Clinical and Demographic Characteristics of Patients with Urinary Tract Hydatid Disease

Jason Mulvenna,Mou Huang,Hong Zheng

doi:10.1371/journal.pone.0047667

Abstract

BackgroundHuman cystic echinococcosis (CE) is caused by flatworm larvae of Echinococcus granulosus and is endemic in many parts of the world. In humans, CE cysts primarily affect the liver and pulmonary system, but can also affect the renal system. However, the clinical manifestations of renal CE can be subtle, so healthcare professionals often overlook renal CE in differential diagnosis. In this study, we examined the clinical and demographic characteristics of patients with urinary tract CE and analyzed the diagnosis and treatment procedures for this disease.MethodsThe records of 19 consecutive renal CE patients who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1983 to April 2011 were retrospectively reviewed. In all cases, CE of the urinary tract was confirmed by pathological examination and visual inspection during surgery.ResultsFifteen patients were males and 4 were females. The most common symptoms were non-specific lower back pain and percussion tenderness on the kidney region. All patients were followed up for 9–180 months after surgery. None of the patients experienced a recurrence of renal CE, but 4 patients experienced non-renal recurrence of hydatid disease.ConclusionsHydatid cysts from E. granulosus are structurally similar in the liver and urinary tract. Thus, the treatment regimen for liver CE developed by the World Health Organization/Informal Working Group on Echinococcosis (WHO/IWGE) could also be used for urinary tract CE. In our patients, the use of ultrasound, computed tomography, serology, and clinical characteristics provided a diagnostic accuracy of 66.7% to 92.3%.

Highlights

Cystic echinococcosis (CE), known as hydatid disease, is a condition caused by infection with the larval form of the parasitic tapeworm Echinococcus granulosis
Urinary tract cystic echinococcosis (CE) can be difficult to diagnose due to the slow growth of cysts, the presence of non-specific and subtle clinical manifestations, and the rarity of daughter vesicles in the urine, the defining sign of this disease [4,22,23]
Our results indicate that pre-operative serological analysis of echinococcus granulosus cyst fluid antigen B (EgB) and Em2 antibodies using the Rapid Diagnostic Kit for Human Echinococcosis had a 92.3% positive rate for detection of CE, comparable to other common serological detection methods such as ELISA [12,20,21,23]

Summary

Introduction

Cystic echinococcosis (CE), known as hydatid disease, is a condition caused by infection with the larval form (metacestode) of the parasitic tapeworm Echinococcus granulosis. Once the eggs hatch in the intestines of the human host, the embryos (oncospheres) can enter the circulatory system, invade various organs, and develop into hydatid cysts that can cause life-threatening complications [5]. Human cystic echinococcosis (CE) is caused by flatworm larvae of Echinococcus granulosus and is endemic in many parts of the world. CE cysts primarily affect the liver and pulmonary system, but can affect the renal system. We examined the clinical and demographic characteristics of patients with urinary tract CE and analyzed the diagnosis and treatment procedures for this disease

Methods

Results

Conclusion