Laboratory Diagnosis of Echinococcus spp. in Human Patients and Infected Animals

Species specificity preliminary evaluation of an IL‐4‐based test for the differential diagnosis of human echinococcosis

“…The geographical distribution of CE and AE greatly overlaps in central Asia and China, making the differential diagnosis of these two conditions particularly challenging. This is further complicated by the high rate of cross‐reactivity of serological tests (50%‐100%) …”

“…[7][8][9] Several approaches, such as the use of different sources of antigens and different readout systems, have been attempted to overcome the serology shortfalls. [9][10][11][12][13][14] The most commonly used serological tests for human CE are based on the detection of IgG antibodies against E granulosus hydatid cyst fluid (HCF). These tests show an 80%-99% sensitivity with variable specificity (60%-97%), while tests detecting IgG against purified or recombinant antigens show a better specificity (80%-100%) but lower sensitivity (38%-93%).…”

Cystic and alveolar echinococcosis: Successes and continuing challenges

“…In this regard, the main advances have been achieved by the combination of serological tests and functional imaging to monitor response to treatment [3, 4, 7] and the use of molecular identification and species characterization in difficult cases [13]. Although antibodies against antigen B or antigen 5 show a higher sensitivity, crude parasite extracts (e.g., hydatid fluid) continue to be most widely used for antibody detection for CE cases [13]. Lack of test accuracy remains a critical issue for the diagnosis of CE, especially during community screenings.…”

“…Despite the use of the highly E . multilocularis -specific Em2 and Em18 antigens, cross-reactivity remains a problem and source of misinterpretation in areas where CE and AE co-exist [13]. …”

Alveolar echinococcosis in the liver of an adolescent boy

“…ELISA and indirect haemagglutination for echinococcosis were 2.01 optical density (OD; normal <0.50 OD) and 1:512 (normal <1:128), respectively. Infection with Echinococcus multilocularis was confirmed by specific bands for 7, 16, 18 and 26–28 kDa in Western blot and specific antibodies against EmG11 and Em18 1. On positron emission tomography (PET)-CT, metabolic activity was noted in the liver suggesting parasite viability2 (figure 2), and staging of the disease was P3N0M0 according to WHO criteria 3.…”