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. 2024 Jan 3;24(1):43.
doi: 10.1186/s12879-023-08937-y.

Viability predictive factors of the daughter vesicles in hepatic cystic echinococcosis

Aymen Trigui  1 , Nahed Khmekhem  2 , Sami Fendri  3 , Rahma Daoud  3 , Amira Akrout  3 , Jihene Trabelsi  4 , Rafik Mzali  3 , Fatma Cheikhrouhou  2 , Ali Ayadi  2 , Chadli Dziri  5 , Mohamed Ben Amar  3 , Saleh Boujelbene  3
Affiliations

Viability predictive factors of the daughter vesicles in hepatic cystic echinococcosis

Aymen Trigui et al. BMC Infect Dis. .

Abstract

Introduction: Management of cystic echinococcosis (CE) requires knowledge of certain aspects related to the survival of Echinococcus granulosus. The viability of daughter vesicles (DV) is a determining factor in guiding therapeutic indications, particularly for transiently active Cysts type CE3b.

Purpose: To determine the predictive factors of DV viability and its impact on the therapeutic management of CE3b type.

Materials and methods: This is a prospective pilot study with an analytical aim on patients with cystic echinococcosis of the liver type CE2 and CE3b, operated in the General Surgery Department of Habib-Bourguiba Academic Hospital, Sfax-Tunisia for 22 months from March 2018 until December 2019. The unit of the study is the DV. A parasitological study of the DV was done in the parasitology laboratory.

Results: During the study period, 27 (40.9%) of 66 operated CE Disease from 21 patients containing 248 DV were explored. The median viability of DV protoscoleces was 16.7%. In bivariate analysis, factors for viability of DV protoscoleces were: fever, acute cholangitis, hyperbilirubinemia, left liver location, rock water and bilious echinococcal fluid (EF), cyst size ≥ 43 mm, Intracystic pressure ≥ 35 mmHg, DV size ≥ 6.5 mm, volume, number of DV/cyst ≥ 5, and opaque wall (p < 0.05). Predictive factors for the Non-viability of DV were: CE3b type, purulent EF, gelatinous EF. In multivariate analysis, only CE2 type, cyst size ≥ 43 mm, number of DV/cyst ≥ 5 and DV size ≥ 6.5 mm were factors significantly associated with the viability of DV protoscoleces.

Conclusion: CE3b cysts without the criteria of viability of DV protoscoleces may become candidates for the 'Wait-and-Watch' procedure.

Keywords: Daughter vesicles; Echinococcus Infection; Hepatic.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Direct observation at *10 magnification showing viable protoscolex (V) retaining their initial translucent color and non-viable protoscolex (NV) with total dye penetration after the 1‰ eosin colorimetric test
Fig. 2
Fig. 2
ROC curve: 2a: cyst size/ 2b: intracystic pressure/ 2c: Daughter vesicle size/ 2d: number of Daughter vesicle /cyst
See this image and copyright information in PMC

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