The pathology, phylogeny, and epidemiology of Echinococcus ortleppi (G5 genotype): a new case report of echinococcosis in China

Infectious Diseases of Poverty

Rui Jiang¹  Robert Bergquist²  Aiya Zhu³  Yang Li³  Ji Zhang³  Xu Wang⁴  Baixue Liu⁴  Weiping Wu⁴  Yayi Guan⁴  Nanzi Xie⁵  Gang Xie⁵  Hongying Cai⁵  Zhenghuan Wang⁶ 

[1] Anshun Center for Disease Control and Prevention, Anshun, Guizhou, China;Geospatial Health Journal, Ingerod, Brastad, Sweden;Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China;National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China;People’s Hospital of Anshun City, Anshun, Guizhou, China;School of Life Sciences, East China Normal University, Shanghai, China;

关键词: Cystic echinococcosis (CE);    Echinococcus ortleppi;    Human;    Non-endemic area;    China;   

DOI  :  10.1186/s40249-021-00907-3

来源: Springer

【 摘 要 】

BackgroundCystic echinococcosis (CE), caused by the larval stage of the complex Echinococcus granulosus sensu lato (s.l.), is a zoonotic parasitic disease with a high social burden in China. E. ortleppi is a species (formerly genotype 5 of E. granulosus s.l.) with unique epidemic areas (tropical areas), transmission patterns (mainly cattle origin), and pathological characteristics (large and small hook lengths) compared to other species that cause CE. A 19-year-old female patient in an area with no history of echinococcosis in Guizhou Province, China, was diagnosed with E. ortleppi infection in 2019. This study is to understand the source of this human E.ortleppi infection.MethodsWe performed computer tomography (CT) scans, surgical operation, morphological sectioning, molecular diagnosis, phylogenetic analyses, and epidemiological investigation in Anshun City, Guizhou Province, China in 2019.ResultsThe patient presented with intermittent distension and pain in the upper abdomen without other abnormal symptoms. Routine blood examination results were normal. However, abdominal CT revealed a fertile cyst with a diameter of approximately 8 cm, uniform density, and a clear boundary, but without an evident cyst wall in the right lobe of the liver. The cyst was fertile, and phylogenetic analyses revealed that the isolates represented a new E. ortleppi genus haplotype. A result of 10‒14 years incubation period with indigenous infection was considered available for the case through the epidemiological survey.ConclusionsCE due to E. ortleppi infection can be confused with other diseases causing liver cysts, resulting in misdiagnosis. A transmission chain of E. ortleppi may exist or existed in the past in the previously considered non-endemic areas of echinococcosis in southwestern China.Graphic abstract

【 授权许可】

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