initially diagnosed as spinal tumor: A case report and review of the literature. Clin Case Rep 2023; 11:e7244. [PMID: 37143458 PMCID: PMC10151595 DOI: 10.1002/ccr3.7244] [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] [Received: 09/17/2022] [Revised: 03/26/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023] Open
Abstract
The spinal hydatid cyst is a benign pathology but has considerable morbidity. It should be considered as a differential diagnosis in patients having signs and symptoms of spinal compression, particularly in endemic areas.
Collapse
Affiliation(s)
- Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of ExcellenceShahid Beheshti University of Medical SciencesTehranIran
- USERN Office, Functional Neurosurgery Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Mohammadreza Shahmohammadi
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of ExcellenceShahid Beheshti University of Medical SciencesTehranIran
| | - Bijan Herfedoust Biazar
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of ExcellenceShahid Beheshti University of Medical SciencesTehranIran
| | - Niloofar Masoumi
- Student Research Committee, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
- USERN OfficeShahid Beheshti University of Medical SciencesTehranIran
- Network of Interdisciplinarity in Neonates and Infants (NINI)Universal Scientific Education and Research Network (USERN)TehranIran
| | - Noosha Samieefar
- USERN OfficeShahid Beheshti University of Medical SciencesTehranIran
- Network of Interdisciplinarity in Neonates and Infants (NINI)Universal Scientific Education and Research Network (USERN)TehranIran
- School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Meisam Akhlaghdoust
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of ExcellenceShahid Beheshti University of Medical SciencesTehranIran
- USERN Office, Functional Neurosurgery Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Network of Interdisciplinarity in Neonates and Infants (NINI)Universal Scientific Education and Research Network (USERN)TehranIran
| |
Collapse
|
10
|
Sun Y, Yan C, Tian D, Zhang C, Zhang Q. Imaging Manifestations and Misdiagnosis Analysis of Six Cases of Bone Hydatid Disease. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:413-417. [PMID: 36588418 PMCID: PMC9806501 DOI: 10.3347/kjp.2022.60.6.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/14/2022] [Indexed: 12/29/2022]
Abstract
We retrospectively evaluated the clinical and imaging features of 6 patients with bone hydatid disease confirmed by surgery and pathological examination. Among the 6 patients, 2 were infected with Echinococcosis granulosus metacestode and 4 were infected with E. multilocularis metacestode. The 2 cases with cystic echinococcosis were diagnosed by computed tomographic (CT) examination, and other 4 cases were diagnosed by magnetic resonance (MR) imaging. On the initial evaluation, 1 case each was misdiagnosed as a giant cell tumor or neurogenic tumor, and 2 were misdiagnosed as tuberculosis. The imaging manifestations of bone hydatid disease are complex, but most common findings include expansive osteolytic bone destruction, which may be associated with sclerosing edges or dead bone formation, localized soft tissue masses, and vertebral lesions with wedge-shaped changes and spinal stenosis. Combining imaging findings with the patient's epidemiological history and immunological examinations is of great help in improving the diagnosis and differential diagnosis of bone hydatid disease.
Collapse
Affiliation(s)
- Yanqiu Sun
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, Qinghai,
China
| | - Chunlong Yan
- Department of Radiology, Jining No.1 People’s Hospital, Jining, Shandong,
China,Graduate school of Soochow University, Suzhou, Jiangsu,
China
| | - Dengfeng Tian
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, Qinghai,
China
| | - Chenhong Zhang
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, Qinghai,
China
| | - Qiang Zhang
- Department of Radiology, Qinghai Provincial People’s Hospital, Xining, Qinghai,
China,Corresponding author ()
| |
Collapse
|
11
|
Samia HR, aicha D, Meriem M, Rabah Y, Imene S, Bousaad H, Chafia T, Ahsene B, Jean G, Saâdia M. Treatment of protoscoleces with gamma radiation: potential immunoprotective effect against experimental murine echinococcosis. Parasite Immunol 2022; 44:e12944. [DOI: 10.1111/pim.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/29/2022] [Accepted: 08/03/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Hadj Rabia Samia
- Department of Nuclear Applications Nuclear Research Center, B.P.43 Sebala‐Draria Algeria
- Laboratory of Biology and Animal Physiology, ENS Kouba Algiers Algeria
| | - Debib aicha
- Laboratory of Management and Valorization of Agricultural and Aquatic Ecosystems (LMVAAE) Morsli Abdallah Tipaza University Center Algeria
| | - Mezaguer Meriem
- Department of ionizing radiation dosimetry Nuclear Research Center, 2bd Frantz Fanon Algiers Algeria
| | - Yefsah Rabah
- Department of Irradiation Technology Nuclear Research Center, 2bd Frantz Fanon Algiers Algeria
| | - Soufli Imene
- Laboratory of Cellular and Molecular Biology Faculty of Biological Science University of Sciences and technology Houari Boumediene, USTHB, PB 32 El‐Alia Algiers Algeria
| | - Hamrioui Bousaad
- Laboratory of Parasitology, Mustapha Bacha Hospital Algiers Algeria
| | - Touil‐Boukoffa Chafia
- Laboratory of Cellular and Molecular Biology Faculty of Biological Science University of Sciences and technology Houari Boumediene, USTHB, PB 32 El‐Alia Algiers Algeria
| | - Baz Ahsene
- Laboratory of Biology and Animal Physiology, ENS Kouba Algiers Algeria
| | - Giaimis Jean
- UMR Qualisud‐Faculty of Pharmacy University of Montpellier I Montpellier France
| | - Mameri Saâdia
- Laboratory of Anatomopathology Mustapha Bacha Hospital Algiers Algeria
| |
Collapse
|
12
|
Akhan O, Yildiz O, Unal E, Yildiz AE, Ciftci TT, Akinci D. Case Report: Imaging-Guided Percutaneous Catheterization and Microwave Ablation of a Bone Hydatid Cyst with Soft-Tissue Component. Am J Trop Med Hyg 2022; 107:tpmd220066. [PMID: 35895346 PMCID: PMC9490662 DOI: 10.4269/ajtmh.22-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/22/2022] [Indexed: 11/07/2022] Open
Abstract
Cystic echinococcosis (CE) of the bone is a rare disease compared with CE of the viscera, and the most involved bony structures are the spine and the pelvis. Both the diagnosis and the treatment of bone CE are challenging for several reasons. The combination of surgery and antimicrobial therapy is the most common approach, the results are far from adequate. Luckily, percutaneous treatment has appeared on the horizon for bone lesions as a more practical option with fewer drawbacks in light of current reports. This article deals with the successful result of ablation-assisted percutaneous treatment of a bone CE lesion and a soft tissue CE lesion treated by modified catheterization technique in a male patient with left hip pain that was unresponsive to previous surgery for CE.
Collapse
Affiliation(s)
- Okan Akhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Oguzhan Yildiz
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emre Unal
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Adalet Elcin Yildiz
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Turkmen Turan Ciftci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Devrim Akinci
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
13
|
Liu P, Feng H, Liu J. A Case of Extensive Thoracolumbar Spinal Intradural Cystic Echinococcosis. World Neurosurg 2022; 165:89-90. [PMID: 35714948 DOI: 10.1016/j.wneu.2022.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022]
Abstract
Spinal cystic echinococcosis (CE) is a rare but devastating form of a neglected parasitic disease caused by the larval stage of the cestode Echinococcus granulosus. CE or hydatid disease, most commonly affects the liver and lungs. Spinal CE occurs in less than 1% of all cases. Patients with cysts confined to the intradural space typically present with neurological impairment due to compression of the spinal cord. We report a case of a 32-year-old woman with unusual, extensive spinal intradural CE, located at the T2 to L5 levels. She was treated with surgical removal of the cystic lesions by laminectomy and instrumentation. Long term oral albendazole was recommended postoperatively. Her status was medically stable at 5-year follow up, but lower limbs paralysis, urinary retention and bowel dysfunction persisted.
Collapse
Affiliation(s)
- Ping Liu
- Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Hailong Feng
- Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Jinping Liu
- Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China.
| |
Collapse
|
14
|
Santos RC, Danda GJDN, Junior AM, Gepp RDA. Spinal hydatid cyst as cause of neurological injury in a patient from Brazilian amazon region. Radiol Case Rep 2022; 17:2238-2242. [PMID: 35496742 PMCID: PMC9039853 DOI: 10.1016/j.radcr.2022.03.102] [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: 03/03/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 11/09/2022] Open
Abstract
Echinococcus granulosus infection is the primary cause of spinal hydatidosis. We describe the case of a 22-year-old man from the Brazilian Amazon region with crural spastic paraparesis and back pain. Radiological examinations showed multilocular lesions involving compression of the thoracic spine and rib injury. The patient underwent vertebrectomy with spinal stabilization and thoracoplasty with resectioning of the costal arch. Subsequently, the patient was prescribed oral treatment with albendazole. Marked recovery of the neurological status was achieved. Bone hydatid disease is rare, accounting for 0.5%-0.4% of all hydatid cysts, affecting the spine in 50% of cases. The treatment of choice is surgery accompanied by antiparasitic medication.
Collapse
|
15
|
Alkan Çeviker S, Yüksel C, Şener A, Önder T, Metineren MH, Özel Ç, Akgül ÖS. Hydatid Cyst of the Spine: A Rare Case Report. TURKIYE PARAZITOLOJII DERGISI 2022; 46:78-81. [PMID: 35232711 DOI: 10.4274/tpd.galenos.2021.29392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hydatid cyst is a zoonotic disease that can affect multiple organs and is difficult to diagnose and treat. Spinal hydatid cyst (SHC) is a rare hydatid cyst involvement observed in 1% of all cases. It can induce various neurological symptoms depending on the region of the involvement. Paraplegia is one of the most prevalent neurological symptoms. In this case report, a 63-year-old male patient with bilateral lower extremity paraplegia was operated on by neurosurgery and diagnosed with SHC at the level of Th 11 vertebra in the pathological examination of surgically removed materials. Thus, we aimed to emphasize the significance of pathological and microbiological examination in the differential diagnosis of spinal disorders.
Collapse
Affiliation(s)
- Sevil Alkan Çeviker
- Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey
| | - Cihan Yüksel
- Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey
| | - Alper Şener
- Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey
| | - Taylan Önder
- Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey
| | - Mehmet Hüseyin Metineren
- University of Health Sciences Turkey, Evliya Çelebi Training and Research Hospital, Physical Therapy and Rehabilition Hospital, Clinic of Pathology, Kütahya, Turkey
| | - Çisil Özel
- Onsekiz Mart University Faculty of Medicine, Department of Microbiology, Çanakkale, Turkey
| | - Ömer Serdar Akgül
- Onsekiz Mart University Faculty of Medicine, Department of Neurosurgery, Çanakkale, Turkey
| |
Collapse
|
16
|
Peña Huertas M, Zafra Martín J, Álvarez García de Quesada I, Díaz Gavela AA, Guerrero Gómez LL, Sánchez García S, Pardo Pérez E, Couñago F, Del Cerro Peñalver E. IJRadiation therapy for recurrent hydatid cyst of the pelvic bone: a case report. Int J Infect Dis 2021; 115:168-170. [PMID: 34883235 DOI: 10.1016/j.ijid.2021.12.313] [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: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Hydatid disease usually affects the liver, but can also extend to other locations, such as the bones. In these cases, complete resection of the bone is considered the only curative approach. However, this is rarely feasible, and patients are left with benzimidazoles as their only option. In this context, there is an evident need for alternative treatments that can improve results. We present the case of a patient with a treatment-refractory hydatid cyst of the bone, who successfully underwent radiotherapy (RT). CASE SUMMARY A 64-year-old woman was diagnosed with a hydatid cyst of the bone in the sacroiliac joint that caused her sciatalgia and paresthesia. She underwent treatment with albendazole and surgery, and was treated with further doses of albendazole after relapsing six months later. After 2 years, she required a new resection, achieving a stable disease for 2 more years. At this point, she began to suffer from more intense pain (visual analogue scale 6/10). Given that further surgery was no longer feasible, she underwent radiotherapy (54 Gy in 27 fractions). No treatment-related toxicity was observed. At 1 month after radiotherapy, the pain had completely disappeared; 9 months later, the patient remains asymptomatic. The titer of anti-Echinococcus-granulosus antibodies and the absolute volume of eosinophils decreased after treatment with radiotherapy. The cyst remains radiologically stable. CONCLUSION Although further studies are needed, radiotherapy seems to be effective for hydatid cysts that are refractory to other treatments.
Collapse
Affiliation(s)
- Marina Peña Huertas
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea, 28670, Madrid, Spain.
| | - Juan Zafra Martín
- Department of Radiation Oncology, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain; Cancer Molecular Biology Group, Section of Immuno-Oncology, Medical Research Center (CIMES), University of Malaga (UMA), Institute of Biomedical Research in Malaga (IBIMA), 29010, Málaga, Spain
| | | | - Ana Aurora Díaz Gavela
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea, 28670, Madrid, Spain; Department of Radiation Oncology, Hospital La Luz, 28003, Madrid, Spain
| | | | | | - Eduardo Pardo Pérez
- Department of Medical Physics and Radiological Protection, Hospital Universitario Quirónsalud Madrid, 28223, Madrid, Spain
| | - Felipe Couñago
- Medicine Department, School of Biomedical Sciences, Universidad Europea, 28670, Madrid, Spain; Department of Radiation Oncology, Hospital La Luz, 28003, Madrid, Spain
| | - Elia Del Cerro Peñalver
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223, Madrid, Spain; Medicine Department, School of Biomedical Sciences, Universidad Europea, 28670, Madrid, Spain; Department of Radiation Oncology, Hospital La Luz, 28003, Madrid, Spain
| |
Collapse
|
17
|
Zhang T, Ma LH, Liu H, Li SK. Incurable and refractory spinal cystic echinococcosis: A case report. World J Clin Cases 2021; 9:10337-10344. [PMID: 34904108 PMCID: PMC8638056 DOI: 10.12998/wjcc.v9.i33.10337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/27/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the incidence and cure rate of spinal hydatidosis are low, the recurrence rate of spinal hydatidosis is high, and the prognosis of spinal hydatidosis is poor. Therefore, we report a typical case of refractory spinal hydatidosis to increase spine surgeons’ awareness of the disease and reduce misdiagnosis and recurrence.
CASE SUMMARY A 48-year-old man presented with back pain, significant weight loss, and paralysis of both lower limbs. The patient was misdiagnosed with spinal tuberculosis in an outside hospital. However, spinal magnetic resonance imaging (MRI) showed hyperintense cystic components on T2-weighted images and hypointensity on T1-weighted images. A lobulated, multiocular, honeycomb-appearance, septated cystic mass protruding intraspinally and compressing the spinal cord at segments T8–T9 was present. Paravertebral polycystic lobular lesions presented as a “bunch of grapes”. The ELISA test result for Echinococcus granulosus was positive. Then, a diagnosis of spinal hydatidosis and lung hydatid disease was made, and the patient underwent left transthoracic approach lobectomy, paravertebral lesion debridement, and subtotal vertebrectomy with vertebral body replacement of segments T8 and T9 by a mesh cage. The patient also underwent albendazole chemotherapy before and after surgery. One year after stopping the drug therapy, the patient developed recurrent T5 vertebral lesions and underwent a second subtotal vertebrectomy surgery. The patient is currently in good condition and is receiving long-term medication and follow-up.
CONCLUSION The MRI feature of a “bunch of grapes” is a typical imaging indication of spinal hydatidosis. Subtotal vertebrectomy is a risk factor for postoperative recurrence. Total spondylectomy makes it possible to cure spinal hydatidosis, but antiparasitic drug therapy is also an important supplementary therapy to multimodal therapy. It is preferable for patients with spinal hydatidosis to receive life-long antiparasitic medication therapy and follow-up.
Collapse
Affiliation(s)
- Tao Zhang
- Department of Spine Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou 730050, Gansu Province, China
| | - Li-Hua Ma
- the First Hospital of Lanzhou University, Lanzhou 730050, Gansu Province, China
| | - Hua Liu
- Department of Spine Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou 730050, Gansu Province, China
| | - Song-Kai Li
- Department of Spine Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese PLA, Lanzhou 730050, Gansu Province, China
| |
Collapse
|
18
|
Luan H, Liu K, Deng Q, Sheng W, Maimaiti M, Guo H, Li H. Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients. Int J Infect Dis 2021; 114:261-267. [PMID: 34775114 DOI: 10.1016/j.ijid.2021.11.014] [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: 07/15/2021] [Revised: 10/02/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate and document the complications and outcomes (bone and functional) of multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis. METHODS From January 2007 to February 2019, the medical records and imaging of all patients with mid or advanced spinal echinococcosis, who were treated by multiple debridement of cavity lesions, were evaluated retrospectively. The Braithwaite and Less classification system of spinal echinococcosis and the Frankel classification system were used to evaluate the results, both preoperatively and postoperatively. RESULTS Between January 2007 and February 2019, 33 patients met the criteria and were included in this study, with a mean postoperative follow-up time of 4.9 (1-10) years. They included 18 males (54.5%) and 15 females (45.4%), with a mean age of 41.5 years (range 23-70 years). A satisfactory recovery of lower-limb motor function was found in 32 patients, while 24 patients (72.7%) presented with recurrence of spinal echinococcosis. CONCLUSIONS Multiple debridement and spinal cord decompression, combined with antiparasitic chemotherapy after surgery, are effective methods for delaying or preventing disease progression or recurrence. A recurrence of infection is common in most cases. CT and MRI are the preferred methods for diagnosing this disease.
Collapse
Affiliation(s)
- Haopeng Luan
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| | - Kai Liu
- Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| | - Qiang Deng
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China.
| | - Weibin Sheng
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| | - Maierdan Maimaiti
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| | - Hailong Guo
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| | - Huaqiang Li
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China
| |
Collapse
|
19
|
Annamalai S, Muthu S, Thakur A, Ramakrishnan E. Novel Multimodal Treatment Regimen for the Management of Primary Sacrococcygeal Cystic Echinococcosis. J Orthop Case Rep 2021; 11:22-26. [PMID: 35415120 PMCID: PMC8930321 DOI: 10.13107/jocr.2021.v11.i11.2500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Osseous hydatidosis is a rare condition most commonly involving the spine. Among spinal segments, sacrococcygeal involvement is even rarer. Moreover, the lesion is more prone to recurrence owing to the infiltrative nature of microvesicular lesions involving the spine. In this case report, we describe an effective multimodal management approach toward the management of primary sacrococcygeal cystic echinococcosis. CASE REPORT A 56-year-old female presented with complaints of severe back pain and urinary incontinence for 3 months. She presented with a slow-onset cauda equina syndrome with radiating pain to both lower limbs. Radiographic evaluation showed an expansile lytic lesion affecting the right iliac wing with near-complete cortical bone destruction of the sacrum. Magnetic resonance imaging revealed neural involvement with sacral destruction by a multiloculated cystic mass, extending to the spinal canal. No coexisting lesions were noted anywhere. Echinococcosis was diagnosed with serum enzyme-linked immunosorbent assay. She underwent neoadjuvant therapy with albendazole and praziquantel, followed by ultrasound-guided percutaneous aspiration injection and reaspiration (PAIR) with hypertonic saline followed by sclerosant (95% ethyl alcohol) into the residual cyst cavity. Later, she open excision of the residual multiloculated cystic mass was performed. Adjuvant medical therapy was continued for 3 months post-surgery. The patient regained her neurological functions by 6 months without any residual sequelae or symptomatic recurrence until 4 years of follow-up. CONCLUSION Multimodal treatment regimen comprising of oral medical therapy by albendazole and praziquantel along with PAIR and surgical in toto excision of the cyst followed by post-operative oral medical therapy for 3 months has given excellent results in sacrococcygeal cystic echinococcosis.
Collapse
Affiliation(s)
- Saravanan Annamalai
- Department of Orthopaedics, KAP Viswanathan Government Medical College, Tiruchirappalli, Tamil Nadu, India
| | - Sathish Muthu
- Department of Orthopaedics, Government Medical College & Hospital, Dindigul, Tamil Nadu, India
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Address of Correspondence: Dr. Sathish Muthu, Department of Orthopaedics, Government Medical College & Hospital, Dindigul, Tamil Nadu, India. E-mail:
| | - Aditya Thakur
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - Eswar Ramakrishnan
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
20
|
Cystic Echinococcosis of the Ilium Treated with Curettage and Microwave Thermoablation Followed by Bone Cement Installation: A Novel Treatment Technique for a Rare Disease. Case Rep Orthop 2021; 2021:5533183. [PMID: 34258091 PMCID: PMC8249124 DOI: 10.1155/2021/5533183] [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: 02/09/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022] Open
Abstract
Bone cystic echinococcosis (CE) is a rare condition requiring a high level of suspicion during primary diagnosis. Wide excision of the lesion is the gold standard of treatment, posing however extreme challenges in certain parts of the skeleton, since it may well be accompanied by increased morbidity. We report the case of a 35-year-old Caucasian female with iliac bone CE, referred to our department (a regional referral center for the treatment of patients with musculoskeletal tumors). The patient reported gradually increasing dull pain at the right iliac fossa and antalgic gait, with an onset of approximately 5 years before her referral. Bone CE diagnosis was established based on physical examination, imaging studies, and two subsequent CT-guided core needle biopsies, performed within a period of 3 months, of which the second was diagnostic. Following a musculoskeletal tumor multidisciplinary meeting, it was decided that the optional treatment was the surgical removal of the cyst. Aiming to minimize the morbidity accompanying a wide resection of the lesion, we performed extended curettage of the lesion through a typical iliac spine approach, followed by microwave ablation of the walls of the remaining bone cavity. The remaining iliac defect was treated with the installation of polymethyl methacrylate bone cement. The patient reported immediate remission of symptoms postoperatively and was able to return to everyday activities two weeks postoperatively. She began oral treatment with albendazole on the 7th postoperative day. She remained symptom-free for a period of 25 months, until she developed a seroma at the gluteal area, which was treated with simple drainage. On her latest follow-up six months later, she remained symptom-free and was able to perform all her previous activities. Microwave ablation may serve as a useful adjuvant modality when treating patients with bone CE, in order to prevent relapse of the disease.
Collapse
|
21
|
Safari H, Mirzavand S, Rafiei A, Beiromvand M. Twenty-six years of involvement with cystic echinococcosis: a case report. J Med Case Rep 2021; 15:266. [PMID: 33980278 PMCID: PMC8114538 DOI: 10.1186/s13256-021-02810-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Spinal hydatidosis, a zoonotic disease caused by infection with Echinococcus spp. larvae, is rare, but its treatment remains a significant medical challenge. Approximately 70% of patients with spinal hydatidosis have lesions in their liver, 0-15% have lung involvement, and only 0.5-2% have bone involvement. CASE PRESENTATION Here we report a 38-year-old Iranian man with spinal hydatidosis, who had a history of eight times surgery in over of 26 years due to hydatid cyst in the liver, lungs, and chest wall. At the most recent admission to hospital he presented with chest pain, paraplegia, and urinary incontinence. Magnetic resonance imaging revealed thoracic spinal hydatid disease. He underwent surgery, and the hydatid cysts were completely removed. Lower extremity forces recovered dramatically and completely within 4 weeks. CONCLUSION Spinal hydatidosis is a rare disease, but it is associated with a high degree of morbidity, mortality, and poor prognosis. Because of the infiltrative nature of hydatid disease, surgery alone is rarely curative. The current case study demonstrates the importance of a suitable surgical approach, adequate intraoperative prophylaxis to prevent cyst rupture, and prolonged complete paraplegia.
Collapse
Affiliation(s)
- Hosein Safari
- Department of Neurosurgery, Golestan Hospital-Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Somayeh Mirzavand
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, P.O. Box 61357-15794, Ahvaz, Khuzestan, Iran
| | - Abdollah Rafiei
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, P.O. Box 61357-15794, Ahvaz, Khuzestan, Iran.,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Molouk Beiromvand
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, P.O. Box 61357-15794, Ahvaz, Khuzestan, Iran. .,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
| |
Collapse
|
22
|
Abstract
PURPOSE OF REVIEW The patient who presents with an acute spinal cord syndrome with weakness/paralysis of the limbs presents a diagnostic. Two important syndromes are acute transverse myelitis (ATM) and acute flaccid paralysis (AFP). Both can be caused by a number of infectious and noninfectious causes. Since 2014 there have been outbreaks of acute flaccid myelitis (a subgroup of AFP) in the United States, with a national surveillance program underway. In addition, there have been increasing reports of ATM from new and emerging pathogens, and opportunistic infections in immunocompromised hosts. RECENT FINDINGS Infectious causes of ATM or AFP need to be ruled out first. There may be important clues to an infectious cause from epidemiologic risk factors, immune status, international travel, MRI, and laboratory findings. We summarize key features for the more common pathogens in this review. Advances in laboratory testing have improved the diagnostic yield from cerebrospinal fluid, including real-time polymerase chain reaction, metagenomic next-generation sequencing, and advanced antibody detection techniques. These tests still have limitations and require clinical correlation. SUMMARY We present a syndromic approach to infectious myelopathies, focusing on clinical patterns that help narrow the diagnostic possibilities.
Collapse
|
23
|
Sadjjadi FS, Ahmadi N, Rezaie-Tavirani M, Zali H. Following up of Surgical Treated Human Liver Cystic Echinococcosis: A Proteomics Approach. IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:11-22. [PMID: 33786043 PMCID: PMC7988678 DOI: 10.18502/ijpa.v16i1.5507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Cystic echinococcosis (CE) is one of the most important parasitic zoonosis in the world. Post-surgery follow up in CE patients is an important non-solved problem up to now. Therefore, the investigations on this problematic issue would be very applicable in the view of CE clinical treatment. Methods: A total of 24 confirmed liver CE patients sera including eight sera before surgery (BS), eight sera three months post-surgery (3MPS), and eight sera six months post-surgery (6MPS) were used in the present study. Proteomics methods including 2DE and LC-MS/MS were performed on the specimens followed by bioinformatics analysis such as Gene Ontology (GO) and Protein-Protein Interaction (PPI) network analysis. Results: A total of 235 proteins were detected of which 12 differentially expressed proteins (DEP) were identified by LC-MS/MS in all sera. The proteins were presented in BS and suppressed after surgery as follows: HPX, SERPINA1, SERPINC1, CP, HBD, and HBA2. Comparisons of the protein expression in sera of patients BS, 3MPS, and 6MPS revealed that GC, IGJ, AHSG, CD5L, FGG, and APOC3 have been overexpressed in 3MPS and 6MPS. PPI network analysis demonstrated that SERPINC1 and AHSG with more connection in the network could be considered as hub proteins and potential prognostic biomarkers in response to surgical treatment of liver CE. Conclusion: Application of proteomics methods on patient’s sera could be used as a novel biomarker tool for following-up liver CE patients. In this regards, proteomics and, application of bioinformatics analysis including GO and PPI showed that SERPINC1, AHSG and HPX are of more value as a potential follow up biomarkers in response to surgical treatment.
Collapse
Affiliation(s)
- Fatemeh Sadat Sadjjadi
- Department of Basic Sciences, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nayebali Ahmadi
- Proteomics Research Center, Department of Medical Lab Technology, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Rezaie-Tavirani
- Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hakimeh Zali
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
An Intraoperative Surprise! A Rare Case Report of Primary Craniovertebral Junction Hydatid Disease Mimicking a Bony Tumor. World Neurosurg 2020; 146:171-176. [PMID: 33220475 DOI: 10.1016/j.wneu.2020.11.072] [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: 07/31/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Craniovertebral junction (CVJ) hydatid disease, although rare, forms an important differential diagnosis of CVJ bony pathologies, especially in endemic areas due to the sheer volume of cases presented there. The authors report a rare case of CVJ hydatid disease mimicking a bony expansile tumor on imaging. CASE DESCRIPTION A 21-year-old woman presented with a left-sided neck tilt and pain for 3 months, intermittent low-grade fever, and features of high cervical myelopathy (Nurick grade II). Magnetic resonance imaging and computed tomography imaging showed a solid enhancing mass with numerous small cystic areas with bony erosion of the basiocciput, C1 and C2 vertebrae, suggestive of an expansile bony lesion (osteoblastoma/giant cell tumor/aneurysmal bone cyst). She underwent a posterior approach for decompression and spinal fixation, and multiple clear grape-like cysts were encountered that were confirmed to be hydatid cysts on histopathology. All visible cysts were excised and instrumented fusion of the CVJ performed. Albendazole was continued for 6 weeks and at 3 months' follow-up, the patient remains asymptomatic with no recurrence on imaging. CONCLUSIONS The authors conclude that in tropical regions, hydatid disease of the cervical spine should be considered in the differential diagnosis of patients presenting with high cervical compressive myelopathy, especially when associated with fever. Spinal hydatosis may mimic a bony lesion on imaging and should be kept in mind, as in addition to routine decompression, use of scolicidal agents and intact removal of cysts have a significant effect on reducing the recurrence rate and improving the outcome.
Collapse
|
25
|
Outcomes of Radiotherapy for Osseous Echinococcosis of Meriones meridianus. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6457419. [PMID: 32879885 PMCID: PMC7448241 DOI: 10.1155/2020/6457419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/28/2022]
Abstract
Background Osseous cyst echinococcosis (CE) is an infectious disease that causes disability and deformity in patients, yet there is still no satisfactory treatment. Focusing on the feasibility and prognosis of radiotherapy as an adjuvant or palliative treatment for osseous CE, this study investigated the outcome of Meriones meridianus with osseous CE after radiotherapy. Methods The study utilized a comparison control group design with three groups of gerbils, and 240 osseous CE gerbils were randomly divided into control, 40Gy/5times, and 50Gy/5times groups. Different doses of radiotherapy were given to the gerbils, and then, the effects of radiotherapy on gerbils and lesions were observed at 3 and 6 months after radiotherapy. Statistical analysis was done using χ2 test, unpaired t-test, and one-way ANOVA. Results Significant changes (P < 0.05) were achieved between the three groups in terms of seven parameters at 3 and 6 months, including the number of dead gerbils and lesion sites with ulceration and infection, number of dead scolices, protein content, Ca2+ concentration, the maximum diameter of lesion site, and wet weight of cysts. Except for the number of dead gerbils and lesion sites with ulceration and infection, all other parameters were observed a big difference between 3 months and 6 months in the 50Gy/5times group. Conclusion Radiotherapy at a dose of 50 Gy has inhibitory and therapeutic effects on osseous CE in gerbils, and radiotherapy could probably be a treatment option for persistent or recurrent osseous CE.
Collapse
|
26
|
Llenas-García J, Hurtado R, Lenghel FO, Reyes-Casado Y, Sevilla-Monllor A, Saura-Sánchez E. An Unusual Cause of Chronic Back Pain in a Migrant From Western Sahara. Clin Infect Dis 2020; 68:2131-2134. [PMID: 31143946 DOI: 10.1093/cid/ciy704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jara Llenas-García
- Internal Medicine Department, Hospital Vega Baja, Alicante, Spain.,Infectious Diseases Division, Hospital Vega Baja, Alicante, Spain
| | - Roberto Hurtado
- Internal Medicine Department, Hospital Vega Baja, Alicante, Spain
| | | | | | - Alexandra Sevilla-Monllor
- Traumatology and Orthopedic Surgery Department, Hospital General Universitario de Elche, Alicante, Spain
| | - Eladio Saura-Sánchez
- Traumatology and Orthopedic Surgery Department, Hospital General Universitario de Elche, Alicante, Spain
| |
Collapse
|
27
|
Schleenvoigt BT, Theis B, Wüst M, Forstner C, Pletz MW, Hagel S. Intermittent pain of the pelvis in a Syrian woman. PLoS Negl Trop Dis 2020; 14:e0008183. [PMID: 32555592 PMCID: PMC7302433 DOI: 10.1371/journal.pntd.0008183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Benjamin T. Schleenvoigt
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
- * E-mail:
| | - Bernhard Theis
- Section Pathology of the Institute of Forensic Medicine, Jena University Hospital, Jena, Germany
| | - Michaela Wüst
- Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Christina Forstner
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Mathias W. Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Stefan Hagel
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| |
Collapse
|
28
|
Zahran F, Ezz El-Din HM, Shehata MAS. Study on the effect of an ion channel inhibitor "Fluralaner" on Echinococcus granulosus protoscolices and metacestode layers in vitro. J Parasit Dis 2020; 44:411-419. [PMID: 32508416 DOI: 10.1007/s12639-020-01224-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/12/2020] [Indexed: 02/05/2023] Open
Abstract
Hydatid disease has a great impact on public health, causing high morbidity and mortality. Main lines of treatment include surgery, which mostly requires the installation of a scolicidal agent into hydatid cysts to prevent dissemination. Alternatively, medical treatment involves the use of benzimidazole drugs; however, the results are not satisfactory, and new drug compounds are urgently needed. Fluralaner is a potent inhibitor of GABA-gated chloride channels and L-glutamate-gated chloride channels (GluCls) providing immediate and persistent flea, tick and mite control in dogs after a single oral dose. Researches previously identified different genes encoding ion channels in Echinococcus granulosus, making ion channel inhibitors a promising target for treating hydatid disease. Thus, the present study aimed to evaluate the effect of fluralaner on protoscolices and metacestode layers. Parasite materials (Protoscolices, Metacestodes layers) were exposed to different concentrations of the drug ranging from "12.5-100 ug/ml" and examined for viability after 1, 6 and 24 h. Morphological and ultrastructural alterations were recorded by both light and electron microscopies. Immunohistochemical staining confirmed caspase-3 activation as an indicator of apoptosis- induced therapy. The treated protoscolices and metacestode layers showed loss of the viability, the formation of vacuoles and lipid droplets, separation of the germinal layer, and damage in the laminated layer; apoptosis was prominent after treatment. These findings revealed that fluralaner has a potent scolicidal activity and suggested its therapeutic potential against hydatid disease. Further evaluations for animals and human use in the treatment and prevention of hydatid disease are needed.
Collapse
Affiliation(s)
- Fatima Zahran
- Faculty of Medicine, Ain-Shams University, Ramsis St., Abbassia, Cairo, 11591 Egypt
| | | | | |
Collapse
|
29
|
Majmundar N, Patel PD, Dodson V, Tran A, Goldstein I, Assina R. Parasitic infections of the spine: case series and review of the literature. Neurosurg Focus 2020; 46:E12. [PMID: 30611161 DOI: 10.3171/2018.10.focus18472] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/26/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVEAlthough parasitic infections are endemic to parts of the developing world and are more common in areas with developing economies and poor sanitary conditions, rare cases may occur in developed regions of the world.METHODSArticles eligible for the authors' literature review were initially searched using PubMed with the phrases "parasitic infections" and "spine." After the authors developed a list of parasites associated with spinal cord infections from the initial search, they expanded it to include individual diagnoses, using search terms including "neurocysticercosis," "schistosomiasis," "echinococcosis," and "toxoplasmosis."RESULTSTwo recent cases of parasitic spinal infections from the authors' institution are included.CONCLUSIONSKey findings on imaging modalities, laboratory studies suggestive of parasitic infection, and most importantly a thorough patient history are required to correctly diagnose parasitic spinal infections.
Collapse
|
30
|
Manenti G, Censi M, Pizzicannella G, Pucci N, Pitocchi F, Calcagni A, Amico A, Collura A, Ryan CP. Vertebral hydatid cyst infection. A case report. Radiol Case Rep 2020; 15:523-527. [PMID: 32153692 PMCID: PMC7057157 DOI: 10.1016/j.radcr.2020.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/09/2020] [Accepted: 01/21/2020] [Indexed: 12/02/2022] Open
Abstract
Hydatidosis is a common parasitic zoonosis in Middle Eastern, African, and Mediterranean populations whit primarily and well known involve of liver and lungs, but some complications are extremely rare and underrated. Particularly Hydatid cystic disease of the skeletal is one of the rarest clinical manifestations and when occurs involve in almost 50% of cases the spine. This manifestation is extremely debilitating, hard to correctly identify and manage. We want to underline this rare involve of spine to avoid misdiagnosis and complications.
Collapse
Affiliation(s)
| | | | | | | | | | - Antonello Calcagni
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome “Tor Vergata”, Viale Oxford 81, 00133 Rome, Italy
| | | | | | | |
Collapse
|
31
|
Cattaneo L, Manciulli T, Cretu CM, Giordani MT, Angheben A, Bartoloni A, Zammarchi L, Bartalesi F, Richter J, Chiodini P, Godbole G, Junghanss T, Stojkovic M, Sammarchi L, Dore R, Vercelli A, Benazzo F, Cuzzocrea F, Tamarozzi F, Brunetti E. Cystic Echinococcosis of the Bone: A European Multicenter Study. Am J Trop Med Hyg 2020; 100:617-621. [PMID: 30693857 DOI: 10.4269/ajtmh.18-0758] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus. In humans, the infection induces the formation of parasitic cysts mostly in the liver and lungs, but virtually any organ can be affected. CE of the bone is one of the rarest forms of the disease, yet it is also extremely debilitating for patients and hard to manage for clinicians. Unlike abdominal CE, there is currently no expert consensus on the management of bone CE. In this study, we conducted a survey of the clinical records of seven European referral centers for the management of patients with CE and retrieved data on the clinical management of 32 patients with a diagnosis of bone CE. Our survey confirmed that the patients endured chronic debilitating disease with a high rate of complications (84%). We also found that diagnostic approaches were highly heterogeneous. Surgery was extensively used to treat these patients, as well as albendazole, occasionally combined with praziquantel or nitaxozanide. Treatment was curative only for two patients, with one requiring amputation of the involved bone. Our survey highlights the need to conduct systematic studies on bone CE, both retrospectively and prospectively.
Collapse
Affiliation(s)
- Letizia Cattaneo
- Department of Clinical, Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
| | - Tommaso Manciulli
- PhD School of Experimental Medicine, University of Pavia, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
| | - Carmen-Michaela Cretu
- Parasitology Department, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Andrea Angheben
- Centre for Tropical Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Alessandro Bartoloni
- Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Lorenzo Zammarchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Filippo Bartalesi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin, Berlin, Germany
| | - Peter Chiodini
- Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom
| | - Gauri Godbole
- Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom
| | - Thomas Junghanss
- Section of Clinical Tropical Medicine, University Hospital, Heidelberg, Germany
| | - Marija Stojkovic
- Section of Clinical Tropical Medicine, University Hospital, Heidelberg, Germany
| | - Luigi Sammarchi
- Division of Radiology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Roberto Dore
- Department of Radiology, Istituti Clinici di Pavia e Vigevano, University Hospital, Pavia, Italy
| | - Alessandro Vercelli
- Department of Radiology, Istituti Clinici di Pavia e Vigevano, University Hospital, Pavia, Italy
| | - Francesco Benazzo
- Division of Orthopedics and Traumatology, IRCCS San Matteo Hospital Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
| | - Fabrizio Cuzzocrea
- Division of Orthopedics and Traumatology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Francesca Tamarozzi
- Centre for Tropical Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Enrico Brunetti
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
| |
Collapse
|
32
|
Liang Q, Xiang H, Xu L, Wen H, Tian Z, Yunus A, Wang C, Jiang D, Abuduwaili M, Chen J, Song X. Treatment experiences of thoracic spinal hydatidosis: a single-center case-series study. Int J Infect Dis 2019; 89:163-168. [DOI: 10.1016/j.ijid.2019.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/22/2019] [Accepted: 09/25/2019] [Indexed: 12/27/2022] Open
|
33
|
Affiliation(s)
- Brett S Mansfield
- Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.,Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kim Pieton
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sugeshnee Pather
- Division of Anatomical Pathology, National Health Laboratory Services, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| |
Collapse
|
34
|
Haleem S, Niaz S, Qureshi NA, Ullah R, Mahmood HM, Shahat AA. Phytochemical analysis, Antioxidant and Antiprotoscolices potential of ethanol extracts of selected plants species against Echinococcus granulosus: In-vitro study. OPEN CHEM 2019. [DOI: 10.1515/chem-2019-0099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AbstractCystic Echinococossis is a serious zoonotic parasitic infection caused by Echinococcus granulosus species complex. The current study was designed to evaluate the in-vitro antiprotoscolices effect of alcoholic extracts of three selected medicinal plants including Buxus Wallichiana, Berberis vulgaris and Euphorbia heliscopia against Echinococcus granulosus. Fertile hydatid cysts were collected from livestock and viability of the protoscolices was confirmed by 0.1% eosin red stain method. Protoscolices were subjected to three different concentrations of alcoholic extracts (10mg/ml, 30mg/ ml and 50mg/ml) for 10, 20 and 30 min. The highest efficacy was shown by B. vulgaris (97.92%) followed by B. wallichiana (65.98%) and E. heliscopia (61.22%) respectively, after exposure of 30 minutes at 50mg/ml concentration, that lead to the significant reduction in the viability of protoscolices. Alkaloids, flavonoids, tannins and saponnins were identified qualitatively and weighted quantitatively, that might help in the identification of bioactive compounds involved in selective action on the tegument layer of protoscolices. Alcoholic extracts of all the three selected medicinal plants showed toxic activities against protoscolices of Echinococcus granulosus. These findings suggest that all the selected medicinal plants could be a promising source of potent antiprotoscolices effect. However, the mechanism by which plant extracts killed protoscolices and also their safety for living cells are unclear and need to be investigated further.
Collapse
Affiliation(s)
- Sumbal Haleem
- Department of Zoology, Abdul Wali Khan University Mardan, KPK, Pakistan
- Department of Zoology, Kohat University of science and Technology, Kohat, KPK, Pakistan
| | - Sadaf Niaz
- Department of Zoology, Abdul Wali Khan University Mardan, KPK, Pakistan
| | | | - Riaz Ullah
- Department of Pharmacognosy (Medicinal, Aromatic & Poisonous Plants Research Center (MAPPRC), College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh11451, Saudi Arabia
| | - Hafiz Majid Mahmood
- Department of Pharmacology, College of Pharmacy, King Saud UniversityPO box 2457, Riyadh11451, Saudi Arabia
| | - Abdelaaty A. Shahat
- Department of Pharmacognosy (Medicinal, Aromatic & Poisonous Plants Research Center (MAPPRC), College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh11451, Saudi Arabia
| |
Collapse
|
35
|
Abstract
PURPOSE OF REVIEW This review draws attention to patients with cystic echinococcosis migrating from highly endemic to non-endemic countries with limited experience in cystic echinococcosis management, to ultrasound-based cyst staging, and to the WHO cyst classification as a powerful, to date underused tool to triage patients into the four currently available treatment modalities. RECENT FINDINGS In non- and low-prevalence countries, cystic echinococcosis is often misclassified. Differential diagnoses, such as simple cysts and other benign and malignant space-occupying lesions, have similar appearances on imaging. Serology is confirmatory but often disappointing due to sensitivity and specificity problems. There is increasing confidence in assigning uncomplicated cystic echinococcosis cysts to the four treatment modalities [drug treatment (benzimidazoles), percutaneous methods, surgery, watch and wait] on the basis of cyst stage (WHO cyst classification), size and location. However, current best practice is still not widely implemented outside cystic echinococcosis treatment centres, and further consolidation is needed by well-designed clinical trials. Recently published long-term follow-up studies have shown that patients with inactive cyst stages CE4 and CE5 benefit, especially since they do not need any treatment at all if they have not received prior benzimidazole or percutaneous therapy. Instead, cysts that have reached cyst stages CE4 and CE5 through drug treatment do need careful follow-up as they often relapse. Surgical procedures in which the cysts are opened and percutaneous approaches require very careful control of cyst content spillage to the peritoneum, pleura and intravascularly to prevent dissemination - a still too often neglected issue with severe consequences for patients. SUMMARY Though a neglected disease with predominantly expert-opinion-based treatment strategies, cystic echinococcosis patients can greatly benefit from interdisciplinary management in cystic echinococcosis treatment centres and cyst-stage-based assignment of treatment modalities. Increased suspicion for cystic echinococcosis in migrants from endemic to non-endemic countries is urgently needed at the current level of global mobility.
Collapse
|
36
|
Caglar YS, Ozgural O, Zaimoglu M, Kilinc C, Eroglu U, Dogan I, Kahilogullari G. Spinal Hydatid Cyst Disease : Challenging Surgery - an Institutional Experience. J Korean Neurosurg Soc 2019; 62:209-216. [PMID: 30840976 PMCID: PMC6411577 DOI: 10.3340/jkns.2017.0245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 04/25/2018] [Indexed: 12/27/2022] Open
Abstract
Objective Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2–1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst.
Methods Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined.
Results Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10–156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic).
Conclusion The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.
Collapse
Affiliation(s)
- Yusuf Sukru Caglar
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Onur Ozgural
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Murat Zaimoglu
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Cemil Kilinc
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Umit Eroglu
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Ihsan Dogan
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Gokmen Kahilogullari
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| |
Collapse
|
37
|
Kurz K, Schwabegger A, Schreieck S, Zelger B, Weiss G, Bellmann-Weiler R. Cystic echinococcosis in the thigh: a case report. Infection 2018; 47:323-329. [DOI: 10.1007/s15010-018-1255-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 11/21/2018] [Indexed: 12/30/2022]
|
38
|
Cystic Echinococcosis of the Bone in Kazakhstan. Case Rep Infect Dis 2018; 2018:9682508. [PMID: 30319824 PMCID: PMC6167588 DOI: 10.1155/2018/9682508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/05/2018] [Indexed: 12/30/2022] Open
Abstract
Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease.
Collapse
|
39
|
Incidence, Risk Factors, and Epidemiology of Cystic Echinococcosis: A Complex Socioecological Emerging Infectious Disease in Khyber Pakhtunkhwa, Province of Pakistan. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5042430. [PMID: 30276210 PMCID: PMC6157112 DOI: 10.1155/2018/5042430] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/21/2018] [Accepted: 08/19/2018] [Indexed: 02/07/2023]
Abstract
Cystic echinococcosis is a serious zoonotic disease caused by Echinococcus granulosus species complex. The current study is the first attempt to determine the level of infection in domestic livestock and to explore the CE-related knowledge and awareness among livestock farmers in different districts of Khyber Pakhtunkhwa, province of Pakistan. A total of 1297 animals were examined for hydatid cysts including 538 cows, 428 buffaloes, 208 sheep, and 123 goats, at different slaughter houses in different districts of Khyber Pakhtunkhwa in 2 years from September 2015 to September 2017. For epidemiological investigations, prevalence in association with various factors (climate, age, and gender), organ specificity, types of cysts (fertile, sterile, or calcified), and viability of cysts parameters was recorded. Basing on the results obtained, areas with high prevalence were selected for further follow-ups and administration of questionnaires to the farmers and dog owners, to provide baseline data about this parasitic disease and to identify potential areas of emergence with correspondence animal and of public health significance. The finding of this study revealed the presence of CE in livestock of KP, Pakistan. The prevalence of hydatid cysts was the highest in buffaloes (15.88%) followed by cows (15.79%), sheep (15.38%), and goats (3.25%). Our investigation revealed close relationship between prevalence and animal age and gender in different months of the year. These findings also showed the highest prevalence of hydatid cysts in liver (63.49%), followed by lungs (23.80%) and mesentery (2.64%). Fertile and viable cysts were observed in all animal species except goats. The highest percentage of fertile and viable cysts was reported from the liver and lungs of sheep. For evaluation of risk factors, a total of 384 respondents were investigated. The results of current study revealed that 97.9% of farmers are not familiar with CE and transmission of this infection from dogs to human and livestock. The present study shows that CE will continue to be of medical and veterinary importance in Pakistan.
Collapse
|
40
|
Monge-Maillo B, Chamorro Tojeiro S, López-Vélez R. Management of osseous cystic echinococcosis. Expert Rev Anti Infect Ther 2017; 15:1075-1082. [PMID: 29110551 DOI: 10.1080/14787210.2017.1401466] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Osseous cystic echinococcosis (CE) is one of the most complicated and devastating conditions caused by Echinococcus granulosus. Its management is difficult and there is scant literature about it. Areas covered: A literature review was performed to provide an update on its diagnosis, treatment and follow-up. Expert commentary: In most cases diagnosis of osseous CE can only be confirmed by surgery. Osseous CE should be managed by experienced physicians and addressed as a chronic disease with therapies must be aimed at controlling the disease and its sequels or complications, rather than with a curative intent.
Collapse
Affiliation(s)
- Begoña Monge-Maillo
- a National Referral Unit for Tropical Diseases. Infectious Diseases Department , Ramón y Cajal University Hospital, IRICYS , Madrid , Spain
| | - Sandra Chamorro Tojeiro
- a National Referral Unit for Tropical Diseases. Infectious Diseases Department , Ramón y Cajal University Hospital, IRICYS , Madrid , Spain
| | - Rogelio López-Vélez
- a National Referral Unit for Tropical Diseases. Infectious Diseases Department , Ramón y Cajal University Hospital, IRICYS , Madrid , Spain
| |
Collapse
|
41
|
Gezercan Y, Ökten AI, Çavuş G, Açık V, Bilgin E. Spinal Hydatid Cyst Disease. World Neurosurg 2017; 108:407-417. [PMID: 28899836 DOI: 10.1016/j.wneu.2017.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/01/2017] [Accepted: 09/02/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE A hydatic cyst (HC) is a zoonotic infection affecting the liver and lungs, with rare spinal involvement. We discuss the long-term results in 8 patients with spinal HC who were monitored at our clinic for 7 to 15 years. METHODS The demographic data and clinicopathologic characteristics of 8 patients with spinal HC diagnosed between 2000 and 2016 were evaluated for their contribution to recurrence, and the long-term follow-up results were examined. RESULTS Four male and 4 female patients with a median age of 30.75 years (range, 17-45 years) at the first surgery were included. Infections were localized in the thoracic (3), thoracolumbar (1), lumbar (1), sacral (1), cervicothoracic (1), and lumbosacral (1) regions. Two patients had secondary HCs that spread from another organ (lung and kidney). Patients underwent 2 to 5 surgeries during the study period, with an average follow-up time of 8.5 years (range, 7-15 years) after the first surgery. The surgical treatments included an anterior corpectomy and anterior plate for a patient with cervical localization and cystectomy for a patient with sacral localization; the other patients underwent cystectomy with corpectomy and stabilization with an anterior approach, cyst excision and laminectomy with a posterior approach, or additional posterior transpedicular screw stabilization. The patients were prescribed albendazole. CONCLUSIONS Spinal HC treatment is difficult, particularly in patients with vertebral and paraspinal involvement, spinal instability, and recurrence. Long-term follow-up is critical, and patients require medical and surgical treatment, with regular clinical, radiologic, and serologic examinations. The cysts must be removed without rupture during surgery, and the surgical area must be irrigated with hypertonic saline solution to reduce the risk of recurrence.
Collapse
Affiliation(s)
- Yurdal Gezercan
- Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Ali Ihsan Ökten
- Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Gökhan Çavuş
- Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey.
| | - Vedat Açık
- Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Emre Bilgin
- Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey
| |
Collapse
|
42
|
Meinel TR, Gottstein B, Geib V, Keel MJ, Biral R, Mohaupt M, Brügger J. Vertebral alveolar echinococcosis-a case report, systematic analysis, and review of the literature. THE LANCET. INFECTIOUS DISEASES 2017; 18:e87-e98. [PMID: 28807628 DOI: 10.1016/s1473-3099(17)30335-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/13/2017] [Accepted: 05/11/2017] [Indexed: 01/03/2023]
Abstract
Alveolar echinococcosis caused by Echinococcus multilocularis is an infrequent zoonosis with a high degree of disability, morbidity, and mortality, especially in disease clusters of the northern hemisphere. The diagnosis is complicated by extended incubation time, diverse clinical manifestations, and mimicking of differential diagnoses. The primary organ affected is the liver, but extrahepatic disease is possible, with vertebral involvement in only a few dozen cases described worldwide. Although vertebral alveolar echinococcosis seems to be rare, it might be under diagnosed, and it might be seen more often as the number of people with immunocompromised conditions increases. Recognition of this syndrome is crucial, because advances in medical and surgical management strategies since the introduction of benzimidazole in 1976 have controlled and relieved symptoms in most cases. In this Grand Round, we present the case of a 75-year-old woman who was referred for biopsy of a lumbar lesion 3 months after she was diagnosed with chronic myeloid leukaemia. The diagnosis of hepatic alveolar echinococcosis with metastasis to the lumbar spine and paravertebral region as well as the brain was confirmed by biopsy, PCR, and serology. The patient was given albendazole and referred for palliative surgery with the aim of pain control. Clinical features of the case are presented and discussed in the context of the literature. This case and review illustrate the complexity of extrahepatic alveolar echinococcosis manifestations and the necessity of an interdisciplinary approach.
Collapse
Affiliation(s)
| | - Bruno Gottstein
- Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Vanessa Geib
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland
| | - Marius Johann Keel
- Department of Orthopedic Surgery, Bern University Hospital, Inselspital, Bern, Switzerland; Trauma Center Hirslanden, Clinic Hirslanden, Zurich, Switzerland
| | | | - Markus Mohaupt
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland
| | - Jan Brügger
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland.
| |
Collapse
|
43
|
Sridharan S, Jagan Narayana GS, Chidambaram K, Jayachandiran AP. Primary Paraspinal Hydatidosis Causing Acute Paraplegia. J Neurosci Rural Pract 2017; 8:472-474. [PMID: 28694639 PMCID: PMC5488580 DOI: 10.4103/jnrp.jnrp_513_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The zoonotic infection hydatidosis is caused by the tapeworm cestode, Echinococcus granulosus. Though considered endemic in India where association of humans with sheep and dogs form part of the livelihood, primary skeletal muscle involvement of the disease is an extremely rare event. We report a case of primary paraspinal hydatidosis with extradural extension causing acute paraplegia. Excision of the cyst and decompression of the cord was done along with albendazole therapy. Paraspinal hydatid disease is a rare entity, and in regions where hydatid disease is endemic, it can be involved in the differential diagnosis of acute compressive myelopathy. Although antihelminthic chemotherapy forms the mainstay of the treatment, surgical intervention forms a major part of the management.
Collapse
Affiliation(s)
- Srihari Sridharan
- Department of Neurosurgery, Institute of Neurosurgery, Madras Medical College, Chennai, Tamil Nadu, India
| | - G S Jagan Narayana
- Department of Neurosurgery, Institute of Neurosurgery, Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Anand Prasath Jayachandiran
- Department of General Surgery, Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
| |
Collapse
|
44
|
Toğral G, Arıkan ŞM, Ekiz T, Kekeç AF, Ekşioğlu MF. Musculoskeletal Hydatid Cysts Resembling Tumors: A Report of Five Cases. Orthop Surg 2017; 8:246-52. [PMID: 27384735 DOI: 10.1111/os.12246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 02/13/2016] [Indexed: 12/27/2022] Open
Abstract
Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce. This paper presented 5 patients (3 males, 2 females) with a mean age of 41.6 years with tumor-like lesions of HC. Three of them had left ilium and acetabulum involvement, one involved left femur, and one involved left thigh muscle compartments. Pain was the main symptom and was seen in all patients. Clinical examination, radiologic evaluation, and histologic analysis were performed for diagnosis. Patients were treated through different surgical options, including simple debridement, bone cement filling with or without internal fixation, hip arthrodesis, reconstruction using hemipelvic replantation with femoral prosthesis and distal femur endoprosthetic replacement. After surgery, the operation region was washed by 20% hypertonic saline, and debridement was performed carefully without contamination. All patients received albendazole treatment. Cases were followed up 1 to 9 years for the recurrence. Walking difficulty and pain were the main symptoms during the follow-up. One patient was symptom-free. A reoccurrence in the perioperative soft tissue was detected in only one patient and control visits with antihelmintic treatment were recommended. We would like to emphasize that HC should be kept in mind for the differential diagnosis of the cystic or tumoral lesions of the musculoskeletal system, particularly in the endemic regions. Prompt diagnosis is of paramount importance for preventing destruction and complications.
Collapse
Affiliation(s)
- Güray Toğral
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Şefik M Arıkan
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Timur Ekiz
- Department of Physical and Rehabilitation Medicine, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Ahmet F Kekeç
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet F Ekşioğlu
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
45
|
Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 258] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
Collapse
Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
| |
Collapse
|
46
|
Mon ST, Li Y, Shepherd S, Daniel S, Poonnoose S, McDonald M. Recurrence of chest wall hydatid cyst disease involving the thoracic spine in an Australian patient. J Clin Neurosci 2016; 30:132-136. [PMID: 27050921 DOI: 10.1016/j.jocn.2016.01.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
Abstract
Hydatid disease involving the spine is a relatively uncommon occurrence. The cestode Echinococcus granulosus is the primary pathogen associated with hydatid disease and most patients present with signs and symptoms of spinal cord compression depending on the location of the spinal involvement. We present a rare case of recurrent hydatid disease with extensive hemithorax involvement, including the thoracic spine, associated with spinal cord compression. This case highlights the role of staged and minimally invasive spine surgery in spinal hydatid disease with spinal cord compression, the importance of ongoing medical treatment and long term follow-up.
Collapse
Affiliation(s)
- Su Thet Mon
- Department of Neurosurgery, Flinders Medical Centre, Adelaide, Flinders Drive, Bedford Park, SA 5042, Australia.
| | - Yingda Li
- Department of Neurosurgery, Flinders Medical Centre, Adelaide, Flinders Drive, Bedford Park, SA 5042, Australia
| | - Sarah Shepherd
- SA Pathology, Flinders Medical Centre, Adelaide, SA, Australia
| | - Santosh Daniel
- Infectious Diseases Unit, Division of Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Santosh Poonnoose
- Department of Neurosurgery, Flinders Medical Centre, Adelaide, Flinders Drive, Bedford Park, SA 5042, Australia
| | - Matthew McDonald
- Department of Neurosurgery, Flinders Medical Centre, Adelaide, Flinders Drive, Bedford Park, SA 5042, Australia
| |
Collapse
|
47
|
Sahlu A, Mesfin B, Tirsit A, Wester K. Spinal cord compression secondary to vertebral echinococcosis. J Neurosci Rural Pract 2016; 7:143-6. [PMID: 26933365 PMCID: PMC4750316 DOI: 10.4103/0976-3147.165357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We describe a patient with progressive lower limb weakness and paresthesia 3 days after falling from a considerable height. Magnetic resonance imaging and computed tomography revealed collapsed Th2 and Th3 vertebrae. A tuberculous (TB) spondylitis was suspected, and anti-TB medication was started however with no clinical improvement. She was referred to our center and operated. A 3 level discectomy and 2 level corpectomy were performed with iliac bone grafting and anterior plating via an anterior cervical approach. The patient developed an esophagocutaneous fistula that was repaired and cured. The biopsy specimen showed a hydatid cyst of the vertebra as the cause of the lesion. After the result, she was started on oral albendazole. At follow-up nearly 4 months after surgery, the patient had regained significant power in her lower limbs with a muscular strength of 5/5 in both legs, thus making it possible to walk without support.
Collapse
Affiliation(s)
- Abat Sahlu
- Department of Surgery, Neurosurgery Unit, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Brook Mesfin
- Department of Surgery, Neurosurgery Unit, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abenezer Tirsit
- Department of Surgery, Neurosurgery Unit, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Knut Wester
- Department of Surgery, Neurosurgery Unit, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia; Department of Clinical Medicine (K1), University of Bergen, Norway
| |
Collapse
|
48
|
Abstract
Spinal infection is rare. Clinical suspicion is important in patients with nonmechanical neck and/or back pain to make the proper diagnosis in early disease. Before planning surgery, a thorough evaluation of the spinal stability, alignment, and deformity is necessary. Timing of surgery, side of approach, appropriate surgical technique, and spinal instruments used are crucial. Biomechanical preservation of the spinal column during and after the infection is a significant issue. Postoperative spine infection is another entity of which spinal surgeons should be aware of. Proper septic conditions with meticulous planning of surgery are essential for successful spine surgery and better outcome.
Collapse
Affiliation(s)
- Derya Burcu Hazer
- Department of Neurosurgery, Mugla Sitki Kocman University School of Medicine, Orhaniye Mahallesi, Haluk Ozsoy Caddesi, Mugla 48000, Turkey
| | - Selim Ayhan
- Malatya State Hospital, Department of Neurosurgery, Firat Mahallesi, Hastane Caddesi, Malatya 44330, Turkey
| | - Selcuk Palaoglu
- Department of Neurosurgery, Hacettepe University School of Medicine, Sihhiye, Altindag, Ankara 06100, Turkey.
| |
Collapse
|
49
|
Chen T, Moon K, deMello DE, Feiz-Erfan I, Theodore N, Bhardwaj RD. Case report of an epidural cervical Onchocerca lupi infection in a 13-year-old boy. J Neurosurg Pediatr 2015; 16:217-21. [PMID: 25932778 DOI: 10.3171/2014.12.peds14462] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A 13-year-old boy presented with fever and neck pain and stiffness, which was initially misdiagnosed as culture-negative meningitis. Magnetic resonance images of the brain and cervical spine demonstrated what appeared to be an intradural extramedullary mass at the C1-3 level, resulting in moderate cord compression, and a Chiari Type I malformation. The patient underwent a suboccipital craniectomy and a C1-3 laminectomy with intradural exploration for excisional biopsy and resection. The lesion containing the parasite was extradural, extending laterally through the C2-3 foramina. Inflammatory tissue secondary to Onchocerca lupi infection was identified, and treatment with steroids and doxycycline was initiated. At the 6-month follow-up, the patient remained asymptomatic, with MR images demonstrating a significant reduction in lesional size. However, 10 weeks postoperatively, the infection recurred, necessitating a second operation. The patient was treated with an additional course of doxycycline and is currently maintained on ivermectin therapy. This is the second reported case of cervical O. lupi infection in a human. In the authors' experience, oral doxycycline alone was insufficient in controlling the disease, and the addition of ivermectin therapy was necessary.
Collapse
Affiliation(s)
- Tsinsue Chen
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center
| | - Karam Moon
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center
| | - Daphne E deMello
- Department of Pathology and Laboratory Medicine, Phoenix Children's Hospital
| | - Iman Feiz-Erfan
- The University of Arizona, College of Medicine-Phoenix; and.,Division of Neurosurgery, Maricopa Medical Center, Phoenix, Arizona
| | - Nicholas Theodore
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center
| | - Ratan D Bhardwaj
- Division of Neurological Surgery, Barrow Neurological Institute, Phoenix Children's Hospital
| |
Collapse
|
50
|
Richter PJ, Holtfreter M, Orhun A, Müller-Stöver I, Kubitz R, Hillenbrand A, Kratzer W, Gräter T, Grüner B. Echinokokkose-Erkrankungen. MMW Fortschr Med 2015; 157:56-63. [PMID: 26099410 DOI: 10.1007/s15006-015-2727-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pisa Joachim Richter
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Unversität, Moorenstr. 5, D-40225, Düsseldorf, Deutschland,
| | | | | | | | | | | | | | | | | |
Collapse
|