Aged ; Brain ; parasitology ; Echinococcosis, Hepatic ; diagnosis ; etiology ; therapy ; Echinococcosis, Pulmonary ; diagnosis ; etiology ; therapy ; Female ; Humans ; Lymphoma, T-Cell ; complications

OBJECTIVETo approach the clinical characteristics and surgical treatment of children with pulmonary echinococcus.

METHODSRetrospective analysis of child patients with pulmonary echinococcus from January 1980 to December 2008 was carried out, associated with clinical manifestations, diagnosis and treatment, operation methods (complete removal of endocyst and cystectomy with needle aspiration), prognosis and recurrence. There were 93 patients (54 male and 39 female) aged from 2 to 14 years. There were 82 cases lived in the echinococcosis pulmonary endemic areas, accounting for 88.1% (82/93), and 79 cases of patients had obvious contact with dogs or sheep, accounting for 84.9% (79/93). There were 68 cases with simple pulmonary echinococcus accounted for 73.1% (68/93), 25 cases suffered from complexity pulmonary hydatid, accounting for 26.9% (25/93).

RESULTSAll patients were cured or improved after surgery except one dead. Six cases got postoperative pulmonary infection, 3 cases had wound infection, 1 case suffered from bile-pleura fistula. There were 76 patients (81.7%) followed up for 1 to 10 years after surgery. Five cases had recurrence, the recurrence rate was 5.4% (5/93).

CONCLUSIONSThe clinical symptoms of pulmonary echinococcus in children is not typical, misdiagnosis and missed diagnosis take place easily. Complete removal of endocyst has low postoperative complications and lower relapse rate.

Adolescent ; Child ; Child, Preschool ; Echinococcosis, Pulmonary ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies

Adult ; Benzimidazoles ; therapeutic use ; Echinococcosis, Pulmonary ; diagnosis ; drug therapy ; Female ; Humans

A 20 year-old woman was admitted to our clinic complaining of dyspnea, cough, chest pain and pleural effusion. The diagnosis of pulmonary hydatid cyst was made on the basis of parasitology laboratory findings, computed tomographic results and chest radiographic findings. A giant pulmonary hydatid cyst (33x14x12 cm) was located in the left lower lobe, which involved more than 90% of the lobe. The patient was treated surgically using cystotomy and capitonnage. This is a case of a giant pulmonary hydatid cyst published in the literature, which was surgically treated without a lobectomy, by preserving the lung parenchyma.
Albendazole/therapeutic use ; Antiparasitic Agents/therapeutic use ; Cystotomy/methods ; Echinococcosis, Pulmonary/*diagnosis/radiography/*surgery ; Female ; Humans ; *Pneumonectomy ; Young Adult

To establish a definite diagnosis for pulmonary hydatid disease, combination of radiology and serology is useful. In this study, 19 preoperative sera from patients with surgically confirmed pulmonary hydatidosis, 40 sera from patients with other parasitosis and pulmonary diseases, and 20 sera from healthy donors were evaluated using 4 different serological tests, i.e., the commercial ELISA (ELISA-kit) test, the ELISA (ELISA-lab) test prepared in our laboratory, the commercial indirect hemagglutination assay kit (IHA-kit) test, and the IHA test using sensitized sheep red blood cells with tannic acid (IHA-TA). The ELISA-kit was the most sensitive (84.2%) and the most specific test (100.0%). The ELISA-kit also demonstrated the highest positive (100.0%) and negative (95.2%) predictive values. The sensitivity of the ELISA-lab test, that we prepared, was found to be 73.6%, whereas the IHA-kit test and the IHA-TA test were found to be 73.6% and 68.4%, respectively. The specificity of these tests was 96.6%, 98.3%, and 83.3%, respectively. When all 4 tests were assessed together, it was found that the sensitivity had risen to 94.7%. When the ELISA-kit was assessed with the IHA-kit and IHA-TA together, it was found that the sensitivity was 89.5% and 84.2%, respectively. Likewise, the combination of the ELISA-lab and IHA-kit or IHA-TA allowed us to achieve a sensitivity of 84.2% in cases of pulmonary echinococcosis. In conclusion, the diagnosis would be imminent if least 2 tests were applied together.
Echinococcosis, Pulmonary/*diagnosis ; Enzyme-Linked Immunosorbent Assay/*methods ; Hemagglutination Tests/*methods ; Humans ; Predictive Value of Tests ; Sensitivity and Specificity ; Serologic Tests/methods

The diagnosis of human hydatidosis is primarily made using radiological and serological methods. Radiological methods are generally of low specificity and serological methods lack sensitivity, especially for pulmonary disease. In this study the capabilities of a new rapid test, the hydatid antigen dot immunobinding assay (HADIA), which was developed for the diagnosis of pulmonary hydatidosis, were studied and compared with another immunodiagnostic method, indirect hemagglutination (IHA). The study subjects included 18 patients, 9 women, 9 men; range 7 to 63 years; mean 30 years, with surgically proven pulmonary hydatidosis, a control group comprised of 14 patients; viral respiratory infections (1), cirrhosis (2), connective tissue disease (2), taeniasis (3), and 6 healthy donors. We found that the HA-DIA test had a sensitivity of 67% and specificity of 100%, and that the IHA test had a sensitivity of 50% and specificity of 100%. We conclude that HA-DIA is a simple, rapid, low cost assay that does not require instrumentation and has a higher sensitivity than IHA for the diagnosis of pulmonary hydatidosis.
Adolescent ; Adult ; Antibodies, Helminth/*blood ; Child ; Echinococcosis, Pulmonary/*diagnosis ; False Negative Reactions ; False Positive Reactions ; Female ; Humans ; Immunoblotting/*methods ; Male ; Middle Aged ; Sensitivity and Specificity

Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement. Fewer than 25 cases of joint hydatidosis have been reported in literature to date. In the second case, the intramural hydatid cyst was incidentally discovered at autopsy, in the left heart ventricle of a 52-year-old male hospitalized for a fatal brain hemorrhage, as a result of rupture of an anterior communicating artery aneurysm. The conclusion of our paper is that echinococcosis should be taken into account for the differential diagnosis of cystic lesions, independently from their location.
Aged ; Autopsy ; Diagnosis ; Diagnosis, Differential ; Echinococcosis* ; Echinococcus granulosus ; Female ; Heart Ventricles ; Heart* ; Hip Joint* ; Hip* ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Joints ; Liver ; Lung ; Male ; Membranes ; Middle Aged ; Myocardium ; Osteoarthritis, Hip ; Rupture ; Synovial Membrane ; Tuberculosis ; Tuberculosis, Pulmonary

In December 2011, we reported an autochthonous case of Echinococcus multilocularis infection in a 42-year-old woman in Korea. The diagnosis was based on histopathological findings of the surgically resected liver cyst. In the present study, we evaluated the serological and molecular characteristics of this Korean E. multilocularis case. The patient's serum strongly reacted with affinity-purified native Em18 and recombinant Em18 antigens (specific for E. multilocularis) but negative for recombinant antigen B8/1 (reactive for Echinococcus granulosus). In immunoaffinity chromatography, the serum also strongly reacted with E. multilocularis and only weakly positive for E. granulosus. We determined the whole nucleotide sequence of cox1 (1,608 bp) using the paraffin-embedded cystic tissue which was compared with E. multilocularis isolates from China, Japan, Kazakhstan, Austria, France, and Slovakia. The Korean case showed 99.8-99.9% similarity with isolates from Asia (the highest similarity with an isolate from Sichuan, China), whereas the similarity with European isolates ranged from 99.5 to 99.6%.
Adult ; Animals ; Antibodies, Helminth/*blood ; Antigens, Helminth/genetics/*immunology/metabolism ; Base Sequence ; Echinococcosis, Hepatic/*immunology/parasitology ; Echinococcosis, Pulmonary/diagnosis/genetics/immunology ; Echinococcus granulosus/genetics/immunology ; Echinococcus multilocularis/genetics/*immunology/isolation & purification ; Electron Transport Complex IV/genetics ; Female ; Humans ; Mitochondria/genetics ; Molecular Sequence Data ; Republic of Korea ; Sequence Analysis, DNA