Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives

Abstract

Clinical management of cystic echinococcosis (CE) has evolved over decades without adequate evaluation of important features such as efficacy, effectiveness, rate of adverse reactions, relapse rate, and cost. CE occurs in health care environments as different as Europe/North America and resource-poor countries of the South and the East. This creates setting-specific problems in the management of patients. Furthermore, studies carried out in either of the two fundamentally different environments lack external validity, i.e., results obtained in one setting may be different from those in the other and practices that can work in one may not be applicable to the other. In this paper, we review the current management procedures of CE with particular emphasis on the evidence base and setting-specific problems.

Factors Influencing the Serological Response in Hepatic Echinococcus granulosus Infection

“…CE3 cysts have been further differentiated into CE3a (with detached endocyst or water lily sign) and CE3b (predominantly solid with daughter vesicles). 7 According to a study on the metabolic profiles of these stages, CE3b cysts should be classified as active, while CE3a can be equally likely to be active or inactive. 8 Serology has a complementary role to imaging in the diagnosis of CE.…”

Profile of patients with hepatic hydatid disease not treated surgically

“…The mean cyst size was 5.5 cm (range: 2.1-12.5 cm) with a median size of 7.5 cm. Based on the WHO classification (7,8): 16 cysts were small (< 5 cm), 14 medium (5 to 10 cm) and 3 large (> 10 cm) (7,8). The cyst location was the right liver in 14 patients (48%), left liver in 5 patients, bilobar in 6 patients, and intra-abdominal dissemination in 2 cases.…”

“…The diagnosis of HHD was made in all the patients by means of sonography, abdominal CT and indirect hemagglutination serology. The variables studied were: age, sex distribution, number of cysts, size of the largest cyst, cyst location, type of cyst according to the WHO classification: CE1, CE2 and CE3b (active), CE3a (transitional), and CE4 and CE5 (inactive) (7,8), clinical form of presentation (asymptomatic, jaundice, abdominal pain or other), casual or targeted diagnosis, a new case or recurrence of a previously treated case, ASA grade, the surgeon's therapeutic decision, the patient's final decision and, if both decisions coincided, the type of treatment used. The statistical analysis was made with SPSS 16.0 for Mac.…”

A comparison of imaging guided double percutaneous aspiration injection and surgery in the treatment of cystic echinococcosis of liver

“…23,24 It is a potentially life-threatening disease found in pastural regions with an incidence as high as 220 per 100,000 inhabitants in some endemic areas. 3 A wide range of treatment modalities available at various stages with an equally wide range of resources, technological and training backgrounds are necessary for implementation and delivery of each of these modalities.…”