1921
Volume 99, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Human cystic echinococcosis (CE) is a chronic, complex and neglected infection causing severe disease in humans. Hepatic CE cysts are detected and classified mainly by using ultrasound. Expert opinion and published data suggest that uncomplicated inactive liver cysts do not require treatment and only need to be monitored over time (“Watch and Wait”). Here we update our findings as published in 2014 on the “Watch and Wait” approach applied to inactive, asymptomatic cysts of the liver to keep the medical community informed. Clinical data of patients who accessed the World Health Organization Collaborating Center for CE at the University of Pavia-San Matteo Hospital Foundation from January 1991 to October 2017 were analyzed. Inclusion criteria were presence of one or more inactive uncomplicated cysts in the liver (CE4 or CE5), without any history of previous treatment, and an ultrasound-based follow-up of at least 24 months. Fifty-three patients with 66 inactive cysts fulfilled the inclusion criteria. Of these, 11 patients are newly described here; 37 were part of our previously described cohort and the follow-up for 17 of them was further extended; and five were excluded from the previously published analysis as their follow-up was too short, but could be included now. Without the need for treatment and without development of complications, 98.5% of cysts remained inactive over time. In only one patient (1.9% of patients), a reactivation of one cyst (1.5% of cysts) was observed.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.18-0164
2018-06-04
2019-11-16
Loading full text...

Full text loading...

/deliver/fulltext/14761645/99/2/tpmd180164.html?itemId=/content/journals/10.4269/ajtmh.18-0164&mimeType=html&fmt=ahah

References

  1. WHO Echinococcosis WHO/OIE Manual on Echinococcosis, 2001. Echinococcosis in Humans and Animals: A Public Health Problem of Global Concern. World Organization for Animal Health (Office International des Epizooties) and World Health Organization. Available at: http://www.who.int/echinococcosis/resources/929044522X/en/. Accessed January 10, 2018.
  2. Craig PS, Budke CM, Schantz PM, Li T, Qiu J, Yang Y, Zeyhle E, Rogan MT, Ito A, , 2007. Human echinococcosis: a neglected disease? Trop Med Health 35: 283292. [Google Scholar]
  3. Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A, , 2003. Hydatid disease from head to toe. Radiographics 23: 475494. [Google Scholar]
  4. Brunetti E, Kern P, Vuitton DA, Writing Panel for the WHO-IWGE; , 2010. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114: 116. [Google Scholar]
  5. Stojkovic M, Rosenberger K, Kauczor HU, Junghanss T, Hosch W, , 2012. Diagnosing and staging of cystic echinococcosis: how do CT and MRI perform in comparison to ultrasound? PLoS Negl Trop Dis 6: e1880. [Google Scholar]
  6. Piccoli L, Tamarozzi F, Cattaneo F, Mariconti M, Filice C, Bruno A, Brunetti E, , 2014. Long-term sonographic and serological follow-up of inactive echinococcal cysts of the liver: hints for a “watch-and-wait” approach. PLoS Negl Trop Dis 8: e3057. [Google Scholar]
  7. Stojkovic M, Rosenberger KD, Steudle F, Junghanss T, , 2016. Watch and wait management of inactive cystic echinococcosis–does the path to inactivity matter–analysis of a prospective patient cohort. PLoS Negl Trop Dis 10: e0005243. [Google Scholar]
  8. Solomon N, Kachani M, Zeyhle E, Macpherson CNL, , 2017. The natural history of cystic echinococcosis in untreated and albendazole-treated patients. Acta Trop 171: 5257. [Google Scholar]
  9. Junghanss T, Da Silva AM, Horton J, Chiodini PL, Brunetti E, , 2008. Clinical management of cystic echinococcosis: state of the art, problems, and perspectives. Am J Trop Med Hyg 79: 301311. [Google Scholar]
  10. Stojkovic M, Zwahlen M, Teggi A, Vutova K, Cretu CM, Virdone R, Nicolaidou P, Cobanoglu N, Junghanss T, , 2009. Treatment response of cystic echinococcosis to benzimidazoles: a systematic review. PLoS Negl Trop Dis 3: e524. [Google Scholar]
  11. WHO Informal Working Group, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253261. [Google Scholar]
  12. Rinaldi F, De Silvestri A, Tamarozzi F, Cattaneo F, Lissandrin R, Brunetti E, , 2014. Medical treatment versus “watch and wait” in the clinical management of CE3b echinococcal cysts of the liver. BMC Infect Dis 14: 492. [Google Scholar]
  13. Larrieu E, 2011. Programme for ultrasound diagnoses and treatment with albendazole of cystic echinococcosis in asymptomatic carriers: 10 years of follow-up of cases. Acta Trop 117: 15. [Google Scholar]
  14. Solomon N, 2018. Cystic echinococcosis in Turkana, Kenya: 30 years of imaging in an endemic region. Acta Trop 178: 182189. [Google Scholar]
  15. Tamarozzi F, 2017. Prevalence and risk factors for human cystic echinococcosis in the Cusco region of the Peruvian highlands diagnosed using focused abdominal ultrasound. Am J Trop Med Hyg 96: 14721477. [Google Scholar]
  16. Chebli H, 2017. Human cystic echinococcosis in Morocco: ultrasound screening in the Mid Atlas through an Italian-Moroccan partnership. PLoS Negl Trop Dis 11: e0005384. [Google Scholar]
  17. Hosch W, Junghanss T, Stojkovic M, Brunetti E, Heye T, Kauffmann GW, Hull WE, , 2008. Metabolic viability assessment of cystic echinococcosis using high-field 1H MRS of cyst contents. NMR Biomed 21: 734754. [Google Scholar]
  18. Evering T, Weiss LM, , 2006. The immunology of parasite infections in immunocompromised hosts. Parasite Immunol 28: 549565. [Google Scholar]
  19. Rossi P, 2016. The first meeting of the European Register of Cystic Echinococcosis (ERCE). Parasit Vectors 9: 243. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.18-0164
Loading
/content/journals/10.4269/ajtmh.18-0164
Loading

Data & Media loading...

  • Received : 23 Feb 2018
  • Accepted : 22 Apr 2018
  • Published online : 04 Jun 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error