Echinococcus granulosus

细粒棘球蚴
  • 文章类型: Journal Article
    囊性包虫病(CE)是一种影响人类和动物的人畜共患疾病。尽管对寄生虫-中间宿主相互作用的许多细节缺乏清晰,包虫感染引发的免疫反应的性质揭示了新的观点。本研究讨论了阐明包虫病免疫机制及其检测的最新进展以及提高血清诊断准确性的潜在方法。此外,纳米生物传感器已经根据其提高治疗效率和帮助早期诊断囊性包虫病的潜力进行了评估。中间宿主的血清可以通过分析细粒棘球蚴诱导的抗体来诊断CE。该方法最显著的特点是无创、灵敏度高,这两者都使其成为临床诊断的绝佳工具。几种血清学测试,包括ELISA和免疫印迹,可以检测这些抗体来评估疾病的状态并确定治疗结果。彻底了解交叉反应性的含义和疾病的阶段对于解释血清学结果至关重要。在检测包虫囊肿方面,纳米生物传感器也被证明比常规生物传感器更好。此外,它们在检测特定的生物标志物时非常敏感和通用,提高诊断准确性。这些免疫调节分子,由E.granulosus诱导,是诊断囊性包虫病的良好候选者,因为它们会改变宿主的中间免疫反应。通过纳米生物传感器也增强了包虫囊肿的检测,这提供了更好的准确性。
    Cystic echinococcosis (CE) is a zoonotic disease affecting humans and animals. Despite a lack of clarity about many details of parasite-intermediate host interactions, the nature of the immune responses triggered by hydatid infection has revealed new perspectives. This study discusses the latest advances in elucidating the immunologic mechanism of echinococcosis and its detection and potential approaches to enhance serodiagnosis accuracy. Moreover, nanobiosensors have been evaluated according to their potential to improve treatment efficiency and aid in an early diagnosis of cystic echinococcosis. The serum of an intermediate host can diagnose CE by analyzing antibodies induced by Echinococcus granulosus. Among the most notable features of this method are its noninvasive ability and high sensitivity, both of which make it an excellent tool for clinical diagnosis. Several serological tests, including ELISAs and immunoblotting, can detect these antibodies to assess the disease\'s state and determine the treatment outcome. A thorough understanding of what cross-reactivity means and the stage of the disease are crucial to interpreting serological results. Nanobiosensors have also proven better than conventional biosensors in detecting hydatid cysts. Additionally, they are highly sensitive and versatile when detecting specific biomarkers, improving diagnostic accuracy. These immunomodulatory molecules, induced by E. granulosus, are a good candidate for diagnosing cystic echinococcosis because they alter intermediate host immune responses. Hydatid cyst detection is also enhanced through nanobiosensors, which provide better accuracy.
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  • 文章类型: Case Reports
    包虫囊肿病,由细粒棘球蚴幼虫形成,通常会影响肝脏,肺,和泌尿生殖道。该病例报告详细介绍了一名62岁男性的包虫囊肿的异常表现,该男性有膀胱后包虫囊肿手术史。病人出现阴茎根部疼痛,随后的成像显示耻骨上囊肿,耻骨,和左果胶肌肉区域。尽管COVID-19大流行带来了挑战,患者于2023年接受了手术切除.讨论强调了这种局部囊肿的罕见性,诊断成像技术,以及手术干预的必要性。术后期间涉及阿苯达唑的疗程。虽然直肠膀胱包虫囊肿并不常见,这一病例强调了在肿块鉴别诊断中考虑它们的重要性,特别是在流行地区。手术切除仍然是有症状的包虫囊肿的主要治疗方法。
    Hydatid cyst disease, caused by the Echinococcus granulosus tapeworm larval form, typically affects the liver, lungs, and genitourinary tract. This case report details an unusual manifestation of hydatid cysts in a 62-year-old male with a history of retrovesical hydatid cyst surgery. The patient presented with pain at the root of the penis, and subsequent imaging revealed cysts in the suprapubic, pubic bone, and left pectineus muscle regions. Despite the challenges posed by the COVID-19 pandemic, the patient underwent surgical excision in 2023. The discussion emphasizes the rarity of such localized cysts, diagnostic imaging techniques, and the necessity of surgical intervention. The postoperative period involved a course of albendazole. While rectovesical hydatid cysts are uncommon, this case underscores the importance of considering them in the differential diagnosis of masses, particularly in endemic regions. Surgical excision remains the primary treatment for symptomatic hydatid cysts.
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  • 文章类型: Systematic Review
    人囊性棘球蚴病(CE)是由tape虫的幼虫期引起的寄生虫感染,主要影响肝脏和肺。尽管在所有CE病例中只有0.02-2%的心脏受到影响,相当多的案例是,并继续,已发布。然而,由于心脏CE的罕见发生以及由此导致的临床试验的缺乏,关于疾病各个方面的知识仍然有限。为了获得更清晰的解剖图像,临床,心脏CE的诊断和治疗方面,我们系统地回顾了1965年至2022年之间发表的文献。受影响的心脏结构的解剖模式遵循供应毛细血管床的延伸。大多数患者(82.7%)有症状,并出现长期的非特异性症状,如呼吸困难,胸痛和心悸。急性并发症通常源于囊肿破裂,发生在18.3%的病例中,表现为栓塞,心包填塞,或过敏反应在83.2%,分别为17.8%和10.9%,分别。至于位于其他器官的CE囊肿,心脏CE的诊断是通过影像学进行的。血清学由于其有限的敏感性而发挥次要作用。与腹部CE囊肿不同,心脏CE囊肿通常切除独立于其阶段(活动/非活动),因为它们的存在会损害心脏性能,并有长期后遗症的风险。超过80%的患者通过单一手术干预进行治疗。我们发现与疾病有关的病死率为11.1%。由于局部复发报告长达108个月,继发性CE报告长达72个月术后,患者应至少随访10年.
    Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.
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  • 文章类型: Journal Article
    囊性棘球蚴病(CE)是一种由脑纲动物引起的人畜共患病,细粒棘球蚴的幼虫期。尽管世界卫生组织(WHO)将CE定义为一种被忽视的疾病,它是第二重要的食源性寄生虫病,它仍然是一个重要的公共卫生问题,考虑到其地带性和潜在的发病率。控制和预防CE是世卫组织的相关目标,尤其是从一个健康的角度来看,因为这种疾病不仅影响动物和人类,还影响食物链。由于并非所有国家都有CE监测战略或报告系统和具体的管理指南,最近的流行病学数据相对较少,有关该疾病特定地理分布的研究正在进行中。要向主题添加新信息,我们分析并收集了来自国家指南和多个医学数据库的数据.在最初确定的751篇研究文章中,在应用特定的纳入和排除标准后,只有52人被纳入研究.介绍了做出重大贡献并产生积极影响的著名国际项目。现有数据与世卫组织关于该主题的建议相关,从而展示了采取的措施和那些仍然需要适当控制疾病的传播。
    Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus. Although the World Health Organization (WHO) has defined CE as a neglected disease, it is the second most important foodborne parasitic disease, and it remains an important public health issue, considering its zonal endemicity and potential morbidity. The control and prevention of CE is a relevant WHO target, especially from a One Health perspective, as the disease affects not only animals and humans but also the food chain. Since not all countries have a CE surveillance strategy or reporting system and specific management guidelines, recent epidemiological data are relatively scarce, and research concerning the specific geographical distribution of the disease is ongoing. To add new information to the subject, we have analyzed and collected data from national guidelines and several medical databases. Out of the 751 research articles that were originally identified, only 52 were included in the investigation after applying specific inclusion and exclusion criteria. Notable international projects that have provided significant contributions and had a positive impact are presented. The available data were correlated with WHO recommendations on the subject, thus showcasing the measures taken and those that are still needed to properly control the disease\'s spread.
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  • 文章类型: Systematic Review
    背景:囊性棘球蚴病(CE)是一种被忽视的人畜共患疾病,是由细粒棘球蚴引起的。其生命周期涉及多个主机。我们对非洲大角(GHA)的E.granulosuss.l.进行了系统评价(SR),提供其在所有宿主中的最新流行病学图片。
    方法:对于此SR,根据系统审查和荟萃分析(PRISMA)声明的首选报告项目进行,五个电子数据库,还咨询了该地区的专家,以检索2000年至2022年之间发布的记录,报告了GHA中任何自然宿主中都存在E.granulosuss.l感染(吉布提,厄立特里亚,埃塞俄比亚,肯尼亚,苏丹,索马里,南苏丹,坦桑尼亚和乌干达)。
    结果:总共保留了247条记录,描述了在整个GHA中存在E.granulosuss.l.,除了吉布提。在该地区仅进行了很少的人类CE人口调查,患病率在0.3%至11.3%之间。在动物中,报告的骆驼患病率高达61.6%,牛占88.4%;山羊占65.2%,9.9%的猪,绵羊为67.8%,狗为94.5%。此外,E.granulosuss.l.在野生动物中也有报道。在不同的宿主中总共报告了五种物种,即E.granulosussensustricto(G1,G3,GOmo),E.加拿大(G6/7),E.ortleppi(G5),E.费利迪斯,和马蹄(G4)。
    结论:我们证实了颗粒大肠杆菌在整个GHA中普遍存在。然而,尽管我们努力屏蔽灰色文学,准确评估GHA的流行病学仍然具有挑战性,由于缺乏组合主机,深入的危险因素和行为研究,以及所研究的亚群和使用的诊断工具的广泛多样性。跨学科和跨界伙伴关系对于设计有效的控制策略至关重要,调谐到GHA设置。
    BACKGROUND: Cystic echinococcosis (CE) is a neglected zoonotic disease that is caused by Echinococcus granulosus sensu lato (s.l.), the life cycle of which involves multiple hosts. We conducted a systematic review (SR) on E. granulosus s.l. in the Greater Horn of Africa (GHA), to provide a picture of its recent epidemiology across all hosts.
    METHODS: For this SR, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, five electronic databases, as well experts in the region were consulted to retrieve records published between 2000 and 2022, reporting the presence of E. granulosus s.l. infections in any natural host in the GHA (Djibouti, Eritrea, Ethiopia, Kenya, Sudan, Somalia, South Sudan, Tanzania and Uganda).
    RESULTS: A total of 247 records were retained, describing the presence of E. granulosus s.l. throughout the GHA, except for Djibouti. Only few population surveys on human CE were conducted in the area, with the prevalence ranging between 0.3 and 11.3%. In animals, the reported prevalence ranged up to 61.6% in camels, 88.4% in cattle; 65.2% in goats, 9.9% in pigs, 67.8% in sheep and 94.5% in dogs. In addition, E. granulosus s.l. was also reported in wildlife. A total of five species were reported in the different hosts, namely E. granulosus sensu stricto (G1, G3, GOmo), E. canadensis (G6/7), E. ortleppi (G5), E. felidis, and E. equinus (G4).
    CONCLUSIONS: We confirm that E. granulosus s.l. is prevalent throughout the GHA. Nevertheless, despite our efforts to screen grey literature, an accurate assessment of the epidemiology in GHA remains challenging, due to the lack of combined host, in-depth risk factor and behavioural studies, as well as the wide diversity in subpopulations studied and diagnostic tools used. Interdisciplinary and transboundary partnerships would be essential for the design of effective control strategies, tuned to the GHA setting.
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  • 文章类型: Case Reports
    包虫囊肿的后窝定位并不常见;在这些情况下,囊肿通常位于小脑。蛛网膜下腔或脑脊液心室系统内的定位是例外。在本报告中,这似乎是文献中的第七个,我们描述了2例小脑桥脑池包虫囊肿。磁共振成像结果显示,模仿蛛网膜囊肿的非肿瘤性囊性病变。囊肿的包虫性质在术前是出乎意料的。在这两种情况下,通过穿刺成功切除了囊肿,抽吸,灌溉,通过乙状窦后入路切除技术。组织病理学检查证实囊肿本质上是细粒棘球蚴。在小脑桥脑池的蛛网膜囊肿的鉴别诊断中,可以考虑包虫囊肿,以确定进行哪种外科手术并避免意外并发症。还讨论了以前发表的案例。
    Posterior fossa localization of a hydatid cyst is uncommon; in these cases, the cyst usually locates in the cerebellum. Localization within the subarachnoid spaces or the cerebrospinal fluid ventricular system is exceptional. In the present report, which appears to be the seventh in the literature, we describe two cases of a hydatid cyst in the cerebellopontine cistern. Magnetic resonance imaging findings revealed a nonneoplastic cystic lesion mimicking an arachnoid cyst. The hydatid nature of the cyst was unexpected preoperatively. In both cases, the cyst was successfully removed using the puncture, aspiration, irrigation, and resection technique via a retrosigmoid approach. Histopathological examination confirmed the cysts to be Echinococcus granulosus in nature. Hydatid cyst may be considered in the differential diagnosis of arachnoid cysts of the cerebellopontine cistern to determine which surgical procedure to perform and to avoid unexpected complications. Previous published cases were also discussed.
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  • 文章类型: Case Reports
    背景:包虫囊肿是由a虫引起的人畜共患疾病,细粒棘球蚴。腹膜后包虫囊肿极为罕见,其诊断具有挑战性,特别是在早期阶段,因为它可以模拟胰腺假性囊肿等几种区域性病变,胰腺肿瘤,和其他腹膜后囊性病变。
    方法:我们报告了一例罕见的39岁尼泊尔男性,患有左侧腹膜后包虫囊肿,表现为左侧区域疼痛和肿块感,持续6个月。通过腹部计算机断层扫描和磁共振成像进行诊断,并通过膀胱部分切除术进行治疗。
    结论:腹膜后包虫囊肿可表现为慢性疼痛,质量,以及因腹膜后位置不同而产生的质量效应引起的症状。腹膜后囊肿的早期诊断在临床和放射学上可能具有挑战性。即使在后期,超声检查可能不够,诊断需要额外的成像技术,如计算机断层扫描或磁共振成像。
    结论:在流行地区,在治疗腹膜后肿胀时,应考虑包虫囊肿,以便早期诊断和预防破裂。有了高度的临床怀疑和放射学发现,腹膜后包虫囊肿可以诊断,手术是主要的治疗方法。
    BACKGROUND: Hydatid cyst is a zoonotic disease caused by a tapeworm, Echinococcus granulosus. A retroperitoneal hydatid cyst is extremely rare and its diagnosis can be challenging, particularly in the early stage as it can mimic several regional pathologies like pancreatic pseudocyst, pancreatic neoplasm, and other retroperitoneal cystic lesions.
    METHODS: We report a rare case of 39-year-old Nepalese male with a left retroperitoneal hydatid cyst who presented with pain and feeling of mass in the left flank region for 6 months. Diagnosis was made by abdominal computed tomography and magnetic resonance imaging and management was done by partial cystectomy.
    CONCLUSIONS: Retroperitoneal hydatid cysts can present with chronic pain, mass, and symptoms resulting from the mass effect which varies according to the different retroperitoneal locations. Diagnosis of the retroperitoneal cyst can be challenging clinically and radiologically in its early stages. Even in the late stage, ultrasonography may not suffice and additional imaging techniques such as computed tomography or magnetic resonance imaging are required for the diagnosis.
    CONCLUSIONS: In endemic areas, hydatid cyst should be considered while dealing with a retroperitoneal swelling for early diagnosis and prevention of rupture. With a high level of clinical suspicion and radiological findings, retroperitoneal hydatid cyst can be diagnosed and surgery is the principal method of treatment.
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  • 文章类型: Case Reports
    包虫病是由细粒棘球蚴引起的人畜共患病。人类是异常的中间宿主,在感染后,寄生虫可能感染身体的任何器官,肝脏和肺是最受累的器官。包虫囊肿病累及门静脉极为罕见,据我们所知,仅有7例病例。我们介绍了一名62岁的波斯男性,患有偶然的肝囊肿。他的实验室检查在正常范围内。超声检查(美国),计算机断层扫描(CT)和磁共振成像(MRI)的发现显示肝脏包虫病伴远端门静脉受累和侧支静脉形成。患者正在接受随访,尚未接受手术。它有侵入多器官系统的倾向,尤其是肝脏和肺。包虫病给特别是发展中国家的医疗保健系统带来了沉重负担。这种疾病的表现通常是非特异性的,而一部分感染人群仍然无症状。门静脉侵犯和阻塞是一种罕见的并发症,区分它和静脉血栓形成是很重要的,因为这些实体的管理需要不同的方法。
    Hydatid disease is a zoonosis caused by Echinococcus granulosus. Humans are aberrant intermediate hosts and following the infection, the parasite may infest any organ of the body, with the liver and lungs being the most involved organs. Portal vein involvement by hydatid cyst disease is extremely rare with only seven cases published to our knowledge. We present a 62-year-old Persian male with an incidental liver cyst. His laboratory tests were in normal ranges. The ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) findings show hydatid disease of the liver with distal portal vein involvement and collateral venous formations. The patient is being followed and has not gone under surgery yet. It possesses a propensity to invade multiple organ systems, notably the liver and lungs. Hydatid disease is imposing a significant burden on healthcare systems specifically in developing countries. Manifestations of the disease are often non-specific, while a subset of the infected population remains asymptomatic. Portal vein invasion and obstruction is a rare complication, and it is important to distinguish it from vein thrombosis, as the management of these entities requires different approaches.
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  • 文章类型: Case Reports
    虽然相当罕见,脊椎包虫病应始终被视为脊柱表现的鉴别诊断,特别是在包虫病的流行地区。
    在本文中,我们报告了一例罕见的无症状多发性硬膜内,髓外脊髓包虫病,偶然诊断为有真正突出椎间盘的体征和症状的患者。虽然相当罕见,脊椎包虫病应始终被视为脊柱表现的鉴别诊断,特别是在包虫病的流行地区。
    UNASSIGNED: Although quite rare, vertebral hydatidosis should always be considered as a differential diagnosis for spinal presentations, particularly in endemic areas for echinococcosis.
    UNASSIGNED: In this paper, we report a rare case of asymptomatic multiple intradural, extramedullary spinal hydatidosis, incidentally diagnosed in a patient with signs and symptoms of a true protruded disc. Although quite rare, vertebral hydatidosis should always be considered as a differential diagnosis for spinal presentations, particularly in endemic areas for echinococcosis.
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  • 文章类型: Review
    目的:囊性包虫病(CE)是一种常见的,构成主要公共卫生问题的复杂寄生虫病。CE在使用狗进行放牧或畜牧业与牲畜密切接触的地区表现出很高的地方性。它可以在临床上表现出各种体征和症状,比如胆管炎,黄疸,胰腺炎,外胆瘘,下腔静脉阻塞,门静脉高压症,和重复感染。后者尤其可能与化脓有关,无论是破裂还是菌血症.这项研究的目的是报告我们的76岁患者,该患者患有主要感染的巨大化脓的肝脏包虫囊肿及其手术治疗。方法:在这种情况下,诊断主要基于临床表现,计算机断层扫描(CT)扫描,和磁共振成像(MRI)的病人的腹部。选择的手术方法是部分保留囊膜和引流囊性内容物(部分性周切除术)。结果:我们的患者的手术管理和细致的长期随访产生了积极的结果,没有任何术后并发症。
    Purpose: Cystic echinococcosis (CE) is a common, complex parasitic disease that constitutes a major public health concern. CE demonstrates high endemicity in areas where dogs are used for herding or where animal husbandry practices involve close contact with livestock. It can clinically manifest with a variety of signs and symptoms, such as cholangitis, jaundice, pancreatitis, external biliary fistula, inferior vena cava obstruction, portal hypertension, and superinfection. The latter can notably be related to suppuration, either by rupture or bacteremia. The aim of this study is to report our 76-year-old patient who presented with a primarily infected giant-suppurated hydatid cyst of the liver and its surgical management. Methods: In this case, the diagnosis was based primarily on clinical presentation, computed tomography (CT) scan, and magnetic resonance imaging (MRI) of the patient\'s abdomen. The surgical procedure of choice was the partial retaining of the pericystic membrane and drainage of the cystic contents (partial pericystectomy). Results: The surgical management and meticulous long-term follow-up of our patient produced a positive outcome without any post-operative complications.
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