Balázs Dezsényi1, Zsolt Dubóczki2, Tamás Strausz3, Eszter Csulak4, Veronika Czoma5, Zsolt Káposztás4, Mária Fehérvári6, Áron Somorácz7, András Csilek8, Attila Oláh9, Kálmán Almási10, Attila Patonai11, Dénes Görög11, Zoltán Széll12, Zoltán Tolnai12, Tamás Sréter12, József Danka13, Herbert Auer14, Beate Grüner15, Thomas F E Barth16, Adriano Casulli17,18. 1. Temporarily unaffiliated, Budapest, Hungary. 2. National Institute of Oncology, Tumour Surgery Centre, Budapest, Hungary. 3. National Institute of Oncology, Centre of Surgical and Molecular Tumor Pathology, Budapest, Hungary. 4. Somogy County Teaching Hospital, Department of Surgery, Kaposvár, Hungary. 5. Somogy County Teaching Hospital, Department of Pathology, Kaposvár, Hungary. 6. Jósa András County Teaching Hospital, 4th Department of Internal Medicine, Nyíregyháza, Hungary. 7. 2nd Department of Pathology, Semmelweis University, Budapest, Hungary. 8. Borsod-Abaúj-Zemplén County Teaching Hospital, Department of Infectology, Miskolc, Hungary. 9. Petz Aladár County Teaching Hospital, Department of Surgery, Győr, Hungary. 10. Petz Aladár County Teaching Hospital, Department of Pathology, Győr, Hungary. 11. Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary. 12. National Reference Laboratory for Parasites, Fish and Bee Diseases, National Food Chain Safety Office, Budapest, Hungary. 13. National Reference Laboratory for Human Parasitic Diseases, National Public Health Centre, Budapest, Hungary. 14. Department of Medical Parasitology, Centre of Pathophysiology, Infectology and Immunology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University Vienna, Vienna, Austria. 15. Division of Clinical Infectious Diseases, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany. 16. Department of Pathology, Ulm University, Ulm, Germany. 17. WHO Collaborating Centre for the epidemiology, detection and control of cystic and alveolar echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. adriano.casulli@iss.it. 18. European Union Reference Laboratory for Parasites. Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. adriano.casulli@iss.it.
Abstract
BACKGROUND: 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. METHOD: Between 2003 and 2018, epidemiological and clinical data of suspected AE patients were collected retrospectively from health database management systems. RESULTS: This 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. CONCLUSIONS: 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. 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.
BACKGROUND:Humanalveolar 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. METHOD: Between 2003 and 2018, epidemiological and clinical data of suspected AE patients were collected retrospectively from health database management systems. RESULTS: This 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. CONCLUSIONS: AE is an emerging infectious disease in Hungary with a high fatality rate since based on our results, almost every fifth AE patientdied 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.
Entities:
Keywords:
Case series; Clinical epidemiology; Echinococcus multilocularis; Human alveolar echinococcosis; Hungary
Authors: Paul R Torgerson; Alexander Schweiger; Peter Deplazes; Maja Pohar; Jürg Reichen; Rudolf W Ammann; Philip E Tarr; Nerman Halkic; Beat Müllhaupt Journal: J Hepatol Date: 2008-04-28 Impact factor: 25.083