Diagnostic, Surgical, and Medicinal Approaches of Human Cystic Echinococcosis

Abstract

Background Cystic echinococcosis (CE) is a significant zoonotic disease in various parts of the world including Iran. The aim of this study was to review the results of different diagnostic techniques and treatment management of the disease. Methods Medical records of 203 patients (117 females and 86 males) who underwent surgical treatment for CE between 1999 and 2009 in Tehran were explored and analyzed. Outcomes measured were recurrence, antiparasitic drug, hospital stay, and diagnostic and surgical techniques. Results Diagnosis of CE in the region is largely dependent on ultrasonography (US) followed by computed tomographic scan, so that 69% of the cases are diagnosed by US alone (39.5%) and in conjunction with computed tomographic scan (29.5%). Among surgical procedures for human CE, evacuation and drainage are mostly preferred in general hospitals of Tehran. Mean ± SD total hospital stay was 11.11 ± 8.62 days (range, 1–68 days). Most (61.6%) of the patients are required to stay in hospitals from 1 to 10 days after surgery. In contrast, 22.2% of them estimated hospitalization of more than 15 days of postoperative hospital stay. Recurrent CE was observed in 48 patients (25%) in this 10-year period, and 10 (5.2%) of them were operated on for at least the third time. However, a decreasing trend in the incidence of recurrence after 2003–2004 was observed. Eighty-one patients (39.9%) received albendazole (76 patients with albendazole alone and 5 cases with metronidazole) among the surgically treated cases. Conclusion Hydatid cyst should be in mind for differential diagnosis of tissue masses and suitable treatment, particularly for patients who lived in, or traveled to, an endemic area. Surgery is an effective treatment for CE in patients. The high rate of relapse of the disease may provide new insights on diagnostic methods and treatment management and may also be useful for assessing the cost effectiveness of designing effective intervention programs to reduce recurrence and to control the disease in this and other endemic areas.