Progressive alveolar echinococcosis after discontinuation of anthelmintic therapy

Particle and Fibre Toxicology

Martin Hoenigl⁴  Holger Flick⁵  Robert Krause⁴  Katharina Seeber⁴  Emil C Reisinger²  Peter Kern³  Marion Pollheimer¹  Christina Stoeckl⁴  Michael Meilinger⁵ 

[1] Department of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, Austria;Abteilung für Tropenmedizin und Infektionskrankheiten, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany;WHO Informal Working Group on Echinococcosis, Comprehensive Infectious Diseases Center, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany;Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;Division of Pulmonology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 20, 8036 Graz, Austria

关键词: Liposomal amphotericin B;    Anthelmintic therapy;    Albendazole;    Echinococcus multilocularis;    Alveolar echinococcosis;   

Others  :  824372
DOI  :  10.1186/1756-3305-6-287

 received in 2013-08-28, accepted in 2013-09-26,  发布年份 2013

【 摘 要 】

We report a case of a female patient with alveolar echinococcosis (AE) who presented with progressive pulmonary and hepatic lesions and had a fatal outcome. AE affecting the liver, the lungs and the brain had been diagnosed 20 years ago and treated successfully with albendazole and stereotactic gamma knife therapy. Due to severe hair loss albendazole was stopped 14 years before presentation. Lesions had remained stable in imaging studies for at least 11 years, but then had started to progress. Lifelong anthelmintic maintenance therapy and regular follow-up may therefore be crucial in order to prevent such a dramatic clinical course.

【 授权许可】

   
2013 Meilinger et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Schmid M, Samonigg H, Stoger H, Auer H, Sternthal MH, Wilders-Truschnig M, Reisinger EC: Use of interferon gamma and mebendazole to stop the progression of alveolar hydatid disease: case report. Clin Infect Dis 1995, 20:1543-1546.
• [2]Schmid M, Pendl G, Samonigg H, Ranner G, Eustacchio S, Reisinger EC: Gamma knife radiosurgery and albendazole for cerebral alveolar hydatid disease. Clin Infect Dis 1998, 26:1379-1382.
• [3]WHO Informal Working Group on Echinococcosis: Guidelines for treatment of cystic and alveolar echinococcosis in humans. Bull World Health Organ 1996, 74:231-242.
• [4]Kern P: Medical treatment of echinococcosis under the guidance of good clinical practice (GCP/ICH). Parasitol Int 2006, 55(Suppl 1):273-282.
• [5]Kern P, Wen H, Sato N, Vuitton DA, Gruener B, Shao Y, Delabrousse E, Kratzer W, Bresson-Hadni S: WHO classification of alveolar echinococcosis: principles and application. Parasitol Int 2006, 55(Suppl 1):283-287.
• [6]Otero-Abad B, Torgerson PR: A systematic review of the epidemiology of echinococcosis in domestic and wild animals. PLoS Negl Trop Dis 2013, 7:e2249.
• [7]Gurbadam A, Nyamkhuu D, Nyamkhuu G, Tsendjav A, Sergelen O, Narantuya B, Batsukh Z, Battsetseg G, Oyun-Erdene B, Uranchimeg B, Otgonbaatar D, Temuulen D, Bayarmaa E, Abmed D, Tsogtsaikhan S, Usukhbayar A, Smirmaul K, Gereltuya J, Ito A: Mongolian and Japanese joint conference on “echinococcosis: diagnosis, treatment and prevention in Mongolia” June 4, 2009. Parasit Vectors 2010, 3:8. BioMed Central Full Text
• [8]Schneider R, Aspock H, Auer H: Unexpected increase of alveolar echincoccosis, Austria, 2011. Emerg Infect Dis 2013, 19:475-477.
• [9]Torgerson PR, Schweiger A, Deplazes P, Pohar M, Reichen J, Ammann RW, Tarr PE, Halkik N, Mullhaupt B: Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years. J Hepatol 2008, 49:72-77.
• [10]Ammann RW, Fleiner-Hoffmann A, Grimm F, Eckert J: Long-term mebendazole therapy may be parasitocidal in alveolar echinococcosis. J Hepatol 1998, 29:994-998.
• [11]Brunetti E, Kern P, Vuitton DA, Writing Panel for the WHO-IWGE: Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010, 114:1-16.