Balázs Dezsényi1, Tamás Strausz2, Zita Makrai2, Judit Csomor1, József Danka3, Peter Kern4, Giovanni Rezza5, Thomas F E Barth6, Adriano Casulli7,8,9. 1. Joint Hospital of St. Stephen and St. Ladislau, Budapest, Hungary. 2. National Institute of Oncology, Budapest, Hungary. 3. National Center for Epidemiology, Budapest, Hungary. 4. Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany. 5. Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Rome, Italy. 6. Institute of Pathology, Ulm University, Ulm, Germany. 7. Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Rome, Italy. adriano.casulli@iss.it. 8. European Reference Laboratory for Parasites, Rome, Italy. adriano.casulli@iss.it. 9. World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis (in Humans and Animals), Rome, Italy. adriano.casulli@iss.it.
Abstract
BACKGROUND: Alveolar echinococcosis is a zoonotic parasitic disease causing a severe clinical condition and is known as the most deadly of all helminth infections. Moreover, this disease is also an increasing concern in Northern and Eastern Europe due to its spread in the wildlife animal host. CASE PRESENTATION: An asymptomatic 70-year-old woman from south-western Hungary was diagnosed with multiple liver lesions. Imaging techniques (ultrasound, computed tomography and magnetic resonance imaging), serology (ELISA, indirect hemagglutination and Western blot), and conventional staining methods (hematoxylin-eosin and periodic acid-Schiff) were used for the detection of the disease. A histopathological re-evaluation of formalin-fixed paraffin block by immunohistochemical staining with the monoclonal antibody Em2G11 definitively confirmed the diagnosis of alveolar echinococcosis. CONCLUSIONS: To our knowledge, this is the first confirmed autochthonous case of human alveolar echinococcosis in Hungary. To what extent diagnostic difficulties may contribute to underestimate this zoonosis in Eastern Europe is unknown. Differential diagnosis with alveolar echinococcosis should be considered for patients with multiple, tumor-like cystic lesions of the liver, in countries where this parasite is emerging.
BACKGROUND:Alveolar echinococcosis is a zoonotic parasitic disease causing a severe clinical condition and is known as the most deadly of all helminth infections. Moreover, this disease is also an increasing concern in Northern and Eastern Europe due to its spread in the wildlife animal host. CASE PRESENTATION: An asymptomatic 70-year-old woman from south-western Hungary was diagnosed with multiple liver lesions. Imaging techniques (ultrasound, computed tomography and magnetic resonance imaging), serology (ELISA, indirect hemagglutination and Western blot), and conventional staining methods (hematoxylin-eosin and periodic acid-Schiff) were used for the detection of the disease. A histopathological re-evaluation of formalin-fixed paraffin block by immunohistochemical staining with the monoclonal antibody Em2G11 definitively confirmed the diagnosis of alveolar echinococcosis. CONCLUSIONS: To our knowledge, this is the first confirmed autochthonous case of humanalveolar echinococcosis in Hungary. To what extent diagnostic difficulties may contribute to underestimate this zoonosis in Eastern Europe is unknown. Differential diagnosis with alveolar echinococcosis should be considered for patients with multiple, tumor-like cystic lesions of the liver, in countries where this parasite is emerging.
Entities:
Keywords:
Alveolar echinococcosis; Case report; Differential diagnosis; Echinococcus multilocularis; Histopathological re-evaluation; Public health threat
Authors: Thomas F E Barth; Tobias S Herrmann; Dennis Tappe; Lorenz Stark; Beate Grüner; Klaus Buttenschoen; Andreas Hillenbrand; Markus Juchems; Doris Henne-Bruns; Petra Kern; Hanns M Seitz; Peter Möller; Robert L Rausch; Peter Kern; Peter Deplazes Journal: PLoS Negl Trop Dis Date: 2012-10-25
Authors: Petra Kern; Karine Bardonnet; Elisabeth Renner; Herbert Auer; Zbigniew Pawlowski; Rudolf W Ammann; Dominique A Vuitton; Peter Kern Journal: Emerg Infect Dis Date: 2003-03 Impact factor: 6.883
Authors: Balázs Dezsényi; Zsolt Dubóczki; Tamás Strausz; Eszter Csulak; Veronika Czoma; Zsolt Káposztás; Mária Fehérvári; Áron Somorácz; András Csilek; Attila Oláh; Kálmán Almási; Attila Patonai; Dénes Görög; Zoltán Széll; Zoltán Tolnai; Tamás Sréter; József Danka; Herbert Auer; Beate Grüner; Thomas F E Barth; Adriano Casulli Journal: BMC Infect Dis Date: 2021-02-10 Impact factor: 3.090