Case-series study of hepatic echinococcal cysts in Serbia: viability of scolices, seropositivity and epidemiological characteristics

Abstract

Cystic echinococcosis (CE) is an endemic helminthic disease caused by infection with Echinococcus granulosus metacestodes. Although CE is endemic in the Balkan region, the exact epidemiology remains unknown. We conducted a case-series study with the aim of evaluating the correlation between seropositivity, socio-epidemiological data, pre-operative treatment with albendazole and viability of protoscolices in human hepatic hydatid cysts. Consecutive patients with hepatic CE underwent surgery to extract E. granulosis cysts. The viability of protoscolices was measured by their ability to absorb 0.1% eosin. Socio-epidemiological data were collected and serological testing was performed. In the present study, 38 patients (28 adults and 10 children) with hepatic CE were treated surgically. The scolex viability test was positive in 30/38 (79%) samples. All patients with non-viable cysts had seronegative results. The viability test was positive in 11/12 (91.6%) adult patients with pre-operative albendazole treatment and in 9/10 (90%) children. Statistically more patients were from an urban area compared with a rural area (65.8% vs. 15.7%). The increasing number of stray dogs shedding E. granulosus eggs in urban public areas in the Balkans might be the reason for the significant difference in the rate of infection between urban and rural areas in the present study. In addition, uncontrolled slaughtering of livestock, common in rural settlements, and feeding the infected viscera to dogs, favour the maintenance of the parasite cycle. We believe that the results of our study will encourage physicians, veterinarians and health authorities to initiate a programme to prevent and control CE in the Balkan region.

Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007–2022

“…Regarding the gender distribution of CE, more than half of our patients were female. Similar results were also reported by other authors [12,42,44,[51][52][53]. Moreover, in the cross-sectional study on healthy blood donors from Western Romania, females tended to have a higher seropositivity rate compared to males [54].…”

“…Recently, in Eastern European countries, a lower incidence of CE has been reported. For instance, in Eastern Hungary, Dezsényi and colleagues [3] found an incidence of 1.49 cases/100,000 inhabitants, while in Serbia, another country with CE-endemic regions, the incidence was estimated at 0.73/100,000 [12].…”

“…Serology is based on finding the specific antibodies in the serum of a patient, and along with the imaging techniques help in establishing the diagnosis [3,4]. Still, specific anti-Echinococcus antibody production depends on various factors like the individual immune response, the affected organ, or the number of hydatid cysts [12].…”

An extraordinary rare presentation of liver hydatidosis with hydatid cyst scolices

“…Total leukocyte count was 6400 uL ‐1 with 1% eosinophils, and the positive serum antigen along with the imaging studies (Ultrasound, Computed Tomography) confirmed liver hydatidosis. Cystic echinococcosis is an endemic helminthic disease, caused by the infection of Echinoccocus granulosus metacestodes 1 . Albendazole was given 4 weeks prior to surgery.…”

Should Pediatricians Be Aware of Cystic Echinococcosis? A Literature Review

“…Hepatic echinococcosis can be asymptomatic until the cysts reach considerable size, or they may be discovered incidentally. The most commonly reported symptoms are abdominal pain, palpable mass, or, in case of bile ducts involvement, compression and jaundice (26,27).…”