Echinococcus Infection Research Articles

7667 Cushing’s Puzzle: Echinococcal Pituitary Cyst In A Rare Encounter

Abstract Disclosure: E. Sari: None. F. Erenler: None. Introduction: Echinococcus is a rare parasitic infection endemic in the Mediterranean, Middle East, South America and Africa, which can cause cystic disease in several organs. Central nervous system involvement is known to comprise 1-2% of all cystic echinococcal disease. Hereby, we report a case of an opportunistic pituitary echinococcus infection in a patient with hypercortisolism due to adrenocortical adenoma with initial misdiagnosis of Cushing’s disease. Clinical Case: A 40-year-old South American female with poorly controlled T2DM on oral agents and hypertension presented to the ER with abdominal pain and subsequent CT of the abdomen with contrast showed a right adrenal mass measuring up to 2.8 cm. A follow up CT with adrenal protocol confirmed 3.3 cm right adrenal mass, 46 HU in precontrast images with >50% washout. Review of records revealed that a recent MRI brain with contrast was performed for headache evaluation and showed an incidental 5x7x4 mm lesion in the pituitary gland. Endocrinology evaluation revealed 24-hour urine volume 1800 mL, elevated free cortisol levels 277.6 mcg/24hr (RR: 4.0-50.0 mcg/24hr), creatinine of 0.67g/24hr (RR: 0.50-2.15g/24hr). 1 mg dexamethasone suppression test showed AM cortisol of 28.7 mcg/dL. ACTH was elevated at 67 pg/mL (RR: 6-50 pg/mL). FSH, LH, and GH were normal. Presumed diagnosis of ACTH-dependent hypercortisolism was made and she underwent bilateral inferior petrosal sinus sampling with confirmed successful cannulation but this was inconclusive due to low ACTH levels. Follow-up MRI of the pituitary gland showed T1 bright, T2 isointense circumscribed lesion measuring 7x6x3 mm at anterior pituitary gland with a thin rim of peripheral enhancement consistent with cystic features. She underwent transsphenoidal resection of the pituitary lesion and the pathology specimen showed parasites consistent with echinococcosis. Infectious disease was consulted, and the patient started on albendazole. Post-operative laboratory evaluation was notable for persistently elevated AM cortisol, 24-hour urine free cortisol levels, and low ACTH levels, confirming ACTH independent hypercortisolism. She underwent right adrenal nodule resection and pathology was consistent with adrenocortical adenoma. Post-adrenalectomy AM cortisol levels were < 2 mcg/dL, indicating the resolution of hypercortisolism along with substantiating the diagnosis of primary adrenocortical hyperfunction. Conclusion: To the best of our knowledge, this is the first case report of an opportunistic echinococcus infection presenting as a pituitary lesion in the setting of Cushing Syndrome. We would like to highlight the importance of recognizing opportunistic infections, including Echinococcus as a potential etiology in the setting of hypercortisolism, especially for patients from endemic regions. Presentation: 6/2/2024

Spinal hydatid disease: A case report

Introduction: The parasitic tapeworm Echinococcus granulosus causes cystic echinococcosis, also known as hydatidosis. It is a serious medical condition that can show up in a lot of different ways. Although spinal involvement occurs in about 45% of bone echinococcosis cases, it represents only 0.5–4% of all echinococcosis cases. The disease can spread to the spine through hematogenous dissemination, direct invasion, or cerebrospinal fluid seeding from ruptured cysts. While the liver and lungs are the most commonly affected organs, spinal involvement can lead to severe complications, including radiculopathy, motor deficits, and paraparesis. Imaging, such as computed tomography (CT) and (MRI), typically makes the diagnosis by revealing cystic and osteolytic lesions. Case Report: The patient is a 51-year-old male from the Kakheti region (a region in Georgia) who presented with progressive generalized weakness, nausea, vomiting, and lumbar pain. He had a history of spinal echinococcosis, diagnosed 15 years ago, but was unable to complete antiprotozoal treatment due to intolerance to albendazole. Over the years, his condition deteriorated, leading to lower paraplegia and urinary incontinence, necessitating a suprapubic cystostomy. Imaging revealed extensive septated cystic lesions in Th4-S1, which spread to the ribs and subcutaneous tissues. Despite neurosurgical intervention to reduce the cyst burden, the infestation persisted. Multiple hospitalizations were required for complications, such as urinary tract infections and pneumonia. Joint supervision managed the patient’s condition, but he continued to experience spherocyte discharge from numerous fistulas. Conclusion: This case underscores the severe and chronic nature of spinal echinococcal infection, particularly when complete antiprotozoal treatment is not feasible. The patient did not experience severe neurological complications despite the extensive disease burden and the development of multiple vertebral-cutaneous fistulas, possibly due to the continuous drainage of spherocytes. This unusual clinical course highlights the importance of comprehensive management and the potential impact of innovative approaches on managing complex parasitic infections.

Construction and application of a risk index of Echinococcus infection based on the classification of echinococcosis lesions

To investigate the feasibility of constructing the risk index of Echinococcus infection based on the classification of echinococcosis lesions, so as to provide insights into the management of echinococcosis. The imaging data of echinococcosis cases were collected from epidemiological surveys of echinococcosis in China from 2012 to 2016, and the detection of incident echinococcosis cases was captured from the annual echinococcosis prevention and control reports across provinces (autonomous regions) and Xinjiang Production and Construction Corps in China from 2017 to 2022. After echinococcosis lesions were classified, a risk index of Echinococcus infection was constructed based on the principle of discrete distribution marginal probability and multi-group classification data tests. The correlation between the risk index of Echinococcus infection and the detection of incident echinococcosis cases was evaluated in the provinces (autonomous regions and corps) from 2017 to 2022, and the correlations between the short and medium-term risk indices and between the medium and long-term risk indices of Echinococcus infection were examined using a univariate linear regression model. A total of 4 014 echinococcosis cases in China from 2012 to 2016 were included in this study. The short-, medium- and long-term risk indices of E. granulosus infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ2 = 4.12 to 708.65, all P values < 0.05), with high short- (0.058), medium- (0.137) and long-term risk indices (0.104) in Tibet Autonomous Region, and the short-, medium- and long-term risk indices of E. multilocularis infection varied in echinococcosis-endemic provinces (autonomous regions and corps) of China (χ2 = 6.74 to 122.60, all P values < 0.05), with a high short-term risk index in Sichuan Province (0.016) and high medium- (0.009) and long-term risk indices in Qinghai Province (0.018). There were no significant correlations between the risk index of E. granulosus infection and the detection of incident cystic echinococcosis cases during the study period (t = -0.518 to 2.265, all P values > 0.05), and strong correlations were found between the risk indices of E. multilocularis infection and the detection of incident alveolar echinococcosis cases (including mixed type) in 2018, 2020, 2021, 2022, during the period from 2017 through 2020, from 2017 through 2021, from 2017 through 2022 (all r values > 0.7, t = 2.521 to 3.692, all P values < 0.05). Linear regression models were established between the risk index of E. multilocular infection and the detection of alveolar echinococcosis cases (including mixed type), and the models were all statistically significant (b = 0.214 to 2.168, t = 2.458 to 3.692, F = 6.044 to 13.629, all P values < 0.05). The regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. granulosus infection were 2.339 and 0.765, and the regression coefficients for the correlations between the medium- and short-term, and between the long- and medium-term risk indices of E. multilocular infection were 0.280 and 1.842, with statistical significance seen in both the regression coefficients and regression models (t = 16.479 to 197.304, F = 271.570 to 38 928.860, all P values < 0.05). The risk index of Echinococcus infection has been successfully established based on the classification of echinococcosis lesions, which may provide insights into the prevention and control, prediction, diagnosis and treatment, and classified management of echinococcosis.

Differences between the intestinal microbial communities of healthy dogs from plateau and those of plateau dogs infected with Echinococcus

ObjectiveCystic echinococcosis (CE) represents a profoundly perilous zoonotic disease. The advent of viral macrogenomics has facilitated the exploration of hitherto uncharted viral territories. In the scope of this investigation, our objective is to scrutinize disparities in the intestinal microbiotic ecosystems of canines dwelling in elevated terrains and those afflicted by Echinococcus infection, employing the tool of viral macrogenomics.MethodsIn this study, we collected a comprehensive total of 1,970 fecal samples from plateau dogs infected with Echinococcus, as well as healthy control plateau dogs from the Yushu and Guoluo regions in the highland terrain of China. These samples were subjected to viral macrogenomic analysis to investigate the viral community inhabiting the canine gastrointestinal tract.ResultsOur meticulous analysis led to the identification of 136 viral genomic sequences, encompassing eight distinct viral families.ConclusionThe outcomes of this study hold the potential to enhance our comprehension of the intricate interplay between hosts, parasites, and viral communities within the highland canine gut ecosystem. Through the examination of phage presence, it may aid in early detection or assessment of infection severity, providing valuable insights into Echinococcus infection and offering prospects for potential treatment strategies.

Recombinant CD5 and CD6 Ectodomains Induce Antiparasitic and Immunomodulatory Effects in Secondary Cystic Echinococcosis.

Scavenger receptors participate in a wide range of biological functions after binding to multiple non-self or altered self-ligands. Among them, CD5 and CD6 are lymphocyte scavenger receptors known to interact with different microbial-associated molecular patterns, and the administration of the recombinant soluble ectodomains of human CD5 (rshCD5) and/or CD6 (rshCD6) has shown therapeutic/prophylactic potential in experimental models of fungal, bacterial and echinococcal infections. The latter is a zoonosis caused by the larval stage of the cestode parasite Echinococcus granulosus sensu lato, which in humans can induce secondary cystic echinococcosis (CE) after the spillage of protoscoleces contained within fertile cysts, either spontaneously or during surgical removal of primary hydatid cysts. Herein, we have analysed the mechanisms behind the significant protection observed in the mouse model of secondary CE following prophylactic administration of rshCD5 or rshCD6. Our results show that both molecules exhibit intrinsic antiparasitic activities in vitro, as well as immunomodulatory functions during early secondary CE, mainly through Th1/Th17 cytokine bias and promotion of peritoneal polyreactive antibodies. These data support the relevance of the parasite components bound by rshCD5 and rshCD6, as well as the potential of their prophylactic administration as a useful strategy to reduce secondary CE in patients.

Serological Comparison of Native Antigen ELISAs with Rapid ICT Test Kits for the Diagnosis of Human Alveolar and Cystic Echinococcosis in China.

The aim of this study was to compare the diagnostic performance of native antigen ELISAs and ADAMU-AE/CE commercial ICT test kits in subjects either exposed to Echinococcus infection or with clinically diagnosed alveolar (AE) or cystic (CE) echinococcosis. A total of 370 subjects with a previous clinical confirmation of CE or AE from northwestern China were recruited. Serum samples were also obtained from 3923 children/teenagers during a community survey. All sera were tested using native antigen ELISAs. The ADAMU-AE/CE test kits were subsequently used for the serology of the 370 clinically confirmed individuals and of 251 children/teenagers that were ELISA antibody-positive for both Echinococcus species but ultrasound-negative during baseline survey. An analysis of the association between the serological tests and ultrasound classification was carried out amongst 89 AE and 164 CE cases. A Kappa consistency analysis was undertaken to compare the diagnostic performance of the native antigen ELISAs and the ADAMU kits and the ultrasound imaging results. The χ² test was also used for a comparison of the different seropositivity rates between the groups. There was poor consistency (Kappa = 0.26 and 0.28 for AE and CE respectively) between the native antigen ELISAs and the ADAMU kits for the diagnosis of AE and CE among the cases and the surveyed children/teenagers, but a relatively good consistency (Kappa = 0.63) between the ADAMU-AE kit and ultrasound observations for the AE cases. Additionally, of the 251 teenagers co-positive for both AE and CE antibodies by the native antigen ELISAs, only one was found positive by the ADAMU-AE kit, verified as a new AE case on subsequent ultrasound follow-up. The remainder (N = 250) were negative by serology using the ADAMU-AE/CE kits and by ultrasound examination. The two native antigen ELISAs did not discriminate well between cases of clinically diagnosed AE and CE. In contrast, ADAMU-AE and ADAMU-CE commercial ICT test kits readily differentiated cases of AE from CE with specificities of 99% for AE and 100% for CE. The ADAMU-AE/CE kits proved reliable, accurate, and amenable diagnostic tools in the clinical setting for confirmation of suspected AE/CE cases. The native antigen ELISAs tests can provide useful information on the level of human exposure to Echinococcus infection.

Effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source in Sichuan Province from 2010 to 2022

To evaluate the effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source in Sichuan Province from 2010 to 2022, so as to provide insights into formulation of future control interventions. Data pertaining to comprehensive echinococcosis control measures with emphasis on management of infectious source and echinococcosis surveillance in Sichuan Province from 2010 to 2022 were collected. The effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source was evaluated with prevalence of human echinococcosis, detection of newly diagnosed echinococcosis patients, prevalence of Echinococcus infection in domestic dogs, prevalence of cystic echinococcosis in livestock, prevalence of alveolar echinococcosis in small mammals and awareness of echinococcosis control knowledge, and Spearman's rank correlation analysis. The prevalence of human echinococcosis reduced from 1.08% in 2010 to 0.40% in 2022 in Sichuan Province (χ2 = 1 482.97, P < 0.05), with a reduction from 0.30% to 0.02% in the detection of newly diagnosed echinococcosis cases (χ2 = 2 776.41, P < 0.05), a reduction from 15.87% to 0.46% in the prevalence of Echinococcus infection in domestic dogs (χ2 = 20 823.96, P < 0.05), a reduction from 8.05% to 1.07% in the prevalence of cystic echinococcosis in livestock (χ2 = 1 296.02, P < 0.05), and the awareness of echinococcosis control knowledge increased from 50.65% to 95.24% (χ2 = 34 938.63, P < 0.05); in addition, there was a year-specific prevalence rate of alveolar echinococcosis in small mammals (χ2 = 164.07, P < 0.05). Spearman's rank correlation analysis revealed that the detection of newly diagnosed echinococcosis cases correlated positively with the prevalence of Echinococcus infections in domestic dogs (rs = 0.823, P < 0.05) and the prevalence of cystic echinococcosis in livestock (rs = 0.795, P < 0.05), and correlated negatively with the awareness of echinococcosis control knowledge (rs = - 0.918, P < 0.05), and the prevalence of Echinococcus infection in domestic dogs correlated positively with the prevalence of cystic echinococcosis in livestock (rs = 0.753, P < 0.05) and negatively with the awareness of echinococcosis control knowledge (rs = -0.747, P < 0.05); however, there was no correlation between the prevalence of Echinococcus infections in domestic dogs and the prevalence of alveolar echinococcosis in small mammals (rs = -0.750, P > 0.05). The comprehensive echinococcosis control measures with emphasis on management of infectious source had achieved remarkable effectiveness in Sichuan Province; however, the transmission chain of echinococcosis has not been interrupted. Reinforced comprehensive echinococcosis control measures with emphasis on management of infectious source and sustained tracking evaluation of the effectiveness are recommended in Sichuan Province.

What are the Strategies for Controlling Hydatid Cysts in Developing Countries?

Hydatid cysts (HC), caused by the tapeworm of the genus Echinococcus, pose a significant public health challenge in many developing countries. These cysts primarily affect livestock, such as sheep, cattle, and goats, but can also infect humans, the two most important forms in humans are cystic echinococcosis (hydatidosis) and alveolar echinococcosis, leading to serious health complications. Control measures for HC are crucial to lessen the impact on both human and animal health. This editorial explores the possible strategies for controlling HC in developing countries, focusing on prevention, surveillance, treatment, and community education [1,2]. Preventing HC in developing countries may require a multifaceted approach. One crucial aspect is controlling the transmission of Echinococcus eggs from infected animals to humans. This involves implementing measures such as deworming programs for livestock, proper disposal of infected animal carcasses, and promoting good hygiene practices among livestock handlers and population Furthermore, community education plays a vital role in preventing HC. Educating individuals about the risks associated with handling infected animals, the importance of proper hand hygiene, and the benefits of cooking meat thoroughly can help reduce the transmission of the parasite [2]. Effective surveillance is essential for monitoring the prevalence of HC and identifying high-risk areas in developing countries. Surveillance systems should involve regular screening of both livestock and humans for Echinococcus infection. This can be achieved through the use of diagnostic tests such as serological assays and imaging techniques like ultrasound. Additionally, active surveillance programs can help detect outbreaks early and facilitate timely intervention measures. Collaborative efforts between government agencies, healthcare providers, and veterinary professionals are crucial for establishing robust surveillance systems in resource-limited settings [3, 4]. Treating HC in developing countries often presents challenges due to limited access to healthcare resources and diagnostic tools. However, prompt diagnosis and treatment are essential to prevent complications such as cyst rupture and dissemination. Surgical intervention remains the primary treatment option for HC, involving the removal of the cysts and surrounding tissue. In some cases, minimally invasive techniques such as puncture–aspiration–injection–re-aspiration (PAIR) may be used as an alternative to surgery, particularly in resource-limited settings. In addition to medical treatment, access to safe and effective anthelmintic drugs is crucial for controlling HC. Ensuring the availability of these medications and training healthcare providers in their appropriate use are essential components of treatment strategies in developing countries [5,6]. Educating communities about HC, their transmission, and prevention measures might play a significant role in sustainable control efforts. This can be achieved through various educational initiatives, including workshops, community outreach programs, and the distribution of educational materials. Furthermore, engaging with local community leaders and healthcare providers can facilitate the adoption of preventive measures within communities. Emphasizing the importance of early detection, timely treatment, and proper hygiene practices can empower individuals to take proactive steps in protecting themselves and their livestock from HC. In conclusion, controlling HC in developing countries requires a comprehensive approach that addresses prevention, surveillance, treatment, and community education. By implementing targeted interventions and fostering collaboration between government agencies, healthcare providers, community stakeholders, and the scientific community However, extensive research and investigations in this regard are highly recommended.

Echinococcal infection of the liver and the lung.

Echinococcal infection of the liver and the lung.

Prevalence of Echinococcus infections in wild carnivores based on copro - DNA tests in Serthar County of Sichuan Province

To investigate the prevalence of Echinococcus infections in wild carnivores in Serthar County, Sichuan Province, so as to provide insights into echinococcosis control in local areas. Stool samples were collected from wild carnivores in Serthar County, Sichuan Province in May 2021, and the host sources of stool samples and Echinococcus infections were identified using PCR assays. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was estimated in different hosts. A total of 583 stool samples were collected from wild carnivores, including 147 stool samples from fox, 154 from wolf, 227 from wild dogs and 11 from lynx. The overall prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.68%, 0.19% and 14.20% in canine stool samples, and no E. granulosus infection was detected in fox stool samples, while the prevalence of E. multilocularis and E. shiquicus infections was 0.68% and 47.62% in fox stool samples (χ2 = 88.41, P < 0.001). No E. granulosus or E. shiquicus infection was detected in wolf stool samples, and the prevalence of E. multilocularis infection was 10.39% in wolf stool samples. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.73%, 0.44% and 2.20% in canine stool samples (χ2 = 12.13, P < 0.01). In addition, the prevalence of E. multilocularis infections was significantly higher in wolf stool samples than in canine and fox stool samples (χ2 = 13.23, P < 0.01), and the prevalence of E. shiquicus infections was significantly higher in fox stool samples than in canine and wolf stool samples (χ2 = 187.01, P < 0.001). No Echinococcus infection was identified in 11 lynx stool samples. The prevalence of Echinococcus infections is high in wild canines in Serthar County, Sichuan Province. Wolf, wild dog and fox all participate in the wild life cycle of E. multilocularis in Serthar County, and wolf and wild dogs may play a more important role.

Efficiency of sandwich enzyme immunoassay for the diagnosis of larval echinococcus infection in cattle in the Republic of Azerbaijan

The purpose of the research is to develop a sandwich enzyme-linked immunosorbent assay (ELISA) for laboratory diagnosis of echinococcosis in animals. Materials and methods. The diagnostic efficiency of the ELISA test system developed by us against cystic echinococcus infection in cattle was studied by comparing the obtained results with the data of a postmortem examination of animal carcasses. The sera from 80 animals delivered to the slaughterhouse from farms of different regions of the Republic of Azerbaijan were tested. Results and discussion. A positive ELISA test result was obtained in 42 animals, which was 52.5% of the total number of the animals studied. The postmortem diagnosis was confirmed in 32 animals, which was 40.0%. The comparison of the ELISA diagnostic efficiency with the postmortem examination data was 68.75%. Fasciola species were found in the bile ducts in 7 animals with a positive ELISA test response to echinococcosis and a negative diagnosis in the postmortem examination, and Cysticercus tenuicollis was found in one animal.

Multiple and bilaterally pulmonary hydatid cystic present as metastas

Hydatid cyst is a parasitic infections of the humans that caused by echinococcus infection. This infection is considerable problem of public health. The most common locations in human body of a hydatid cyst are the liver (75%) and the lung tissue (15%) in the review of medical literature there was a few reports from bilaterally pulmonary hydatidosis which clinically mimics metastatic malignant tumors at initial clinical finding. Because of unusual presentation, the diagnosis with clinical presentations and CT-scan and CXR may easily be missed. For of this missed diagnosis problem, multiple and bilaterally hydatid cyst of lung should be in difrienciated diagnosis of others pulmonary diseases.

Cardiac hydatid disease; a systematic review

Background and objectivesHuman cystic echinococcosis (CE), is a common health problem in low- and middle-income countries. Cardiac involvement is a relatively rare manifestation of Echinococcus infection. This study aims to summarize the evidence regarding the features of cardiac CE.MethodsCase series of the patients with cardiac CE, were included in this study. Non-English papers, case reports, reviews, letters, , commentaries, and conference abstracts were not included. A systematic search was conducted in PubMed and EMBASE databases and the risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist.ResultsOut of 3985 results of the searches, finally 37 studies were included in this systematic review. Based on available evidence, cardiac involvement is an uncommon but serious presentation of CE which presents with some non-specific signs and symptoms. Dyspnea, chest pain, and palpitation are the most common symptoms of the disease and normal sinus rhythm is the most common Electrocardiogram (ECG) feature. The disease is not associated with high mortality in case of timely diagnosis and appropriate management.DiscussionConsecutive and complete inclusion of participants, statistical analysis, and appropriate reporting of the demographics were the sources of bias in the included studies. The exclusion of non-English papers was a limitation during the review process.FundingThe research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 69380).RegistrationThis study was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42022381204).

The first case of Echinococcus canadensis found in a moose in Norway: What does it entail?

The first case of Echinococcus canadensis found in a moose in Norway: What does it entail?

Molecular Screening of Echinococcus spp. and Other Cestodes in Wild Carnivores from Central Italy.

Tapeworm infections are among the most relevant parasitic diseases in humans and animals. Tapeworms from the Genus Echinococcus are particularly important as they can cause cystic or alveolar echinococcosis. A molecular screening was performed on 279 fecal samples collected from carcasses of wild carnivores from Central Italy using PCR targeting diagnostic fragments of nad1, rrnS, and nad5 genes. Samples positive for either Taenia spp. or Echinococcus granulosus were sequenced to taxonomically identify the parasitic DNA. Of the 279 samples, 134 (48.0%) gave positive results in the multiplex PCR. Only one (0.4%) sample from an Apennine wolf tested positive for Echinococcus granulosus sensu stricto (genotype G3), whereas no sample tested positive for E. multilocularis. The most frequently detected tapeworms were: Mesocestoides corti (syn M. vogae) (12.9%), M. litteratus (10.8%), Taenia serialis (9.3%), and T. hydatigena (6.5%), other tapeworms were rarely detected. The results suggest that Echinococcus infections in Central Italy do not seem to be sustained by sylvatic cycles, confirming the absence of E. multilocularis in Central Italy. The survey corroborates, yet again, the importance of passive surveillance of wild animals that can serve as reservoirs for zoonotic pathogens, especially on wild canids that in other areas are strongly implicated in the transmission of E. granulosus and E. multilocularis.

Prevalence of Echinococcus infection in small mammals captured from Shiqu County, Sichuan Province from 2015 to 2020

To investigate the prevalence of Echinococcus infection in small mammals in Shiqu County, Sichuan Province from 2015 to 2020, so as to provide insights into echinococcosis control in Shiqu County. One setting with frequent activity of small mammals was sampled as the survey site from each of 9 townships where human alveolar echinococcosis was hyperendemic, in Shiqu County, Sichuan Province from 2015 to 2020. Two quadrats measuring 50 m × 50 m were assigned in each survey site during the period between July and August from 2015 to 2020 to capture all small mammals in quadrats, and the species of small mammals were identified by morphological characteristics. All captured small mammals were dissected in the field and Echinococcus infection was identified by visual examinations. The affected organs of Echinococcus - infected small mammals were collected, and Echinococcus infection was detected using PCR assay, with Echinococcus species characterized. The prevalence of Echinococcus infection was calculated in small mammals, and the trends in the prevalence of Echinococcus infection were analyzed during the period from 2015 to 2020. In addition, the prevalence of Echinococcus infection was compared in small mammals using visual examinations and PCR assay. A total of 2 692 small mammals were captured in the survey sites of Shiqu County from 2015 to 2020, and morphology characterized 1 360 Microtus fuscus (50.52%) and 1 332 Plateau pika (49.48%). The prevalence rates of Echinococcus infection were 35.63%, 19.16%, 21.41%, 8.40%, 7.68% and 4.44% by visual examinations and 18.96%, 5.36%, 5.61%, 4.58%, 3.30% and 0.37% by PCR assay in small mammals in Shiqu County from 2015 to 2020, both showing a tendency towards a decline year by year (χ2 = 215.024 and 117.045, both P values < 0.001). The prevalence of Echinococcus infection was significantly higher in small mammals by visual examinations than by PCR assay during the period from 2015 to 2020 except in 2018 (χ2= 33.597, 21.815, 51.373, 17.268 and 9.537, all P values < 0.01). PCR assay detected a reduction in the prevalence of E. multilocularis infection from 10.21% to 0.37% and a reduction in the prevalence of E. shiquicus infection from 8.75% to 0 in small mammals in Shiqu County from 2015 to 2020, both appearing a tendency towards a decline year by year (χ2 = 117.045 and 43.436, both P values < 0.001). In addition, the prevalence of E. multilocularis and E. shiquicus infections reduced from 15.19% to 0.45% and from 8.23% to 0 in M. fuscus, and the prevalence of E. multilocularis and E. shiquicus infections reduced from 7.76% to 0 and from 9.01% to 0 in P. pika in Shiqu County from 2015 to 2020. M. fuscus and P. pika were dominant species of small mammals in Shiqu County, Sichuan Province from 2015 to 2020, and E. multilocularis infection was mainly found in M. fuscus and E. shiquicus infection mainly found in P. pika. The prevalence of Echinococcus infection appeared a tendency towards a decline in both M. fuscus and P. pika year by year during the period from 2015 to 2020.

A Rare Case of Hepatic MALT Lymphoma with Coexistence of Hepatitis B Virus and Echinococcus Infection

Primary hepatic extranodal mucosa-associated lymphoid tissue (MALT) lymphoma is seen extremely rare compromising 0,016% among non-Hodgkin lymphomas. Association of chronic inflammatory conditions or infectious processes mostly hepatitis B virus (HBV) infection has been reported by scarce number of case presentations. Whereas MALT lymphoma accompanied by echinococcus granulosus infection was described only in one primary pulmonary lymphoma case. We herein present a primary hepatic MALT lymphoma case with both HBV carrier state and liver hydatid cyst history. A 86 years old male patient referred to our clinic with a sole liver mass and was diagnosed with primary hepatic MALT lymphoma by core biopsy. Positron emission tomography detected increased uptake in the liver lesion without any other uptake site. He was successfully treated with rituximab-chemotherapy, tenofovir and albendazole. By adding one more case to the literature we aimed to emphasize the probable etiologic causative role of echinococcus infection in MALT lymphoma.

Response of wild rodents to red fox feces: implication for the echinococcus infection.

Echinococcus multilocularis causes zoonotic disease, alveolar echinococcosis. The life cycle of E. multilocularis is maintained by the predator-prey relationship between red foxes and rodents. Infection to red fox (Vulpes vulpes) of E. multilocularis is considered that rodents take eggs of E. multilocularis, then red fox forage the rodents. However, it has been not known how to take eggs by rodents. On infection process of E. multilocularis from red foxes to rodents, we predicted that rodents would forage or touch with feces of red fox to use undigested materials within the feces. We monitored rodent's response to fox feces and their distance to the feces by using camera trap from May to October 2020. Myodes spp. and Apodemus spp. touched fox feces, and touch rate of Apodemus spp. was significantly higher than that of Myodes spp. We found smelling and passing as contact behaviors to fox feces by Myodes spp., while Apodemus spp. showed behaviors which oral directly contacted feces. There was no significant difference on the shortest distance between Apodemus spp. and Myodes spp. The distance between 0 cm and 5 cm was mostly observed for both rodents. The results that Myodes spp. did not forage feces and their contact to feces was low frequency suggested that the infection from red foxes to Myodes spp., the main intermediate host, was to be other pathways. The approach to feces and the act near feces might increase the probability attached with eggs.

Spontaneous Intraperitoneal Rupture of Hydatid Cyst – A Case Report

Spontaneous rupture of a hydatid cyst into the abdomen is one of the severe complications of echinococcal infection in endemic areas. The incidence of hydatid cyst rupture into the abdomen resulting in anaphylaxis and secondary infections, is on the rise. Rupture can be fatal if not diagnosed and managed promptly. Here we report a middle-aged man with clinical suspicion of a hydatid cyst who denied further evaluation and presented to the OPD after 6 hours with severe abdominal pain. Imaging studies revealed a ruptured hydatid cyst in the intraperitoneal cavity. Intra peritoneal rupture is a serious life-threatening complication of a hydatid cyst. Therefore, it is essential to diagnose and manage patients with hydatid cysts promptly. Expediting medical management with adherence to treatment regimen and surgical interventions if and when required at the earliest is imperative for a good prognosis.

Immunization with EmCRT-Induced Protective Immunity against Echinococcus multilocularis Infection in BALB/c Mice

Alveolar echinococcosis (AE) is a severe parasitic zoonosis caused by the larval stage of Echinococcus multilocularis. The identification of the antigens eliciting acquired immunity during infection is important for vaccine development against Echinococcus infection. Here, we identified that E. multilocularis calreticulin (EmCRT), a ubiquitous protein with a Ca2+-binding ability, could be recognized by the sera of mice infected with E. multilocularis. The native EmCRT was expressed on the surface of E. multilocularis larvae as well as in the secreted products of metacestode vesicles and protoscoleces (PSCs). The coding DNA for EmCRT was cloned from the mRNA of the E. multilocularis metacestode vesicles and a recombinant EmCRT protein (rEmCRT) was expressed in E. coli. Mice immunized with soluble rEmCRT formulated with Freund’s adjuvant (FA) produced a 43.16% larval vesicle weight reduction against the challenge of E. multilocularis PSCs compared to those that received the PBS control associated with a high titer of IgG, IgG1 and IgG2a antibody responses as well as high levels of Th1 cytokines (IFN-γ and IL-2) and Th2 cytokines (IL-4, IL-5 and IL-10), produced by splenocytes. Our results suggest that EmCRT is an immunodominant protein secreted by E. multilocularis larvae and a vaccine candidate that induces partial protective immunity in vaccinated mice against Echinococcus infection.