UNASSIGNED: In cystic lesions of the pancreas, hydatid cyst should be considered in the differential diagnoses and its presence should be ruled out before any invasive interventions. Serological tests along with imaging studies related to hydatid cyst diagnostic indicators should be performed in people who live in Echinococcus granulosus endemic areas and suffer from cystic lesions of the gastrointestinal tract.
UNASSIGNED: Primary pancreatic hydatid cysts, caused by the tapeworm Echinococcus granulosus, represent a rare occurrence often challenging to diagnose due to their similarity to other pancreatic conditions. This case report outlines a 67-year-old male presenting with jaundice and cholestasis but lacking typical symptoms associated with pancreatic hydatid cysts. Laboratory findings revealed elevated bilirubin levels, liver enzyme abnormalities, and tumor markers, prompting imaging studies that indicated a cystic mass near the pancreatic head. Misdiagnosed initially as a mucinous cystic neoplasm, the patient underwent Whipple surgery, unveiling a large cystic lesion upon examination.

Omalizumab, a humanized anti-IgE monoclonal antibody, is commonly employed in the treatment of antihistamine-refractory chronic spontaneous urticaria (CSU), where it significantly reduces free IgE levels, minimizing histamine release from basophils and mast cells. Despite its efficacy, there are concerns regarding its effect on parasitic defense due to IgE\'s role in combating parasitic infestations. We present a case of a 28-year-old female agriculturist with a six-month history of CSU who experienced a paradoxical exacerbation of her symptoms following an increase in the omalizumab treatment dose. This deterioration coincided with a serologically confirmed parasitic infection with Echinococcus granulosus and Toxocara canis. Despite normal eosinophil counts and IgE levels, which are typically used to identify parasitic infections, the patient\'s clinical worsening prompted further investigation that led to the identification of the parasitic infection. Treatment with albendazole and omalizumab discontinuation led to the resolution of her CSU, suggesting that the parasitic infection was contributing to the symptom exacerbation. This case highlights the need for careful screening for parasitic infections before initiating omalizumab in antihistamine-refractory CSU patients from endemic regions, or patients who deteriorate clinically on omalizumab, especially when other indicators such as eosinophil count and IgE levels might not suggest infection. It also underscores the importance of considering a tailored approach to managing CSU that balances effective treatment with the potential for adverse effects related to immunomodulation.

BACKGROUND: Cystic echinococcosis, a zoonotic disease caused by the larval form of Echinococcus granulosus, predominantly affects the liver and lungs, with humans acting as accidental hosts.
METHODS: Our retrospective study at the Department of Radiology and Imageology, Nizam\'s Institute of Medical Sciences, included 187 histopathologically or serologically proven cases. The mean age of presentation was 49.4 years.
RESULTS: Liver involvement was most prevalent, accounting for 83.4% (n=156) of cases, followed by sporadic involvement of other organs such as the mesentery, spleen, pancreas, thalamus, kidney, lung, spine, and omentum. Characteristic diagnostic features observed on imaging included peripheral calcifications in 33% of cases, internal septations in 25% (n=47), dense calcifications in 15% (n=29), daughter cysts in 6% (n=11), and floating membranes in 5% (n=10). Among hepatic lesions, 90% (n=141) were showing involvement of a single lobe. Notably, 78% (n=110) of lesions were limited to the right lobe, 21% (n=30) to the left lobe, and 1% (n=1) to the caudate lobe. The most affected hepatic segment was segment VIII, while the least common was segment I (caudate lobe). Complications were identified in 13% (n=25) of cases of hepatic hydatidosis.
CONCLUSIONS: The findings of our study emphasize the systemic nature of E. granulosus infection which can affect various organs in the body. It also illustrates the invaluable insights imaging provides for timely and accurate diagnosis of hydatid disease.

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.

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.

Hydatidosis is a zoonosis due to the development of the larval form of Echinococcus granulosus in humans. This disease is very frequent in many countries of North Africa such as Morocco. The most frequent locations of hydatid cysts are the liver (75%) and the lungs (15.4%). Splenic hydatid cyst occurs in only 5.1% of cases. The diagnosis remains challenging and is made upon a hundle of clinical, radiological, biological, and histological arguments. In this paper, we report a case of spleen-preserving surgery for a splenic hydatid cyst to suggest the best management of these hydatid cysts and avoid recurrences.

The emergence of pandemics with dramatic consequences for human health has obscured endemic diseases that continue to pose a problem for human and animal health in several regions of the world. Among these diseases, cystic echinococcosis, a zoonotic parasitic infection caused by a group of cestodes, Echinococcus granulosus sensu lato, remains a real human and animal health problem in several regions of the world, including the Mediterranean Basin. Despite the implementation of a number of governmental control programmes using several tools (dog treatment, meat inspection, etc.), this infection is still highly prevalent in North Africa. Here we present a review of the epidemiology of cystic echinococcosis in Tunisia, an analysis of the constraints limiting the effectiveness of the control programmes implemented, and finally argue for the use of the One Health framework to improve the effectiveness of future programmes.
UNASSIGNED: L’échinococcose kystique (infection par Echinococcus granulosus sensu lato) en Tunisie, une perspective « Une seule santé » pour un futur programme de contrôle.
UNASSIGNED: L’émergence de pandémies affectant de manière très importante la santé humaine a occulté les maladies endémiques qui continuent de représenter un problème de santé animale et humaine dans plusieurs régions du monde. Parmi ces maladies, l’échinococcose kystique, une parasitose zoonotique provoquée par un groupe de cestodes, Echinococcus granulosus sensu lato, reste un réel problème de santé humaine et animale dans plusieurs régions du monde, incluant le Bassin méditerranéen. Malgré la mise en place de nombreux programmes de lutte utilisant plusieurs outils (traitement des chiens, inspection des viandes, etc.), cette infection est encore hautement prévalente en Afrique du Nord. Nous présentons ici une revue de l’épidémiologie de l’échinococcose kystique en Tunisie, une analyse des contraintes limitant l’efficacité des programmes de lutte mis en place, et finalement nous argumentons l’utilisation du concept « Une seule santé » pour améliorer l’efficacité des programmes futurs.
UNASSIGNED: مرض الكيس المائي (العدوى بالطفيليEchinococcus granulosus sensu lato ) في تونس، منظور صحي واحد لبرنامج مكافحة مستقبلي.
UNASSIGNED: أدى ظهور الأوبئة التي تؤثر بشكل كبير على صحة الإنسان إلى حجب الأمراض المستوطنة التي لا تزال تمثل مشكلة لصحة الحيوان والإنسان في العديد من مناطق العالم. ومن بين هذه الأمراض، لا يزال مرض الكيس المائي، مرض طفيلي مشترك المتسبب فيه مجموعة من الديدان الشريطية، المشوكة الحبيبية بالمعنى الواسع Echinococcus granulosus sensu lato ، يمثل مشكلة حقيقية لصحة الانسان و الحيوان في العديد من مناطق العالم، بما في ذلك حوض البحر الأبيض المتوسط. وعلى الرغم من تنفيذ عدد من برامج المكافحة باستخدام عدة أدوات (علاج الكلاب، فحص اللحوم، وغيرها)، إلا أن هذه العدوى لا تزال منتشرة بشكل كبير في شمال أفريقيا. نقدم هنا استعراضا لوبائيات مرض الكيس المائي في تونس، وتحليلا للقيود التي تحد من فعالية برامج المكافحة المطبقة، وأخيرا نناقش استخدام مفهوم الصحة الواحدة لتحسين فعالية البرامج المستقبلية.

Parasites possess remarkable abilities to evade and manipulate the immune response of their hosts. Echinococcus granulosus is a parasitic tapeworm that causes cystic echinococcosis in animals and humans. The hydatid fluid released by the parasite is known to contain various immunomodulatory components that manipulate host´s defense mechanism. In this study, we focused on understanding the effect of hydatid fluid on dendritic cells and its impact on autophagy induction and subsequent T cell responses. Initially, we observed a marked downregulation of two C-type lectin receptors in the cell membrane, CLEC9A and CD205 and an increase in lysosomal activity, suggesting an active cellular response to hydatid fluid. Subsequently, we visualized ultrastructural changes in stimulated dendritic cells, revealing the presence of macroautophagy, characterized by the formation of autophagosomes, phagophores, and phagolysosomes in the cell cytoplasm. To further elucidate the underlying molecular mechanisms involved in hydatid fluid-induced autophagy, we analyzed the expression of autophagy-related genes in stimulated dendritic cells. Our results demonstrated a significant upregulation of beclin-1, atg16l1 and atg12, indicating the induction of autophagy machinery in response to hydatid fluid exposure. Additionally, using confocal microscopy, we observed an accumulation of LC3 in dendritic cell autophagosomes, confirming the activation of this catabolic pathway associated with antigen presentation. Finally, to evaluate the functional consequences of hydatid fluid-induced autophagy in DCs, we evaluated cytokine transcription in the splenocytes. Remarkably, a robust polyfunctional T cell response, with inhibition of Th2 profile, is characterized by an increase in the expression of il-6, il-10, il-12, tnf-α, ifn-γ and tgf-β genes. These findings suggest that hydatid fluid-induced autophagy in dendritic cells plays a crucial role in shaping the subsequent T cell responses, which is important for a better understanding of host-parasite interactions in cystic echinococcosis.

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.

UNASSIGNED: In Kazakhstan, the study of Echinococcus infection among farm animals is crucial to monitor the invasion among livestock and map the data obtained. Unfortunately, there are only partial data on the study of Echinococcus among cattle\'s in Kazakhstan, which makes it difficult to conduct a comparative analysis of the epidemiological situation among livestock animals. The present study aimed to molecularly identify the species and haplotypes of the E. granulosus complex infecting cattle in Kazakhstan and investigate their genetic variation relative to mitochondrial (mt) targets.
UNASSIGNED: Individual cyst isolates (n = 700) were collected from infected cattle lungs and livers after slaughter from the slaughterhouse. Total DNA was extracted from the germinal layers of the cyst from each isolate. This DNA sequenced partial mt genes of cytochrome c oxidase 1 (450 bp) and NADH dehydrogenase 1 (1200 bp).
UNASSIGNED: We determined that all the sequences were detected as E. granulosus s.s., of which 69 (94.5%) samples belonged to G1, and only 4 (5.4%) samples belonged to the G3 genotype. After bioinformatic analysis, 38 haplotypes were identified.
UNASSIGNED: Our findings revealed that the G1 genotype of E. granulosus s.s. is the predominant cattle genotype in Kazakhstan. However, only one region showed the presence of two genotypes G1 and G3, in the sequence, which suggests that further research is needed to investigate the epidemiology of Echinococcus infection in cattle in Kazakhstan.