Echinococcus Multilocularis Research Articles

High PD-1 and CTLA-4 expression correlates with host immune suppression in patients and a mouse model infected with Echinococcus multilocularis

BackgroundAlveolar echinococcosis (AE), a fatal disease caused by Echinococcus multilocularis, often affects the liver, with tumor-like growth. However, the mechanism by which E. multilocularis evades host immune surveillance remains unclear.MethodsWe collected liver specimens from hepatic alveolar echinococcosis (HAE) patients and established a mouse model of E. multilocularis infection. Immunofluorescence staining and flow cytometry were performed to analyze programmed cell death protein 1 (PD-1) and cytotoxic T lymphocyte associated antigen 4 (CTLA-4) expression in human samples, while flow cytometry and quantitative real-time polymerase chain reaction (PCR) were performed for similar analyses in mouse samples. Cell proliferation and protoscolex (PSC) killing assays were designed to explore how E. multilocularis induces host immunosuppression.ResultsAn inflammatory reaction band with high PD-1 and CTLA-4 expression was found in close liver tissue (CLT). The ratio of regulatory T cells (Tregs) was higher in CLT than in distant liver tissue (DLT), and Tregs in CLT tended to express higher levels of PD-1 and CTLA-4 than those in DLT from HAE patients. Echinococcus multilocularis-infected mice showed significantly elevated expression of PD-1 and CTLA-4 on splenocytes and peritoneal cells. PD-1/PD-L1 or CTLA-4 pathway blockade could relieve the immunosuppressive effects of Tregs from infected mice and enhance PSC killing by mouse splenocytes.ConclusionsE. multilocularis regulated the function of T cells via the PD-1/PD-L1- and CTLA-4-dependent pathways and subsequently evaded host immune attacks. These findings provide insights for investigating the pathogenic mechanism of AE.Graphical

A computer model of the distribution of the tapeworm Echinococcus multilocularis in Ukraine

Alveolar echinococcosis, caused by the larval form of the parasitic tapeworm Echinococcus multilocularis, aff ects a wide range of animal species, including domestic and wild livestock, and is a highly pathogenic helminthic disease for humans. Recently developed for the species habitat suitability maps are restricted to the border of the European Union and have left Ukraine outside the scope of this study. Our goal was to model and characterize the large-scale ecological niche of E. multilocularis in Europe, placing a particular emphasis on Ukraine, and to justify an assessment of the risk of E. multilocularis transmission in Ukraine under current environmental conditions. Using the CMCC-BioClimInd dataset and a Bayesian modeling approach, we developed a habitat suitability map for the species in Ukraine and distinguished corresponding risk areas. We anticipate the model will enhance future surveillance eff orts and help to understand the epidemiological situation of the disease, especially under wartime conditions.

Emerging Echinococcus tapeworms: fecal PCR detection of Echinococcus multilocularis in 26 dogs from the United States and Canada (2022-2024).

To report quantitative PCR (qPCR) detection of Echinococcus multilocularis DNA in fecal samples from 26 dogs in the US and Canada. 26 dogs with fecal samples submitted for parasite screening by qPCR. Dog signalment, presenting concern, preventive care, and outcomes were obtained from the primary veterinarian via email or telephone, where available. Echinococcus multilocularis was detected in 26 of 2,333,797 dog fecal samples by reference laboratory fecal qPCR surveillance between March 2022 and July 2024. Seventeen E multilocularis-detected samples were sequenced as European haplotypes (E3/E4). Taenia-type eggs were identified by zinc sulfate centrifugal flotation in 8 of 17 samples (47%). Dogs were from the US (n = 16) and Canada (10). Ten dogs had gastrointestinal signs (diarrhea) reported on initial presentation. Clinical history revealed that some dogs were receiving a monthly antiparasitic preventive in the 6-month period prior to sampling (n = 10) and had regular wildlife (rodent) exposure (13). Twenty-five dogs were subsequently confirmed to have received treatment with praziquantel for detected E multilocularis, and 25 of these dogs were qPCR negative 3 to 5 weeks after treatment. Veterinary awareness of endemic risk regions for E multilocularis and its emergence in novel areas (Colorado, Nevada, Wyoming, Montana, Illinois, Washington, Idaho, Kansas, and Oregon) are key for One Health. Dogs can serve as sentinels for Echinococcus tapeworm risk, and detection of E multilocularis tapeworms in dogs through routine qPCR fecal screening can alert clinicians to zoonotic concern and common environmental exposure risk.

Molecular Survey of Parasitic Contamination of Frozen Berries.

Berries represent healthy dietary options and contain bioactive compounds associated with a decreased risk of diseases. Despite representing healthy food choices, these products can be contaminated by pathogenic microorganisms, including parasites. Among foodborne parasites, Giardia duodenalis, Cryptosporidium parvum, Cyclospora cayetanensis, Toxoplasma gondii, and Echinococcus multilocularis are of significant public health importance and have been recently detected in fresh berries in Europe, including Italy. Berries can be purchased fresh or frozen, and it is worrying that even frozen berries could represent a risk for the consumer. In fact, several parasites can resist freezing temperatures and have been responsible for outbreaks of infection. The aim of this study was to investigate the presence of G. duodenalis, C. parvum, C. cayetanensis, T. gondii, and E. multilocularis in frozen berries with simplex and multiplex real-time PCR protocols. A total of 108 packages of mixed frozen berries were bought from supermarkets located in a south-eastern region of Italy. The samples were tested using two simplex real-time PCR protocols targeting C. parvum and G. duodenalis, respectively, and a multiplex real-time PCR targeting C. cayetanensis, T. gondii, and E. multilocularis. None of the investigated parasites were detected in the frozen berry samples tested. This research topic is still unexplored and of great current interest. These results represent a first attempt to investigate parasitic contamination of frozen berries sold on the Italian market, but further large-scale surveys are required.

Resolution of infertility following hydatid cyst removal: a case report

Introduction and Importance: Human echinococcosis, also known as ‘Hydatid cyst,’ constitutes a zoonotic parasitic disease attributed to Echinococcus granulosus or Echinococcus multilocularis. Primary afflictions occur in the liver and lungs, whilst the implication of alternative organs remains infrequent. The clinical presentation can vary and large cysts may cause compression symptoms and complications. This case involved a 21-year-old Palestinian female with three large hydatid cysts in the liver, causing compression of adjacent structures and unique clinical manifestations. Case Presentation: A female-aged 21 arrived with signs of heart palpitations, shortness of breath, tiredness, and pain in the right upper abdomen, alongside a background of infertility. During routine pre-IVF ultrasound, three liver hydatid cysts were unexpectedly found, leading to a referral to the surgical department. Laboratory tests and imaging confirmed this diagnosis. Surgery involved cyst aspiration, hypertonic saline injection, and marsupialization. Postsurgical complications were managed as they occurred. The symptoms lessened afterwards, and a successful pregnancy was achieved nine months post-surgery. Clinical Discussion: Zoonotic infection by cystic echinococcosis (CE) primarily engages liver and lungs. The progression of symptoms is contingent upon cyst placement and resultant pressure on adjacent tissues. Diagnosis requires imaging alongside serological assays, while large cysts necessitate surgical intervention. Conclusion: The presented case underscores the complexity in managing multiple extensive liver hydatid cysts, highlighting the necessity to consider hydatid disease amidst patients presenting with indeterminate symptoms, particularly within endemic zones. An extensive surgical strategy produced positive outcomes, illustrating the significance of prompt intervention for symptom alleviation and sustained patient health.

DEVELOPMENT OF A RAPID SNP PCR ASSAY TO DIFFERENTIATE BETWEEN EUROPEAN AND NORTH AMERICAN HAPLOTYPES OF ECHINOCOCCUS MULTILOCULARIS.

Herein we describe a single nucleotide polymorphism-specific polymerase chain reaction (PCR) assay to rapidly detect and differentiate variants belonging to the European and North American lineages of Echinococcus multilocularis in clinical samples. This is an extremely relevant and applicable test in North America because the range of E. multilocularis continues to expand across the continent and because of a rise in prevalence in wildlife, domestic animals, and humans. The endemic North American (NA) and introduced European (EU) variants are believed to have different pathogenic potentials, with the EU variants being more infective and pathogenic than the NA variants. The rise of the EU variants of E. multilocularis increases the risk of spillover from wildlife to humans because of its increased potential for infectivity. Current PCR-based diagnostics can detect E. multilocularis deoxyribonucleic acid (DNA), but DNA sequencing is required to identify the specific variant. Our assay provides a straightforward conventional PCR method to differentiate the NA and EU variants, and we suggest this same approach could be used for the diagnosis of other parasites or variants that are genetically very similar. As surveillance continues for E. multilocularis across North America, identifying the different genetic variants from different geographic regions will become essential to understanding the current epidemiological shift that the parasite is experiencing, as well as informing public health decisions in affected areas.

Evidence of G1-G3 Complex Life Cycle of Echinococcus granulosus sensu stricto Through Molecular Characterization (Genotyping) in Dogs, Sheep, Goats and Humans of North-western Himalayas, India

Background: The helminthic zoonotic disease echinococcosis is brought on by tapeworms that are members of the genus (Family Taeniidae). Currently, Echinococcus granulosus, Echinococcus multilocularis, Echinococcus vogeli, Echinococcus oligarthrus and Echinococcus shiquicus are identified species. Of them, E. granulosus and E. multilocularisare important zoonotic organisms that cause cystic echinococcosis and alveolar echinococcosis in humans, respectively (Bowles and McManus, 1993). Echinococcus granulosus is mainly spread by dogs and a few other intermediate hosts, although it is hardly ever a part of a naturally occurring predator-prey cycle that is not caused by humans. Methods: In a present study, 1254 small ruminants (723 sheep and 531 goats) and 305 dogs, including 122 pet dogs visiting small animal clinics, 183 stray dogs in Jammu division, for a period of 12 months (July, 2021- June, 2022) were taken for the detection of the prevalence of cystic echinococcosis and molecular detection. Result: Among sheep and goats, 209 animals (sheep = 137 and goats = 72) were found infected with hydatidosis with an overall infection rate of 16.67% (sheep = 18.95% and goats = 13.56%). Molecular prevalence based on copro PCR was conducted in dogs, in which the overall prevalence of Echinococcus was found to be 14.09% [stray (22.95%); pet (0.82%)]. For the identification of Echinococcus species from cyst of sheep, goats and humans, a PCR protocol employing the Cox1 primers was used. The amplified products of PCR were electrophoretically separated on agar gels (1%) and analysed in a gel documentation system. Clear amplification was noticed at 440 bp for sheep, goat andhuman. The generated Cox1 partial sequences were assigned theaccession numbers as: dog (ON427821), goat (ON427822), sheep (ON427823), human 1(OP215294) and human 2 (OP215295). All the Cox1 sequences from dog, goat, sheep and humans were clustering in same clade, irrespective of their geographical location, representingthe cycle of transmission in Jammu region as Echinococcus granulosus G1-G3 complex.

Hepatotoxicity due to albendazole: safe alternatives for echinococcosis therapy

Infection with Echinococcus multilocularis leads to the clinical manifestation of alveolar echinococcosis. This is characterized by the formation of alveolar liver tumours, which usually disintegrate necrotically in the course of the disease. Pseudocysts are formed. Especially in the early stages, curative resection followed by long-term treatment with albendazole is recommended. However, the majority of patients are not amenable to curative surgery. In these cases, albendazole therapy is the first-choice treatment. We present arare case of albendazole-associated hepatitis in apatient with inoperable Echinococcus multilocularis infection, with afavourable outcome following achange in treatment to mebendazole.

Design of a novel EmTSP-3 and EmTIP based multi-epitope vaccine against Echinococcus multilocularis infection.

Current treatments and prevention strategies for echinococcosis are inadequate. Recent advancements in molecular vaccine development show promise against Echinococcus granulosus; however, Echinococcus multilocularis remains a challenge. A Multi-epitope Vaccine could potentially induce specific B and T lymphocyte responses, thereby offering protection against Echinococcus multilocularis infection. This study aimed to develop a MEV against alveolar echinococcosis. Key epitopes from the Echinococcus multilocularis proteins EmTSP3 and EmTIP were identified using immunoinformatics analyses. These analyses were conducted to assess the MEV feasibility, structural characteristics, molecular docking, molecular dynamics simulations, and immune simulations. The immunogenicity and antigenicity of the vaccine were evaluated through in vitro and in vivo experiments, employing ELISA, Western blotting, FCM, challenge infection experiments, and ELISPOT. The effective antigenicity and immunogenicity of MEV were demonstrated through immunoinformatics, as well as in vitro and in vivo experiments. In vitro experiments revealed that MEV increased the secretion of IFN-γ and IL-4 in PBMC and successfully bound to specific antibodies in patient serum. Furthermore, mice immunized with MEV developed a robust immune response, characterized by elevated levels of CD4+ and CD8+ T-cells, increased secretion of IFN-γ and IL-4 by specific Th1 and Th2 cells, and heightened serum antibody levels. Importantly, MEV reduced the weight of cysts by conferring resistance against echinococcosis. These findings suggest that MEV is a promising candidate for the prevention of Echinococcus multilocularis infection. A total of 7 CTL, 7 HTL, 5 linear B-cell, and 2 conformational B-cell epitopes were identified. The vaccine has demonstrated effective antigenicity and immunogenicity against AE through molecular docking, immune simulation, molecular dynamics studies, and both in vitro and in vivo experiments. It provides effective protection against Echinococcus multilocularis infection, thereby laying a foundation for further development.

Alveolar echinococcosis.

Alveolar echinococcosis is a much-feared parasitic zoonosis caused by the larval stage of Echinococcus multilocularis. Mainland Norway is free from infection, but alveolar echinococcosis is, on rare occasions, imported from endemic regions. Those infected develop slow-growing, multicystic tumours that are clinically and radiologically reminiscent of malignant disease. The disease mainly attacks the liver. Treatment often consists of extensive surgical resection in combination with prolonged use of albendazole. In this clinical review article we summarise the life cycle, clinical findings, diagnosis, treatment and epidemiology of alveolar echinococcosis, and provide examples of the disease course with two patient case reports.

Unraveling the enigma: Echinococcus multilocularis in the adrenal gland as a very rare cause of hypertension in a young patient.

Unraveling the enigma: Echinococcus multilocularis in the adrenal gland as a very rare cause of hypertension in a young patient.

A comprehensive bibliometric analysis of the literature between 1945 and 2024 about urinary tract echinococcosis

BackgroundEchinococcosis is a parasitic disease caused by Echinocccus granulosus and Echinococcus multilocularis and declared a neglected tropical disease by the World Health Organization. The disease is a significant cause of morbidity and mortality, especially in India, Australia, China, Turkey, South America, the Middle East, and Eastern European countries. Bibliometric analysis is a popular research trend that gains the advantage of evaluating all the studies about one specific topic and emphasizing the importance and place of the subject in the literature. With this study, we aim to evaluate all the global published literature in the Web of Science core collection database about urinary tract echinococcosis between 1945 and 2024. MethodsAll documents indexed in the Web of Science core collection database between 1945 and 2024 were scanned on March 29, 2024. VOSviewer program 1.6.20 and MS Office Excel 2017 programs were used for forward analysis. Results152 documents were obtained, 102 of which were indexed in SCI-Expanded journals. Turkey (21.71%) was the leading country in terms of the total number of documents, followed by India (21.05%), but citations of Indian publications were higher (21.77%). Spain was in the first rank in terms of average citations per document (19.33). Most of the documents were original articles (78.29%). Okan Akhan was the most prolific author, with three documents. The most-cited document was conducted in 1997 by Angulo et al. and received 74 citations. With seven publications, Urology Case Reports was the journal that published the most documents on urinary tract echinococcosis. ConclusionsEvaluating the studies on urinary system echinococcosis with bibliometric analysis, it is understood that although the number of studies has gradually increased over the years, they are still less than expected. We recommend that more studies be conducted to determine the true prevalence of echinococcosis and ensure more effective management of the disease, especially in countries where it is endemic.

Receptor Tyrosine Kinase Signaling Involves Echinococcus-Host Intercommunication: A Potential Therapeutic Target in Hepatic Echinococcosis.

Echinococcosis, one of the most serious and life-threatening parasitic forms of zoonosis worldwide, is caused by the larvae of Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis). Various drugs are being applied clinically to treat zoonosis; however, their therapeutic efficacy remains a great challenge, especially with albendazole as the preferred drug of choice. Receptor tyrosine kinase (RTK) signaling controls normal cellular proliferation, differentiation, and metabolism in humans and mammals, which are intermediate hosts of E. granulosus and E. multilocularis. Disruption of RTK signaling can cause various forms of carcinogenesis and exacerbate the progression of certain forms of parasitic disease. As a result, a significant number of studies on tyrosine kinase inhibitors (TKIs) have been conducted for the treatment of cancer and parasitic infection, with some TKIs already approved for clinical use for cancer. Notably, RTK signaling has been identified in the parasites E. granulosus and E. multilocularis; however, the mechanisms of RTK signaling response in Echinococcus-host intercommunication are not fully understood. Thus, understanding the RTK signaling response in Echinococcus-host intercommunication and the potential effect of RTK signaling is crucial for identifying new drug targets for echinococcosis. The present review illustrates that RTK signaling in the host is over-activated following infection by E. granulosus or E. multilocularis and can further facilitate the development of metacestodes in vitro. In addition, some TKIs exert strong parasitostatic effects on E. granulosus or E. multilocularis, both in vitro and/or in vivo, through downregulation of RTK signaling molecules. The summarized findings suggest that RTK signaling may be a promising drug target and that TKIs could be potential anti-Echinococcus drugs warranting further research.

Muscular hydatid cyst in the calf – a clinical case

Muscular echinococcosis is a rare parasitic disease caused by the tapeworms Echinococcus granulosus and Echinococcus multilocularis. Clinical symptoms are non-specific and appear late, usually when the hydatid cyst is of significant size. The combination of diagnostic imaging studies and serological tests is the key to making a correct diagnosis. The treatment of muscular echinococcosis is mainly surgical, in the form of complete resection of the hydatid cyst. Adjuvant anthelmintic therapy is also administered to reduce the risk of hydatid cyst recurrence. We present a clinical case of a 17-year-old girl with muscular echinococcosis, diagnosed and treated in our clinic.

Histopathological assessment of the viability of hepatic alveolar echinococcosis.

Infections by the larval stage of the tape worms Echinococcus multilocularis and Echinococcus granulosus s.l. are potentially fatal zoonoses affecting humans as dead-end hosts. Histopathological evaluation of hepatic echinococcosis is an integral part of patient management, including the distinction between alveolar (AE) and cystic echinococcosis (CE), which are associated with different disease courses and treatments. To improve histopathological assessment of Echinococcus lesions, we aimed to develop robust criteria to evaluate their viability and decay. Histomorphological criteria for determining parasitic viability based on the morphology of parasite structures and different stages of their decay were defined based on a clinically and molecularly defined cohort comprising 138 specimens from 112 patients (59 AE and 53 CE); 618 AE lesions were assessed for histopathological viability comparing haematoxylin and eosin (H&E) staining with mAbEm18 and mAbEm2G11 immunostaining. Moreover, parasite viability was systematically mapped in cross-sections of five additional AE lesions. Protoscoleces in CE and AE displayed variable states of degeneration. Albendazole had no significant effect on the morphology of parasite structures. Viability assessment revealed high agreement between H&E and mAbEm18, but not mAbEm2G11 staining, suggesting mAbEm18 staining as reliable for parasite viability assessment. H&E and mAbEm18 staining displayed a central-peripheral gradient of parasite viability and decay across parasitic lesions, with decayed cystic lesions located more towards the lesion centre while the most viable cystic lesions were located more peripherally. Histopathological criteria corroborated by mAbEm18 staining provide a simple and reliable tool to assess the viability of AE lesions, knowledge of which is a valuable decision-making tool for further treatment.

Echinococcus multilocularis serpin regulates macrophage polarization and reduces gut dysbiosis in colitis.

Helminths serve as principal regulators in modulating host immune responses, and their excretory-secretory proteins are recognized as potential therapeutic agents for inflammatory bowel disease. Nevertheless, our comprehension of the mechanisms underlying immunoregulation remains restricted. This investigation delves into the immunomodulatory role of a secretory protein serpin (Emu-serpin), within the larval stage of Echinococcus multilocularis. Our observations indicate that Emu-serpin effectively alleviates dextran sulfate sodium-induced colitis, yielding a substantial reduction in immunopathology and an augmentation of anti-inflammatory cytokines. Furthermore, this suppressive regulatory effect is concomitant with the reduction of gut microbiota dysbiosis linked to colitis, as evidenced by a marked impediment to the expansion of the pathobiont taxa Enterobacteriaceae. In vivo experiments demonstrate that Emu-serpin facilitates the expansion of M2 phenotype macrophages while concurrently diminishing M1 phenotype macrophages, alongside an elevation in anti-inflammatory cytokine levels. Subsequent in vitro investigations involving RAW264.7 and bone marrow macrophages reveal that Emu-serpin induces a conversion of M2 macrophage populations from a pro-inflammatory to an anti-inflammatory phenotype through direct inhibition. Adoptive transfer experiments reveal the peritoneal macrophages induced by Emu-serpin alleviate colitis and gut microbiota dysbiosis. In summary, these findings propose that Emu-serpin holds the potential to regulate macrophage polarization and maintain gut microbiota homeostasis in colitis, establishing it as a promising candidate for developing helminth therapy for preventing inflammatory diseases.

Prevalence and geographic distribution of Echinococcus genus in wild canids in southern Québec, Canada.

Echinococcus spp. is an emerging zoonotic parasite of high concern. In Canada, an increase in the number of human and animal cases diagnosed has been reported, but information regarding the parasite's distribution in wildlife reservoir remains limited. A cross-sectional study was conducted to estimate the prevalence of wild canids infected with Echinococcus spp. and Echinococcus multilocularis in areas surrounding populated zones in Québec (Canada); to investigate the presence of areas at higher risk of infection; to evaluate potential risk factors of the infection; and as a secondary objective, to compare coproscopy and RT-PCR diagnostic tests for Taenia spp. and Echinococcus identification. From October 2020 to March 2021, fecal samples were collected from 423 coyotes (Canis latrans) and 284 red foxes (Vulpes vulpes) trapped in 12 administrative regions. Real-time PCR for molecular detection of genus Echinococcus spp. and species-specific Echinococcus multilocularis were performed. A total of 38 positive cases of Echinococcus spp., of which 25 were identified as E. multilocularis, were detected. Two high-risk areas of infection were identified. The prevalence of Echinococcus spp. was 22.7% (95% CI 11.5-37.8%) in the Montérégie centered high-risk area, 26.5% (95% CI 12.9-44.4%) in the Bas-St-Laurent high-risk area, and 3.0% (95%CI 1.8-4.7%) outside those areas. For E. multilocularis, a prevalence of 20.5% (95% CI 9.8-35.3%) was estimated in the high-risk area centered in Montérégie compared to 2.4% (95% CI 1.4-3.9%) outside. Logistic regression did not show any association of infection status with species, sex, or geolocation of capture (p > 0.05). This study shows the circulation of Echinococcus in a wildlife cycle in 9/12 administrative regions of Québec.

ВЕТЕРИНАРНО-САНИТАРНАЯ ЭКСПЕРТИЗА ПРОДУКТОВ УБОЯ В СТРУКТУРЕ ПАРАЗИТАРНЫХ ЗАБОЛЕВАНИЙ В КАБАРДИНО-БАЛКАРСКОЙ РЕСПУБЛИКЕ

The purpose of research is to study the results of post-mortem examination of beef, to monitor parasitic diseases among the population of the Kabardino-Balkarian Republic. The material for the study was the data obtained from post-mortem examinations from 2020 to 2022 and information from the Center for Hygiene and Epidemiology of the Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Welfare in the Kabardino-Balkarian Republic for the same period. Recently, a significant part of productive animals in the territory of the Kabardino-Balkarian Republic comes from the southern regions of the Russian Federation. Based on the results of reports conducted by the veterinary service for the period 2020–2022. 7,427 cattle carcasses were identified with affected organs and tissues by the following invasive diseases: Fasciolosis, Echinococcosis, Dicrocoeliasis. In 2020, the highest infection rate was due to Echinococcus granulosus infestation – 42.54 %, followed by Fasciola hepatica and Fasciola gigantica – 32.52 %; the smallest – when infected with Dicrocoelium lanceatum – 24.94 %. In 2021, the highest level of infection was also due to infection by Echinococcus granulosus – 39.02 %, then Fasciola hepatica and Fasciola gigantica – 36.72 %, the lowest was due to infection by Dicrocoelium lanceatum – 24.24 %. In 2022, most of the culling occurred due to infestation: Echinococcus granulosus – 38.50 %, then Fasciola hepatica and Fasciola gigantica – 36.80 %, the least due to infection with Dicrocoelium lanceatum – 24.68 %. Favorable natural and climatic conditions, pasture animal husbandry, and peculiarities of the social structure of the population of the Kabardino-Balkarian Republic lead to the interaction of the pathogen and host populations. Based on the results of epidemiological examinations of foci of invasive diseases of the population in the Russian Federation, the following results were obtained: over the past 5 years (2017–2021), 1,909 cases of infection with Echinococcus granulosus were identified. In total, 551 cases of infection with Echinococcus granulosus and Echinococcus multilocularis were registered in the Russian Federation in 2022.

Rapid diagnosis of alveolar echinococcosis from lung puncture sample using metagenomic next-generation sequencing: a case report

IntroductionAlveolar echinococcosis (AE), caused by the larval forms of Echinococcus multilocularis, is a zoonotic disease affecting the liver, lungs, lymph nodes, kidneys, brain, bones, thyroid, and other organs. Diagnosing AE in a non-endemic area is usually challenging. With the rapid development and increasing application of sequencing techniques in recent years, metagenomic next-generation sequencing (mNGS) has become a powerful tool for diagnosing rare infectious diseases.Case PresentationA 45-year-old woman was admitted to the hospital for the presence of pulmonary shadows for more than 3 months. The lung computed tomography (CT) at a local hospital revealed scattered solid and quasi-circular nodules in the left upper lobe, left lower lobe, right middle lobe, and right lower lobe. The largest nodule was located in the dorsal part of the right lung, measuring 2.0 × 1.7 × 1.5 cm. Moreover, abdominal CT revealed one space-occupying lesion each in the left and right lobes. The pathological analysis of the lung biopsy specimen revealed infiltration of lymphocytes, plasma cells, and eosinophils in the alveolar wall and interstitial area. No pathogenic bacteria were observed in the sputum smear and culture tests. There were no parasite eggs in the stool. The mNGS of the lung puncture tissue revealed 6156 sequence reads matching E. multilocularis; thus, the condition was diagnosed as AE. Albendazole 400 mg was administered twice daily, and the patient was stable during follow-up.ConclusionThis case emphasizes the role of mNGS in diagnosing AE. As a novel, sensitive, and accurate diagnostic method, mNGS could be an attractive approach for facilitating early diagnosis and prompt treatment of infectious diseases, especially when the infection was caused by rare pathogens.

Hydropneumothorax as a rare manifestation of primary pulmonary hydatid disease

Echinococcosis, alternatively referred to as hydatid disease, is caused by the larvae of the tapeworm Echinococcus. The primary agents of human infections are Echinococcus granulosus and Echinococcus multilocularis. The present case report pertains to an individual who relocated from an endemic region to the United Arab Emirates and subsequently manifested symptoms of hydropneumothorax. The 44-year-old male patient presented with a 4-day fever and right-sided chest pain, accompanied by cough and breathlessness for 2 weeks. Computed tomography (CT) of the chest revealed right hydropneumothorax and a ruptured hydatid cyst with consolidation. The patient was diagnosed with a ruptured pulmonary hydatid cyst based on a strongly positive hydatid serology and the presence of hydatid tissue on histopathological examination. The patient underwent surgical decortication with cyst removal and received medical treatment with ceftriaxone and albendazole. He was discharged in good condition after a 10-day hospitalisation period. Echinococcosis is a parasitic disease that most often affects the liver and lungs. Although more than half of the patients do not show any symptoms, the main symptoms observed during presentation include dry cough, haemoptysis, and chest pain. Plain radiographs or chest CT scans are used for diagnosis. Surgery is considered the primary treatment for pulmonary hydatid cysts and medical treatment with benzimidazoles (albendazole and mebendazole) is recommended. Complicated pulmonary hydatid disease can manifest in various ways, including hydropneumothorax, as observed in the present case. Early diagnosis, surgical intervention combined with medical treatment, and multidisciplinary teamwork can significantly improve patient outcomes.