Recurrence of cystic echinococcosis in an endemic area: a retrospective study

BMC Infectious Diseases

Research Article

Antonio Muro¹  Carmen Esteban-Velasco²  Luis Muñoz-Bellvis²  Marcelo Fernando Jimenez López³  Virginia Velasco-Tirado⁴  Amparo López-Bernús⁵  Adela Carpio-Perez⁵  Ángela Romero-Alegría⁶  Javier Pardo-Lledias⁷  Miguel Cordero-Sanchez⁸  Moncef Belhassen-García⁹  Juan Luis Muñoz Bellido^1,10  Montserrat Alonso-Sardón^1,11 

[1] Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain;Servicio de Cirugia, CAUSA, IBSAL, Universidad de Salamanca, Salamanca, Spain;Servicio de Cirugía Torácica, CAUSA, IBSAL, Universidad de Salamanca, Salamanca, Spain;Servicio de Dermatologia Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente, Salamanca, Spain;Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Salamanca, Spain;Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Paseo San Vicente, 58-182, 37007, Salamanca, Spain;Servicio de Medicina Interna, Hospital General de Palencia “Río Carrión”, C/ Donantes de Sangre, Palencia, Spain;Servicio de Medicina Interna, Seccion de Enfermedades Infecciosas, CAUSA, CIETUS, IBSAL, Universidad de Salamanca, Salamanca, Spain;Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Paseo San Vicente, 58-182, 37007, Salamanca, Spain;Servicio de Microbiología CAUSA, IBSAL, Universidad de Salamanca, Salamanca, Spain;Área de Medicina Preventiva y Salud Pública, IBSAL, Universidad de Salamanca, Salamanca, Spain;

关键词: Cystic echinococcosis;    Echinococcus granulosus;    Hydatidosis;    Recurrence;    Treatment;   

DOI  :  10.1186/s12879-017-2556-9

 received in 2017-03-14, accepted in 2017-06-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic infection to fatal disease. Clinical management procedures have evolved over decades without adequate evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the major problems in the management of hydatid disease. The aim of this study was to determine the frequency of CE recurrence and the risk factors involved in recurrence.MethodsA descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE according to ICD-9 (code 122–0 to 122–9) criteria admitted at Complejo Asistencial Universitario de Salamanca, Spain, between January 1998 and December 2015.ResultsAmong the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment. Median duration of recurrence’s diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher [OR = 2.7; 95% CI, 1.1–7.1; p < 0.05] when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs 14.2% (31/217) in the cohort. We detected a chance of recurrence [OR = 2.3; 95% CI, 1.4–6.5; p > 0.05] that was two times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention (20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%).ConclusionsDespite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of the major problems in the management of hydatid disease. The current management and treatment of recurrences is still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and multicenter studies will be needed to provide definitive recommendations for its clinical management.

【 授权许可】

CC BY   
© The Author(s). 2017