Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans
- PMID: 19931502
- DOI: 10.1016/j.actatropica.2009.11.001
Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans
Abstract
The earlier recommendations of the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) for the treatment of human echinococcosis have had considerable impact in different settings worldwide, but the last major revision was published more than 10 years ago. Advances in classification and treatment of echinococcosis prompted experts from different continents to review the current literature, discuss recent achievements and provide a consensus on diagnosis, treatment and follow-up. Among the recognized species, two are of medical importance -Echinococcus granulosus and Echinococcus multilocularis - causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. For CE, consensus has been obtained on an image-based, stage-specific approach, which is helpful for choosing one of the following options: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and wait. Clinical decision-making depends also on setting-specific aspects. The usage of an imaging-based classification system is highly recommended. For AE, early diagnosis and radical (tumour-like) surgery followed by anti-infective prophylaxis with albendazole remains one of the key elements. However, most patients with AE are diagnosed at a later stage, when radical surgery (distance of larval to liver tissue of >2cm) cannot be achieved. The backbone of AE treatment remains the continuous medical treatment with albendazole, and if necessary, individualized interventional measures. With this approach, the prognosis can be improved for the majority of patients with AE. The consensus of experts under the aegis of the WHO-IWGE will help promote studies that provide missing evidence to be included in the next update.
Copyright 2009 Elsevier B.V. All rights reserved.
Similar articles
-
Dot immunogold filtration assay (DIGFA) with multiple native antigens for rapid serodiagnosis of human cystic and alveolar echinococcosis.Acta Trop. 2010 Feb;113(2):114-20. doi: 10.1016/j.actatropica.2009.10.003. Epub 2009 Oct 24. Acta Trop. 2010. PMID: 19836341
-
Recent advances in the immunology and diagnosis of echinococcosis.FEMS Immunol Med Microbiol. 2006 Jun;47(1):24-41. doi: 10.1111/j.1574-695X.2006.00060.x. FEMS Immunol Med Microbiol. 2006. PMID: 16706785 Review.
-
Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis.Parasitology. 2007 Nov;134(Pt 12):1657-70. doi: 10.1017/S0031182007003198. Epub 2007 Jul 16. Parasitology. 2007. PMID: 17631693 Review.
-
[Up-dated progress in diagnosis and treatment of echinococcosis].Wiad Parazytol. 1999;45(2):217-23. Wiad Parazytol. 1999. PMID: 16886466 Review. Polish.
-
Echinococcosis with particular reference to Southeast Asia.Adv Parasitol. 2010;72:267-303. doi: 10.1016/S0065-308X(10)72010-8. Adv Parasitol. 2010. PMID: 20624535 Review.
Cited by
-
Promising proteins detected by Western blot from Echinococcus granulosus protoscoleces for predicting early post-surgical outcomes in CE-affected Tunisian children.Parasit Vectors. 2021 Mar 30;14(1):180. doi: 10.1186/s13071-021-04679-5. Parasit Vectors. 2021. PMID: 33781311 Free PMC article.
-
Hepatic hydatid cyst presenting as a cutaneous fistula.Turk J Emerg Med. 2020 Feb 26;20(3):146-148. doi: 10.4103/2452-2473.290071. eCollection 2020 Jul-Sep. Turk J Emerg Med. 2020. PMID: 32832734 Free PMC article.
-
Impact of Albendazole on Cytokine and Chemokine Response Profiles in Echinococcus multilocularis-Inoculated Mice.Biomed Res Int. 2021 May 7;2021:6628814. doi: 10.1155/2021/6628814. eCollection 2021. Biomed Res Int. 2021. PMID: 34041299 Free PMC article.
-
An Integrated Study of Toxocara Infection in Honduran Children: Human Seroepidemiology and Environmental Contamination in a Coastal Community.Trop Med Infect Dis. 2020 Aug 23;5(3):135. doi: 10.3390/tropicalmed5030135. Trop Med Infect Dis. 2020. PMID: 32842560 Free PMC article.
-
Mid-term Outcomes of Laparoscopic Total Cystectomy Versus Open Surgery for Complicated Liver Hydatid Cysts.Surg Laparosc Endosc Percutan Tech. 2020 Aug 5;31(1):44-50. doi: 10.1097/SLE.0000000000000822. Surg Laparosc Endosc Percutan Tech. 2020. PMID: 32769743 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical