Abstract
BackgroundHuman alveolar echinococcosis (AE) caused by Echinococcus multilocularis is an underreported, often misdiagnosed and mistreated parasitic disease mainly due to its low incidence. The aim of this study was to describe the epidemiological and clinical characteristics of human AE patients in Hungary for the first time.MethodBetween 2003 and 2018, epidemiological and clinical data of suspected AE patients were collected retrospectively from health database management systems.ResultsThis case series included a total of 16 AE patients. The mean age of patients was 53 years (range: 24–78 years). The sex ratio was 1:1. Four patients (25%) revealed no recurrence after radical surgery and adjuvant albendazole (ABZ) therapy. For five patients (31.3%) with unresectable lesions, a stabilization of lesions with ABZ treatment was achieved. In seven patients (43.8%), progression of AE was documented. The mean diagnostic delay was 33 months (range: 1–122 months). Three AE related deaths (fatality rate 18.8%) were recorded.ConclusionsAE is an emerging infectious disease in Hungary with a high fatality rate since based on our results, almost every fifth AE patient died in the study period. Differential diagnosis and appropriate surgical and medical therapy for AE is an urging challenge for clinicians in Hungary, as well as in some other European countries where E. multilocularis is prevalent.
Highlights
Human alveolar echinococcosis (AE) caused by Echinococcus multilocularis is an underreported, often misdiagnosed and mistreated parasitic disease mainly due to its low incidence
AE is an emerging infectious disease in Hungary with a high fatality rate since based on our results, almost every fifth AE patient died in the study period
Human alveolar echinococcosis (AE) is one of the most dangerous and potentially lethal parasitic zoonosis in the temperate and arctic regions of Europe, which is caused by Echinococcus multilocularis (Em), a small tapeworm belonging to family Taeniidae [1]
Summary
Human alveolar echinococcosis (AE) caused by Echinococcus multilocularis is an underreported, often misdiagnosed and mistreated parasitic disease mainly due to its low incidence. The aim of this study was to describe the epidemiological and clinical characteristics of human AE patients in Hungary for the first time. Human alveolar echinococcosis (AE) is one of the most dangerous and potentially lethal parasitic zoonosis in the temperate and arctic regions of Europe, which is caused by Echinococcus multilocularis (Em), a small tapeworm belonging to family Taeniidae [1]. Diagnosis of AE is based on clinical and epidemiological data, imaging techniques, histopathology and/or nucleic acid detection and serology [7]. Imaging techniques has a central role in the differential diagnosis and clinical management of human AE. Rescue liver transplantation is a therapeutic option for AE patients with inoperable lesions and/or chronic liver failure [7, 20]
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