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Abstract Background Hydatid disease, also known as echinococcosis, is an endemic parasitic infection, most commonly caused by Echinococcus granulosus. It may affect any organ resulting in the formation of hydatid cysts, but most frequently involves liver and lungs. Hydatid cyst arising primarily from axilla is an extremely rare manifestation of this condition, with only a few cases reported in medical literature. Case presentation Here we present the case of a 32-year-old Indian male farmer, who presented with a painless, slow-growing mass in the left axillary region of 8 months duration. Preoperative imaging led us to the diagnosis of primary axillary hydatid cyst, with no other associated cysts or masses anywhere else in the body. Following antihelmintic therapy, the cyst was surgically excised without rupture. The diagnosis was further confirmed by macroscopic and histopathological examination. Conclusion This case report highlights the importance of considering hydatid cyst in the differential diagnosis of palpable masses in the axillary region, especially in regions where the disease is endemic. Early recognition and accurate diagnosis are crucial for appropriate management and optimal patient outcomes.

Introduction: Hydatidosis/cystic echinococcosis (CE) is considered a neglected disease due to its preventive nature and impact on low-income populations. In Latin America, there is a high incidence, and in the high Andean regions, it is considered an endemic disease. The objective of this study was to quantify and analyze the scientific production of hydatidosis/echinococcosis through a bibliometric analysis in Latin America up to 2022. Methods: A bibliometric analysis study was conducted based on the scientific production of CE in the SCOPUS database until 2022 in Latin American countries. Information was collected through a systematic search. Frequencies and percentages were used to summarize the variables captured in the final database. Results: Scientific production showed growth over the years, with Argentina, Uruguay, and Chile having the highest production. In addition, there has been a trending use of the term “neglected disease” since 2018. The most cited articles were primarily narrative reviews, book chapters, and original articles in that order. Only 27% of the studies were funded by an institution in Latin America. Conclusion: Scientific production in Latin America regarding CE is on the rise, especially in countries with high incidence rates. Furthermore, these countries demonstrate a significant network of international collaboration.

Abstract Background Zoonotic infections, characterized with huge pathogen diversity, wide affecting area and great society harm, have become a major global public health problem. Early and accurate prediction of their outbreaks is crucial for disease control. The aim of this study was to develop zoonotic diseases risk predictive models based on time-series incidence data and three zoonotic diseases in mainland China were employed as cases. Methods The incidence data for schistosomiasis, echinococcosis, and leptospirosis were downloaded from the Scientific Data Centre of the National Ministry of Health of China, and were processed by interpolation, dynamic curve reconstruction and time series decomposition. Data were decomposed into three distinct components: the trend component, the seasonal component, and the residual component. The trend component was used as input to construct the Long Short-Term Memory (LSTM) prediction model, while the seasonal component was used in the comparison of the periods and amplitudes. Finaly, the accuracy of the hybrid LSTM prediction model was comprehensive evaluated. Results This study employed trend series of incidence numbers and incidence rates of three zoonotic diseases for modeling. The prediction results of the model showed that the predicted incidence number and incidence rate were very close to the real incidence data. Model evaluation revealed that the prediction error of the hybrid LSTM model was smaller than that of the single LSTM. Thus, these results demonstrate that using trending sequences as input sequences for the model leads to better-fitting predictive models. Conclusions Our study successfully developed LSTM hybrid models for disease outbreak risk prediction using three zoonotic diseases as case studies. We demonstrate that the LSTM, when combined with time series decomposition, delivers more accurate results compared to conventional LSTM models using the raw data series. Disease outbreak trends can be predicted more accurately using hybrid models.

Due to the side effect of commonly used chemical scolicidals, advantages of micro drug delivery system and growing interest for the phytoceuticals, the present study aimed to find out the scolicidal activity of two volatile terpenes (α-pinene and β-caryophyllene) and their microemulsions on proto-scoleces of Echinococcus granulosus. The ordinary and microemulsions of α-pinene and β-caryophyllene and their combination at three different ratios (2:1, 1:1, 1:2) were developed and cha¬racterised by dynamic light scattering to confirm micro-dimensions. The scolicidal effect of the de-veloped formulations at the concentrations of 0.5, 1, 2, 5 and 10 μg/mL were measured at 10, 30, and 60-min time points. Mortality rates were recorded by eosin exclusion test. At the 10-min time point, ordinary and micro α-pinene at the concentration of 10 μg/mL killed 94.66% and 100% of the proto-scoleces, respectively. At the same time point and concentration, ordinary and micro β-caryophyllene caused 44.33% and 68.66% mortality rates in protoscoleces, respectively. Based on the 50% lethal concentration (LC50) values, there was no significant difference between ordinary and micro-emulsified α-pinene. For the micro β-caryophyllene, a LC50 value of 2.1 µg/mL was obtained which was significantly lower than that of ordinary β-caryophyllene (49.85 µg/mL). No synergistic interac-tion existed between β-caryophyllene and α-pinene regarding their activity on E. granulosus. Development of microemulsions increased the toxicity of these terpenoids on protoscoleces, especially that of β-caryophyllene, probably due to improved penetration into the parasite. Further studies are needed to assess in vivo efficacy and safety of this specific preparation.

Production-limiting diseases, such as helminth infections, are a major concern in temperate regions. They can lead to decreased meat and milk production and quality in livestock. This investigation aimed to assess the prevalence of Fasciola spp., Dicrocoelium spp., and Cystic echinococcosis in different livestock species (cattle, sheep, and goats) at the Khorramabad slaughterhouse between March 21, 2012, and March 20, 2022.ANOVA was employed to assess how disease prevalence varies across different periods and among various livestock species, aiming to comprehend the interplay of these independent variables on disease prevalence. The highest prevalence of Fasciola spp. was related to cattle, with a seasonal pattern showing a higher prevalence in autumn and winter. Hydatid cysts have increased over the past decade, with D. dendriticum being prevalent from 2017 to 2020. The investigation conducted has provided evidence that diseases caused by parasitic infestations in ruminants continue to persist even after treatment. This highlights the need for more effective and targeted sanitary and preventive measures that consider the type of parasite and its prevalence during different seasons. It is hence important to design and implement measures tailored to the specific needs of each parasite species, and aligned with the seasonal fluctuations in its population. This will help minimize the risk of disease transmission, thus reducing the impact on animal health and productivity, ultimately benefitting the livestock industry as a whole.

Abstract Background Echinococcosis, or hydatid disease, is caused by the larval forms of taeniid cestodes belonging to the genus Echinococcus. Echinococcus granulosus and E. multilocularis are the primary species responsible for human echinococcosis, and mostly they affect the liver. The disease course is typically slow, and the patients tend to remain asymptomatic for many years. Case presentation A case of 19-year-old male Somali from Medina, Saudi Arabia, was presented to the Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital with the complaint of right upper quadrant abdominal pain and dysuria for 1 month. A thorough physical examination, laboratory examination, and imaging investigations, including abdominal sonography and computed tomography (CT), were conducted. Both ultrasound and CT scans revealed a cystic lesion in the right lobe of the liver, confirming the diagnosis of a hydatid cyst. Consequently, the patient underwent exploratory laparotomy. It was successfully managed surgically, and the definitive diagnosis was provided by the pathologist, confirming degenerated echinococcal cysts that contain abundant debris. Additionally, the patient received oral albendazole both before and after the surgery and after 7 months and is currently symptom-free. Conclusions Hydatid disease in the liver may persist without symptoms and often goes undiagnosed due to the slow growth of the cysts. The diagnosis needs careful history reporting, physical examination, and appropriate imaging investigations.

Abstract Background Cystic echinococcosis, also known as hydatid disease, is a chronic and endemic illness caused by infection with a parasite called Echinococcus granulosus. In Romania, this disease has an incidence rate of 5.6 per 100,000 individuals, which is the highest in the Dobrogea region. The liver is the most affected site, accounting for 68.8% of cases, followed by the lungs at 17.2%. While cases of hydatid disease in the genital organs are rare, occurring at an incidence rate of only 0.5%, it is worth noting that cases of this disease in pregnancy worldwide are also rare, occurring at an incidence rate of 1 in 20,000 to 1 in 30,000 pregnancies. Case report A 15-year-old Eastern-European woman who was 12 weeks pregnant presented to the emergency room with acute pelvic pain, dysuria, and frequent urination. Her laboratory tests showed that she had a urinary tract infection, and pelvic ultrasound revealed that she had a mass on her right adnexa. Despite receiving treatment, her symptoms did not improve, and she had to undergo surgery to remove the mass, which turned out to be a hydatic cyst. She also had to undergo a cesarean section to deliver her baby owing to fetal distress during labor. Conclusions This medical case report provides a detailed description of a pelvic hydatid cyst that was discovered during pregnancy. What makes this case particularly noteworthy is the cyst’s unusual location—it was found at the level of the right broad ligament of the uterus. Despite the complexity of the situation, the patient was able to receive effective treatment and the cyst was successfully managed with great outcomes for both the patient and the newborn. We hope that this report serves as a valuable example of how medical professionals can navigate challenging cases and provide optimal care for their patients.

ABSTRACT. The article presents a modern view of the diagnosis and treatment of pulmonary echinococcosis. The etiology, pathogenesis, clinical picture, ways of diagnosis and available methods of treatment of this pathology are highlighted. The purpose of the work was to acquaint doctors of various specialties with clinical cases of pulmonary echinococcosis. Two clinical cases of pulmonary echinococcosis became the object of the work. The first clinical example concerned a 17-year-old boy who had a typical course of echinococcosis and who underwent left lower lobectomy. The second clinical example concerned a young woman in whom pulmonary echinococcosis had an atypical course and was diagnosed only intraoperatively. It was concluded that the most effective method of treatment of echinococcal lung cysts is surgical operation. The volume of surgical intervention depends on many factors and is decided individually in each specific case. In the postoperative period, preventive anthelmintic therapy is mandatory.

IntroductionHuman alveolar echinococcosis caused by Echinococcus multilocularis is an important zoonotic disease in the northern hemisphere. The life cycle of E. multilocularis is maintained primarily in wild animals and requires an intermediate host (mainly small mammals). Human can become an intermediate host through accidental ingestion of E. multilocularis eggs. Hokkaido Prefecture is the only area of Japan in which human alveolar echinococcosis is endemic. The purposes of this study were to elucidate the land use ecological factors associated with the density of red fox feces along paved roads and the relationship between the distributions of red fox (Vulpes vulpes) populations and fox feces, which determine the level of hazard from eggs.MethodsA series of surveys was conducted in the central part of the Nemuro Peninsula of Hokkaido, excluding urban areas, over a total of 4 years in May–June in 2014 and 2016–2018 when red foxes remain with their cubs around the dens. Transects of 500 m were set up on paved roads, and feces within the transects were counted. Univariable and multivariable analyses were performed to examine ecological factors including the principal components (PCs) of five land use–type occupancy proportions within 500 m and 1 km, respectively, as explanatory fixed-effect variables. The number of feces in each transect was examined as the response variable using integrated nested Laplace approximation with negative binomial errors with a spatio-temporal autocorrelations structure to separate the effects of similarities of neighboring locations and annual variation. The multivariable models with the lowest widely applicable information criterion values were selected.ResultsThe feces density was explained by the PC of the 500- m buffer (−0.27, 2.5th and 97.5th percentiles: −0.44, −0.10) characterized by mixed forests (−0.82) and scarcity of residential areas (0.29) and the proximity to the nearest livestock farm house (−0.35, 2.5th and 97.5th percentiles: −0.53, −0.17). This suggested that foxes defecate in the areas where prey is abundant, avoiding humans.DiscussionPolicy discussions regarding bait distribution design targeting these conditions should be initiated.

Purpose: To improve the oral bioavailability of albendazole (ABZ), a series of albendazole-bile acid conjugates (ABCs) were synthesized. ABC's transmembrane transport mechanism and in vivo pharmacokinetic properties were preliminarily studied. Methods: The transmembrane transport mechanism of ABCs was studied using the Caco-2 monolayer cell model and intestinal perfusion model. The concentration of ABCs and ABZ were evaluated using High-Performance Liquid Chromatography (HPLC) and HPLC-Mass Spectrometry (HPLC-MS/MS). Results: Compared to ABZ, better permeability was observed for different types and concentrations of ABCs using the Caco-2 monolayer cell model, with ABC-C8 showing the highest permeability. The transmembrane transport of ABCs was affected by ASBT inhibitors, indicating an ASBT-mediated active transport mechanism. Additionally, introducing cholic acid resulted in ABZ no longer being a substrate for P-gp, MRP2, and BCRP, effectively reversing ABZ efflux. In vivo unidirectional intestinal perfusion results in rats showed that ABCs altered the absorption site of ABZ from the jejunum to the ileum. The absorption efficiency of ABCs in each intestinal segment was higher than that of ABZ, and the transmembrane transport efficiency decreased with increasing concentrations of ASBT inhibitors. This further confirmed the presence of both passive diffusion and ASBT-mediated active transport mechanisms in the transport of ABCs. The solubility of ABCs in gastric juice and pharmacokinetics in rats showed that ABZ-C4 exhibited enhanced solubility. Moreover, ABCs significantly increased oral bioavailability compared to ABZ, with ABC-C4 showing an approximately 31-fold increase in bioavailability. Conclusion: The transmembrane transport mechanism of ABCs involves a combination of ASBT-mediated active transport and passive diffusion. Moreover, the incorporation of BAs successfully reverses the efflux of ABZ by efflux proteins. Among the synthesized conjugates, ABC-C4 demonstrated superior dissolution behavior both in vitro and in vivo.

Abstract The complete removal of a pulmonary hydatid cyst by bronchoscopy occurs rarely in clinical practice. We describe a 22‐year‐old male originally from Lebanon, with suspected hydatid cyst rupture on computed tomography chest after experiencing sudden onset fevers and cough whilst taking empiric anthelmintic therapy. Bronchoscopy revealed white gelatinous material in the posterior segment of the left lower lobe. The complete membranes of a hydatid cyst were removed with grasping forceps. Histologic examination confirmed the diagnosis of echinococcosis.

Cystic hydatid disease is an endemic disease caused by the larval form of Echinococcus granulosis. It is especially evident in the liver, lungs, and kidney. Testicular hydatidosis is extremely rare. A case of a hydatid cyst of the testis is reported that was misdiagnosed clinically as a testicular hydrocele. Echinococcosis should be considered in the differential diagnosis of testicular masses especially in endemic countries. Treatment is mainly surgical and, with proper diagnosis and treatment, the prognosis is good.

Hydatid cysts represent the larval stage of Echinococcus granulosus tapeworm and cause echinococcosis (Hydatidosis)in herbivores. It is a zoonotic disease that is widespread in the world. This parasite has Ten genotypes (G1-G10). The current investigation was carried out to identify the prevalent genotypes of Echinococcus granulosus in cattle and buffalo in Babylon governorate, Iraq. Forty hydatid cysts of the livers and lungs of cattle (25) and buffalo (15) were collected from the slaughterhouse of this governorate from March to October 2022. Cyst fluid was analyzed under a light microscope, and an eosin aqueous stain was used to determine the fertility based on the presence of protoscolices. Due to their high DNA purity and fertility of Hydatid cysts, 12 samples (6 include 3livers and 3lungs of cattle, were chosen (6 including three livers and three lungs’ buffalo). Each sample's mitochondrial dehydrogenase NADH subunit 5 (NAD5) was amplified by 297 bp using molecular techniques (conventional PCR method). Isolate samples were recorded at Accession No. (LC775105- LC775116) in the Genbank. The results designate that the sheep strain (G1) buffalo (G3) was responsible for the hydatid cyst infection in Babylon governorate in 91.6 and 8.4%, respectively. Moreover, their sequences correlated with local and regional sequences and genetic diversity compared to the reference strains.

Background: Cystic echinococcosis, which is triggered by the parasite Echinococcus granulosus, is a global zoonotic disease that is common in rural regions in which there are frequent encounters between dogs and other domestic animals. The disease can have devastating consequences, impacting the health of people and animals and leading to huge financial losses, especially in the agricultural industry. In the Kingdom of Saudi Arabia (KSA) and Egypt, despite the high incidence of disease, few investigations have been conducted into the genetic variation in species of the genus Echinococcus. Aim: This study sought to compare the genetic features of the hydatid cysts carried in sheep in KSA with those found in Egypt. Methods: DNA from the protoscolices was used in a PCR targeting the mitochondrial NADH dehydrogenase 1 (NAD1), cytochrome c oxidase subunit 1 (COX1), and nuclear actin II (ACT II) genes, and the resulting amplification products of 30 KSA and Egyptian isolates were sequenced and compared. Results: Among the sheep in KSA, the overall prevalence of cystic echinococcosis was 0.51%. Of the sheep cyst DNA samples, 95%, 100%, and 52% were positive for the Cox1, nad1, and act II genes, respectively. Targeting all three genes, all KSA samples belonged to the E. granulosus genotype (G1), whereas all Egyptian isolates belonged to E. granulosus (G1) and E. canadensis (G6). Conclusions: We conclude that isolates of E. granulosus from the two countries shared a common origin in Arabic North Africa, with sheep and camels as common hosts. [Open Vet J 2024; 14(3.000): 866-878]

Objective: to assess the epidemic situation of echinococcosis in the period 2012–2022 in the endemic territories of the Far Eastern Federal District and South of Russia.Materials and methods: based on the data of the annual statistical reporting forms No. 2 "Information on infectious and parasitic diseases", data from the Reference Center for Monitoring Larval Helminthiasis of Rostov Research Institute Microbiology and Parasitology of Rospotrebnadzor, an analysis of the incidence of echinococcosis in the territories of the Far East and South of Russia in the period 2012–2022 was carried out. For seroepidemiological examination of a conditionally healthy population by the ELISA method, the diagnostic kit "Echinococcus-IgG-ELISA-BEST" (JSC "Vector-Best", Novosibirsk) was used.Results: it is shown that the epidemiological situation of echinococcosis is characterized by pronounced territorial unevenness. In the south of Russia, epidemiological problems with echinococcosis persisted in Kalmykia (0.74–2.19 cases per 100,000 population) and in the Astrakhan region (0.60–1.48 cases per 100,000 population). Among the relatively healthy population, the average seropositivity to E.granulosus antigens in the Far East was 5.8%, in the south of Russia — 2,6%. Conclusions: the data obtained indicate an unfavorable epidemiological situation for echinococcosis in a number of regions of the Far East and South of Russia.

Hydatid cyst is a zoonotic disease and is an important health problem, especially in developing countries. Hydatic cysts are typically observed in the liver and lungs. Cardiac and brain involvement are rare manifestations. Cardiac hydatic cysts are usually located in the left ventricle. Brain involvement is frequently seen as a primary cerebral cyst and is almost always solitary. However, secondary intracerebral cysts are also seen as a result of cardiac cysts rupturing into the left ventricle spontaneously or iatrogenically, and these are usually multiple. Herein, we report a case that has two rare clinical manifestations of hydatid cysts.

Background: Hydatidosis is a leading zoonotic parasitic disease causing economic losses and public health concerns worldwide. The current study aims to determine the seroepidemiological status of hydatid cysts (HCs) and assess the relationship between risk factors and this disease in high-risk individuals in Gonabd City, Iran. Methods: This cross-sectional study was conducted in Gonabad health centers in 2018-2019. Sampling was performed using the census method. A total of 393 serum samples were collected from 259 men and 134 women at risk for HC. A questionnaire was prepared for all participants. Demographic information, such as gender, age, place of residence, education level, participation of children in animal husbandry, the way of washing vegetables, and work experience in animal husbandry were recorded. The levels of immunoglobulin G (IgG) antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Results: The infection rate was 9.7% for men and 10% for women, showing no significant correlation between gender and hydatidosis. Among the affected population, the prevalence rate was 10.4% in undergraduates and 16.3% in the age group of 20-30. Additionally, individuals with less than ten years of experience in animal husbandry had a prevalence rate of 11.7%. Those who had contact with dogs had a prevalence rate of 7.9%, while individuals who did not use disinfectants to wash vegetables had a higher rate of 12%. Conclusion: This study highlights the significant prevalence of HCs in at-risk individuals. This indicates the need for effective preventive measures to reduce the burden of infection. The recommendations include washing vegetables with disinfectants to eliminate any potential sources of contamination. Additionally, obtaining identification certificates for livestock dogs and collecting stray dogs can help control the spread of the disease. It is essential to implement a comprehensive public health strategy to address this issue effectively.

Introduction: Echinococcus species are zoonotic parasites that cause hydatid disease, affecting humans and animals. The seroprevalence of hydatid disease reflects the level of exposure to this parasite and can be used as an indicator of the burden of the disease in a population. Aim: To determine the seroprevalence of hydatid disease. Materials and Methods: The study was a retrospective observational study conducted at JIPMER hospital, a tertiary care centre located in Puducherry, Southern India. In this study, hydatid serological data from January 2019 to December 2022 were collected in March 2023 and retrospectively analysed in April 2023. All the serum samples that tested positive for Enzyme Linked Immuno Sorbent Assay (ELISA) for echinococcosis during the period from January 2019 to December 2022 were included. The demographic details such as age, gender, place of residence, etc., of the patients whose samples were included were collected from their case records. These samples were then analysed using Microsoft Excel for proportions and percentages. Results: The study showed that the seroprevalence of hydatid disease was 70 (34%) out of 206 samples tested. The seroprevalence was higher in the older age group (>45 years), with 41 (58.6%) cases. It was observed that males and females were almost equally infected, with minor differences in the prevalence of 37 (52.9%) males and 33 (47.1%) females. Conclusion: As the prevalence of hydatid disease in Southern India was unknown, it was observed to be lower when compared to other states of India. This study has provided valuable information on the level of exposure of hydatid disease in the population and will help formulate disease control and prevention strategies.

BackgroundEchinococcosis is a uncommon condition in pediatric patients, and encompasses alveolar and cystic forms, predominantly affecting the lungs and liver. Transmission occurs primarily through zoonotic means, such as the contamination of water and food by infected dog and other canid feces. Diagnosis can be challenging due to nonspecific symptoms that often mimic pneumonia.The caseA 6-year-old female patient from a rural area in Ecuador who initially presented with nonspecific symptoms indicative of pneumonia. However, further investigation into socio-environmental factors led to a diagnosis of pulmonary and hepatic hydatid disease.ConclusionThe timely and accurate diagnosis of this infectious disease enabled the patient to receive appropriate treatment and surgical intervention, leading to her complete recovery.

Muscular echinococcosis is a rare parasitic disease caused by the tapeworms Echinococcus granulosus and Echinococcus multilocularis. Clinical symptoms are non-specific and appear late, usually when the hydatid cyst is of significant size. The combination of diagnostic imaging studies and serological tests is the key to making a correct diagnosis. The treatment of muscular echinococcosis is mainly surgical, in the form of complete resection of the hydatid cyst. Adjuvant anthelmintic therapy is also administered to reduce the risk of hydatid cyst recurrence. We present a clinical case of a 17-year-old girl with muscular echinococcosis, diagnosed and treated in our clinic.

IntroductionEchinococcosis is a chronic zoonotic disease caused by tapeworms of the genus Echinococcus. The World Health Organization (WHO) has identified encapsulated disease as one of 17 neglected diseases to be controlled or eliminated by 2050. There is no accurate, early, non-invasive molecular diagnostic method to detect echinococcosis. The feasibility of circulating free DNA as a diagnostic method for echinococcosis has yielded inconclusive results in a number of published studies. However, there has been no systematic evaluation to date assessing the overall performance of these assays. We report here the first meta-analysis assessing the diagnostic accuracy of cfDNA in plasma, serum, and urine for echinococcosis.MethodsWe systematically searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WeiPu databases up to 17 January 2024, for relevant studies. All analyses were performed using RevMan 5.3, Meta-DiSc 1.4, Stata 17.0, and R 4.3.1 software. The sensitivity, specificity, and other accuracy indicators of circulating free DNA for the diagnosis of echinococcosis were summarized. Subgroup analyses and meta-regression were performed to identify sources of heterogeneity.ResultsA total of 7 studies included 218 patients with echinococcosis and 214 controls (156 healthy controls, 32 other disease controls (non-hydatid patients), and 26 non-study-targeted echinococcosis controls were included). Summary estimates of the diagnostic accuracy of cfDNA in the diagnosis of echinococcosis were as follows: sensitivity (SEN) of 0.51 (95% CI: 0.45–0.56); specificity (SPE) of 0.99 (95% CI: 0.97–0.99); positive likelihood ratio (PLR) of 11.82 (95% CI: 6.74–20.74); negative likelihood ratio (NLR) of 0.57 (95% CI: 0.41–0.80); diagnostic ratio (DOR) of 36.63 (95% CI: 13.75–97.59); and area under the curve (AUC) value of 0.98 (95% CI: 0.96–1.00).ConclusionExisting evidence indicates that the combined specificity of circulating cfDNA for echinococcosis is high. However, the combined sensitivity performance is unsatisfactory due to significant inter-study heterogeneity. To strengthen the validity and accuracy of our findings, further large-scale prospective studies are required.Systematic review registrationThe systematic review was registered in the International Prospective Register of Systematic Reviews PROSPERO [CRD42023454158]. https://www.crd.york.ac.uk/PROSPERO/.

Key Clinical Message Hydatid cyst is a sly disease that can manifest with a spectrum of symptoms in almost every part of the human body, so it is crucial to be familiar with different scenarios that a patient may present. Abstract The echinococcus granulosus parasite causes hydatid disease and is common in areas with animal husbandry and agriculture. Here, we report a middle age woman who presented with abdominal pain that further investigation revealed a cyst in subdiaphragmatic area.

Background: Hydatid cysts (HC) are zoonotic diseases that are mainly caused by . Ovarian HC is a rare condition with different and unspecified presentations. Here we report a rare case of primary ovarian HC. Case Presentation: A 47-year-old woman with chronic abdominal pain and left hemipelvic fullness was referred to the Obstetrics Clinic of the Kowsar Hospital of Qazvin. Abdominopelvic sonography revealed a cystic mass, which primarily suggested a cyst adenoma. The tumor marker levels were within normal limits. After surgical resection, histopathological examination showed a cystic mass with dimensions of 10×6×3 cm, smooth external and internal aspects, wall thickness of 0.3 cm, and multiple pieces of irregular gray membranous tissue. The patient was treated with albendazole 3 months after surgery, and a 6-month follow-up sonogram revealed no signs of recurrence.Discussion: HC has non-specific presentations. Radiologists, pathologists, and surgeons should consider HC as a differential diagnosis for any cystic mass in the pelvic cavity, especially in endemic areas. Surgical resection and albendazole administration are the chosen treatments.

Splenic hydatid cysts are caused by the Echinococcus species and rarely occur in pregnancy. This case report describes the management of a 29-year-old pregnant woman with a large (11 × 8.7 × 10.5 cm) splenic hydatid cyst. The cyst had been identified before she became pregnant by her general practitioner with imaging investigations undertaken for her persistent left upper abdominal pain. The patient also had laboratory investigations which were positive for echinococcosis species.Hydatid splenic cysts are very rare and even more so in pregnancy. Risk of splenic cyst rupture exists, and rupture has significant risk of maternal and perinatal morbidity and mortality. Among the few case reports in the literature there is no clear consensus on conservative or surgical management during pregnancy and no clear guidelines for intrapartum care or delivery. The case report reviews the literature on splenic hydatid cyst disease in pregnancy and explores the management and outcome of this patient through her fourth pregnancy, which resulted in an uncomplicated vaginal birth.

Asrat Sime Debela,1 Kibruyisfaw Weldeab Abore,1 Alemayehu Bedane Worke,2 Selamawit Tadesse Wendimagegn3 1Department of Ophthalmology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Radiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Pathology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Kibruyisfaw Weldeab Abore, Department of Ophthalmology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, Email kibruyisfaww@gmail.comBackground: Hydatid disease is a tapeworm parasitic infection caused by Echinococcus granulosus that commonly affects the liver and lungs during its life cycle in the human body. Orbital involvement is a very rare occurrence and isolated orbital Echinococcosis is extremely rare.Case Presentation: A 60-year-old female Eritrean woman presented with 3-month history of painless protrusion of the left eye. Physical examination showed significantly decreased visual acuity of the left eye, left eye proptosis, and papilledema. Laboratory investigations were normal and orbital CT scan examination was suggestive of orbital hydatid cyst. After giving two weeks course of oral Albendazole, anterior orbitotomy and cyst excision was done. Post-op biopsy was conclusive of orbital hydatid cyst. She had mild lid swelling and adduction deficit on her post-operative follow-up. Subsequent longer duration of follow-up of the patient was not possible since the patient relocated back to Eritrea.Conclusion: Orbital hydatid cyst is an extremely rare presentation of human Echinococcus granulosus infection. However, it should be considered one of the differential diagnoses among patients living in an endemic area and presenting with proptosis of the eye. A preoperative course of anthelmintic followed by surgical excision of the cyst is the definitive management.Keywords: hydatid cyst, hydatid disease, orbit, Echinococcosis, Ethiopia

One of the most common methods to observe the indicators of hydatid cyst disease in human societies is to check the annual occurrence rate of confirmed cases in health centers or cases that have undergone surgery. Kenny disease applied Cystic Echinococcosis (CE). The main goal of this study is to systematically review statistical data related to CE between 2003 and 2023 in Fars province, one of the most populated provinces in the southwest of Iran. The results show that the highest prevalence of serology and surgery in this province is related to the age group below 50 years. Among the 299 positive cases detected by ELISA in serology, the prevalence rate among men is 55.85% and 44.14% among women. In 905 surgical cases, 51.60% were men, and 48.4% were women. In general, the obtained results show no significant relationship between the genders of people, but there is a relationship between age and the prevalence of the disease. The changes in this disease during these 20 years have not fluctuated much, and from this point of view, better measures can be taken to control this disease. Teaching the life cycle and transmission methods of this parasitic disease to humans in human societies is very important in preventing this parasitic disease.

Аim: to present the difficulties of surgical treatment of patients with multiple and combined echinococcal lesions. Key points. A 47-year-old patient who lived in Central Asia for up to 29 years of age was diagnosed with multiple echinococcosis of the abdominal cavity (CE1-2): II, Ivb, V, VI, VII segments of the liver, upper and lower poles of the spleen, lesser and greater omentum, small intestine, subphrenic space, area of the hepatoduodenal ligament, gastrocolic ligament. Surgical intervention was performed: atypical resection of liver segments V, VI, VII, subtotal pericystectomy, cholecystectomy, subtotal pericystectomy of cysts of II and IVb liver segments, subtotal pericystectomy of splenic cysts, resection of the greater omentum, echinococcectomy of the lesser omentum, mesentery of the small intestine, hepatoduodenal ligament, gastrocolic ligament, drainage of the abdominal cavity. Pericystectomy was carried out according to the technique of the National Medical Research Center of Surgery named after A. Vishnevsky.Conclusion. Due to the peculiarities of the course of helminthiasis and the pronounced variability of the lesion, it is extremely difficult to develop universal and effective treatment algorithms. The presented clinical observation demonstrates an example of the successful use of special surgical tactics for the treatment of “complex” echinococcosis of the abdominal cavity with good long-term follow-up results.

Objective: Echinococcosis is characterized by cystic structures formed by Echinococcus parasites in various organs, particularly liver, lung, and spleen. Our aim is documenting echinococcosis cases detected in Batman province in Turkey. Methods: Clinicopathological data of all echinococcosis cases with histopathological diagnosis in Batman province between 2010-2022 were retrospectively recorded. Descriptive analyses of the data were made using the IBM SPSS 22.0 package program. Results: A total of 55 echinococcosis cases, 23 male (41.8%) and 32 female (58.2%) were identified. The average age is 30 (3-77). Of 33 cases with known clinical complaints, 22 (66.7%) had abdominal pain, two (6.1%) had chest pain, two (6.1%) had cough, and seven (21.2%) had other complaints. One case was diagnosed incidentally in the post-traumatic examination. The mean diameter was 8.5 cm (2.8-25 cm) in 43 lesions of known diameter. The localization was liver in 36 (65.5%) cases, lung in 10 (18.2%) cases, and spleen in three (5.5%) cases. In three cases (5.5%), there was more than one organ involvement. In addition, echinococcosis was detected in the brain, kidney, and arm in three cases (5.5%). Of 45 cases with known data, 32 (71.1%) were unifocal and 13 (28.9%) were multifocal. Excision was performed in 34 (61.8%) cases, resection in 20 (36.4%), and aspiration in one (1.8%) case. Conclusion: Echinococcosis can be seen in all age groups and present with a variety of findings depending on the organ involvement. It should be kept in mind in the differential diagnosis of cystic lesions in Turkey, which is among the endemic countries.

Echinococcosis represents a major public health issue and continues to be endemic in various regions around the world. Hydatid cysts are commonly located in the liver (primary site), followed by the lungs (secondary site). However, they are also found in less typical organs such as the spleen, kidneys, peritoneum, retroperitoneum, pancreas, gallbladder, and various other organs, as well as in striate muscles. Hydatid cysts involving the psoas muscle are rare, and in the past five years, only a few articles have addressed this condition due to its low incidence. Symptoms can be quite vague, and serological testing might return negative, making imaging studies crucial for an accurate diagnosis. Treatment options involve surgery alongside antiparasitic agents. Despite having a low mortality rate, the recurrence of hydatid disease remains high. This paper aims to provide new clinical data through our case presentation, while also offering a review of the cases of hydatid cysts involving the psoas muscle that have been published over the past five years.

Objectives: Human echinococcosis remains an important public health problem. The aim of this study was to analyze the prevalence and spatial distribution characteristics of human echinococcosis cases in southern Xinjiang, China from 2005 to 2021. Methods: Human echinococcosis cases were collected from the National Infectious Disease Reporting System. Joinpoint regression analysis was performed to explore the trends. Spatial autocorrelation, hot spot analysis, as well as spatial-temporal clustering analysis were conducted to confirm the distribution and risk factors. Results: A total of 4580 cases were reported in southern Xinjiang during 2005–2021, with a mean annual incidence of 2.56/100,000. Echinococcosis incidence showed an increasing trend from 2005 to 2017 (APC = 17.939, 95%CI: 13.985 to 22.029) and a decreasing trend from 2017 to 2021 (APC = −18.769, 95%CI: 28.157 to −8.154). Echinococcosis cases had a positive spatial autocorrelation in 2005–2021 (Moran's I = 0.19, P

Key Clinical Message Hydatid cysts, primarily found in the liver (70%), are caused by parasitic infections and can lead to severe complications such as cyst rupture. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection. Abstract Hydatid cysts are a clinical pathology resulting from parasitic infections. They may occur in different organs of the body. However, these are mostly found in the liver (70%). This can cause significant complications including cyst rupture. Several case reports have described various hydatid cyst ruptures; however, only a few have reported an intra‐biliary hydatid cyst rupture. A 24‐year‐old male patient presented with right upper quadrant pain, jaundice, dark urine, and pale stool. Imaging studies, including Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), revealed a beavertail liver, cystobiliary communication and intrahepatic biliary tree‐ruptured hydatid cysts. The cyst was in the right liver lobe, which is the most common site for hydatid cysts. Surgical intervention involving laparoscopic de‐roofing and cyst removal resulted in a smooth recovery without complications. Several case reports have described various hydatid cyst ruptures; however, only a few have reported originally placed intra‐biliary hydatid cyst ruptures. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection.

Introduction: Echinococcosis is the most common cestode infection globally caused by the Echinococcus species. The most common organ involvement is the lungs and liver, but other organs can also be rarely involved. Here, we present a case with a giant cerebral hydatid cyst. Case report: A 4-year-old boy presented with abnormal gait and walking. Cranial magnetic resonance imaging showed a cyst of 13 cm in diameter. The cyst was enucleated successfully with no rupture. Oral albendazole therapy was started. There was no eosinophilia, and the echinococcal indirect hemagglutination test was negative. Ultrasonography detected an anechoic cystic lesion in the liver. He was evaluated for deep-organ involvement, however, no cysts were detected in other organs. The histopathological examination was compatible with a hydatid cyst. Discussion: Although intracranial hydatid disease in children is rare, it should be considered among the differential diagnoses in patients with neurological symptoms, especially in highly endemic regions.

This case details a 42-year-old farmer experiencing ten months of lower abdominal pain, diagnosed with a retrovesical hydatid cyst (RVHC). Imaging, including ultrasound and CT scans, categorized the cyst as Gharbi type 3. Serological tests confirmed echinococcal antibodies. Surgical intervention comprised the resection of the cyst's prominent dome, following one month of albendazole therapy. The importance of a multidisciplinary approach is highlighted, emphasizing collaboration among urologists, radiologists, and parasitologists for optimal outcomes. This case discussion contributes to the existing literature, providing insights into the management of this rare manifestation of echinococcosis.

Abstract Background Echinococcosis is a multisystem disease that might affect all organs, especially the liver and the lungs among adults. Axillary hydatid cyst, an extremely uncommon disease, was rarely reported in the literature. We report herein a case of axillary hydatid cyst which revealed a disseminated hydatid disease among a previously healthy woman. Case presentation A previously healthy woman, aged 53 years old, presented with a painful mass in her right axillary region. Physical examination revealed a painful semi-mobile right axillary mass, of 12 cm in size. Thoracoabdominal computed tomography scan revealed numerous cystic lesions: right axillary, pulmonary, hepatic, pancreatic, splenic and intraperitoneal lesions. The diagnosis of disseminated hydatid disease was suspected in front of the cystic lesions and the positive serology result for hydatid disease. An excisional biopsy of the axillary mass lesion was performed, confirming the diagnosis of a hydatid cyst. The patient received albendazole after hospital discharge. Conclusions Although axillary hydatid cyst is an extremely uncommon disease, the diagnosis should be rule out in front of the presence of a mass in the axillary region. Imaging results associated with serological tests might suspect the diagnosis, which can only be confirmed with parasitological or/and histopathological examination. Its management include surgical and medical therapy.

Retroperitoneal hydatid cysts are extremely rare and difficult to distinguish from other intra-abdominal pathologies, such as synovial sarcoma. In this study, we present a rare case of a complicated retroperitoneal hydatid cyst originating from the psoas muscle without any other focus. A 59-year-old male patient presented to the outpatient clinic with complaints of constipation and a feeling of gradually increasing swelling in the left lower quadrant of the abdomen and left groin area, progressing toward the left leg. In the examinations performed, a multiloculated giant hydatid cyst that filled the left pelvis in the retroperitoneal region, deviated the intra-abdominal organs to the right side, and extended to the left femoral and inguinal canals was detected. The patient underwent surgical excision and was followed up during the postoperative period. No evidence of recurrence was found at the patient’s 3rd and 6th month follow-ups. Primary muscle hydatid cysts necessitate a distinct approach to treatment and management when compared with hydatid cysts in other bodily organs. While recurrences remain a potential concern after resection, it is noteworthy that the window for the formation of fertile cysts typically spans up to 10 months. Thus, it is advisable to conduct regular postoperative follow-up examinations during the first year following surgery to ensure comprehensive monitoring and care.

Abstract Background Hydatid cysts are most frequently located in the liver and lungs and very rarely can be found in the pericardium. Diagnosis and treatment are quite challenging, as the disease can present itself in many forms depending to the location and the complications that it might cause. Case presentation A 22-year-old man presented to our hospital with ongoing dry cough for more than 1 month prior to admission. Other symptoms included chest pain, fatigue, low grade fever, and night sweats, which have worsened in the past 2 weeks. Physical examination revealed normal respiratory and heart function. Chest X-ray demonstrated mediastinal enlargement and left pleural effusion. Contrast-enhanced computed tomography images showed a walled cystic mass lesion measuring up to 56 × 50 mm in close proximity to the upper left atrium, ascending aorta and pulmonary artery, potentially localized in the pericardium, with a 10 mm endoatrial filling defect, findings were compatible with hydatid cyst, left pleural effusion and peripheral pulmonary upper left lobe consolidation. Cardiac involvement was excluded on magnetic resonance imaging and trans-esophageal ultrasound. The patient underwent fine needle aspiration of the affected lung and thoracocentesis. No malignancy was found, meanwhile the biopsy confirmed the presence of pulmonary infarction. In view of the imaging findings were highly suspicious of a hydatid cyst, we performed a test of antibody titers that was negative. The patient underwent left anterolateral thoracotomy, and after the opening of the pericardium, a cystic mass of 5 cm in diameter was found next to the left atrium and in close proximity with the left pulmonary veins. The content of the cyst was completely removed after the surgical area was isolated with gauze impregnated with hypertonic solution (NaCl 10%). The mass resulted to be an echinococcal cyst with multiple daughter cysts within it that did not penetrate/involve (perforate) the cardiac wall. Conclusion Pericardial echinococcosis is a very rare pathology in which a high expertise multidisciplinary approach is required. The compression mass effect caused by the cyst can lead to complications, such as in our case where the pulmonary vein was compressed, leading to pulmonary infarction. The value of radiology studies and transoesophageal ultrasound are very important in the diagnosis. Surgery in these cases is always recommended, but preferred surgical approach is questionable. In cases such as ours, we recommend anterolateral thoracotomy.

Aim: demonstrate an algorithm for the diagnosis and treatment of acute pancreatitis and obstructive jaundice caused by obstruction of the terminal part of the common bile duct by daughter echinococcal cyst.Key points. The article presents a clinical case of acute echinococcal obstruction of the terminal part of the common bile duct in a patient with a complicated course of liver echinococcosis. A 33-year-old man was hospitalized with epigastrium and right hypochondrium pains and jaundice. In 2019 the patient underwent the removal of a cyst in the 7th liver segment and cholecystectomy for liver and gallbladder echinococcal lesions. Laboratory research revealed leukocytosis, hyperbilirubinemia and an increase in the transaminases level. Transabdominal ultrasound showed signs of dilatation throughout bile ducts. Duodenoscopy revealed a fixed yellowish-white oval formation with transluent capsule, completely blocking bile and pancreatic juice outflow at the major duodenal papilla. After non-annulation endoscopic papillotomy, migration of the substrate (echinococcal cyst) into the duodenum was noted, active flow of bile and pancreatic secretions was restored. Oral transpapillary cholangioscopy was performed for a detailed bile ducts examination. It revealed no echinococcal cysts, residual parasitic structures or biliary tree lesions. The treatment was completed with pancreatic stenting. After complex treatment in the intensive care and surgery unit with complete condition stabilization, the patient was discharged with recommendations for further treatment in a specialized clinic.Conclusion. Migration of a daughter cyst from the echinococcal liver focus can cause acute blockade of the terminal part of the common bile duct and acute obstructive pancreatitis. The combination of clinical, radiological and endoscopic methods allows to diagnose and eliminate this rare complication of liver echinococcosis with subsequent successful treatment.

The purpose of the research is to develop a sandwich enzyme-linked immunosorbent assay (ELISA) for laboratory diagnosis of echinococcosis in animals. Materials and methods. The diagnostic efficiency of the ELISA test system developed by us against cystic echinococcus infection in cattle was studied by comparing the obtained results with the data of a postmortem examination of animal carcasses. The sera from 80 animals delivered to the slaughterhouse from farms of different regions of the Republic of Azerbaijan were tested. Results and discussion. A positive ELISA test result was obtained in 42 animals, which was 52.5% of the total number of the animals studied. The postmortem diagnosis was confirmed in 32 animals, which was 40.0%. The comparison of the ELISA diagnostic efficiency with the postmortem examination data was 68.75%. Fasciola species were found in the bile ducts in 7 animals with a positive ELISA test response to echinococcosis and a negative diagnosis in the postmortem examination, and Cysticercus tenuicollis was found in one animal.

Abstract Background Cystic echinococcosis (CE) is a life-threatening zoonotic disease caused by the larval stage of Echinococcus granulosus sensu lato, which employs various strategies to evade the host immune system for survival. Recent advances have revealed the role of annexins as excretory/secretory products, providing new insights into the immune regulation by these proteins in the pathogenesis of CE. Methods Echinococcus granulosus annexin B proteins EgANXB2, EgANXB18, EgANXB20, and EgANXB23 were cloned, expressed, and analyzed using bioinformatic tools. Membrane binding analysis was used to assess their bioactivity, while their immunoreactivity and tissue distribution characteristics were determined experimentally using western blotting and immunofluorescence staining, respectively. Furthermore, quantitative real-time reverse transcription PCR (qRT-PCR) was used to analyze the mRNA expression profiles of EgANXBs in different developmental stages of E. granulosus. Finally, immunofluorescence staining, cell counting kit 8 assays, flow cytometry, transwell migration assays, and qRT-PCR were used to evaluate the functional effects of rEgANXB18 and rEgANXB20 on mouse peripheral blood mononuclear cells (PBMCs). Results In this study, we identified four EgANXBs with conserved protein structures and calcium-dependent phospholipid binding activities. rEgANXBs were recognized by serum from sheep infected with E. granulosus and distributed in the germinal layer of fertile cysts. Interestingly, transcription levels of the four EgANXBs were significantly higher in protoscoleces than in 28-day strobilated worms. Moreover, we demonstrated that rEgANXB18 and rEgANXB20 were secretory proteins that could bind to PBMCs and regulate their function. Specifically, rEgANXB18 inhibited cell proliferation and migration while promoting cell apoptosis, NO production, and cytokine profile shifting. In contrast, rEgANXB20 showed limited effects on apoptosis but inhibited NO production. Conclusions Our findings suggested that among the four identified EgANXBs, EgANXB2 and EgANXB23 might play a pivotal role for the development of protoscoleces, while EgANXB18 and EgANXB20, as secretory proteins, appeared to participate in the host-parasite interaction by regulating the function of immune cells. Graphical Abstract

Cystic echinococcosis (CE), or hydatid disease, is a parasitic infection caused by Echinococcus granulosus endemic to areas with considerable pastoral farming and animal husbandry. Typical presentations include hydatid cyst formation in the liver, lungs, brain, kidneys, or bones. An isolated splenic hydatid cyst is an extremely rare occurrence, accounting for only 0.5%-4% worldwide incidence rates, and recurrent cases are even more infrequent. Globalization, cross-border travel, and altered immigration patterns over time have shifted some of the burden of CE from the developing to the developed world, making the diagnosis challenging for these nonendemic areas. Judicious use of imaging modalities for prompt diagnosis and effective intervention is necessary to treat the initial disease and prevent a recurrence. Herein, we present the case of a 13-year-old male with recurrent isolated splenic hydatid cyst. The patient presented with chronic and nonradiating pain in his left hypochondrium. Physical examination revealed splenomegaly. Ultrasonography showed multiple cysts. Computerized tomography (CT) scan showed cystic lesions in splenic parenchyma with numerous internal enhancing septae. Surgical evacuation was performed for the management of disease.

ABSTRACT Cystic echinococcosis (CE) is a parasite-borne disease caused by the larval stage of Echinococcus granulosus belonging to family Taeniidae, is an endemic disease, distributed worldwide as a neglected parasite with socioeconomic repercussions. It causes severe alterations in liver of infected host, and it could be fatal if untreated. The main objective of the present study is to measure and evaluate the condition of hydatidosis in slaughtered sheep in Al Baha region, Saudi Arabia. A total of 601 slaughtered sheep in Al Baha abattoirs were examined for hydatidosis during the year 2020. Various organs were examined for the presence of parasite cysts, and the cyst contents were examined by light microscopy. Also, liver sections infected with cysts were examined for pathological alterations and host-parasite interactions. Forty-two animals were infected (6.09%) with the highest prevalence during summer. During gross examination, it was observed that the sheep liver is the most affected organ by the disease. The liver contained multiple cysts with varying sizes, filled with clear to slightly turbid fluid containing protoscoleces. Detailed sections of the infected liver revealed significant fibrosis around the central vein, portal vein congestion, infiltration of inflammatory cells, and necrosis. Sections through hydatid cysts showed the presence of three surrounding layers with a laminar membrane bordering the cyst lined by a germinal epithelium surrounding several brood capsules with many protoscolesces inside supported by a set of rostellar hooklets. Considerable efforts should be spent to control the transmission of parasitic cysts and inhibit the incorrect disposal of infected meat from slaughterhouses. Also, more focus should be done on epidemiological and control programs of these parasites.

Echinococcosis, one of the most serious and life-threatening parasitic forms of zoonosis worldwide, is caused by the larvae of Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis). Various drugs are being applied clinically to treat zoonosis; however, their therapeutic efficacy remains a great challenge, especially with albendazole as the preferred drug of choice. Receptor tyrosine kinase (RTK) signaling controls normal cellular proliferation, differentiation, and metabolism in humans and mammals, which are intermediate hosts of E. granulosus and E. multilocularis. Disruption of RTK signaling can cause various forms of carcinogenesis and exacerbate the progression of certain forms of parasitic disease. As a result, a significant number of studies on tyrosine kinase inhibitors (TKIs) have been conducted for the treatment of cancer and parasitic infection, with some TKIs already approved for clinical use for cancer. Notably, RTK signaling has been identified in the parasites E. granulosus and E. multilocularis; however, the mechanisms of RTK signaling response in Echinococcus–host intercommunication are not fully understood. Thus, understanding the RTK signaling response in Echinococcus–host intercommunication and the potential effect of RTK signaling is crucial for identifying new drug targets for echinococcosis. The present review illustrates that RTK signaling in the host is over-activated following infection by E. granulosus or E. multilocularis and can further facilitate the development of metacestodes in vitro. In addition, some TKIs exert strong parasitostatic effects on E. granulosus or E. multilocularis, both in vitro and/or in vivo, through downregulation of RTK signaling molecules. The summarized findings suggest that RTK signaling may be a promising drug target and that TKIs could be potential anti-Echinococcus drugs warranting further research.

A prospective study on 110 patients with echinococcosis at Dr. Khuroo’s Medical Clinic, Srinagar, Kashmir, India, from March 2019 to April 2024 identified 12 cases (4 males, 8 females; mean age of 46.58 ± 11.97 years) of Alveolar echinococcosis (AE). Two patients were detected through ultrasound examinations carried out for unrelated causes; one presented with features of liver abscess, and nine had pain in the right upper quadrant for a mean period of 2.2 ± 1.79 years. All had the liver as the primary organ involved, with 15 tumor masses of a mean maximum diameter of 9.22 ± 3.21 cm and volume of 426 ± 374.61 cm3. Tumors placed centrally had invaded vessels and the biliary tract in eight patients, and those placed peripherally had invaded the liver capsule and adjacent organs in nine patients. Histologic examination of liver biopsies or resected organs revealed necrotic lesions, calcifications, and granulomatous inflammation with slender, thin-walled vesicles of bizarre configuration that stained strongly eosinophilic with periodic acid Schiff. Two patients had segmental liver resections; one was treated with liver aspiration, while the other nine with advanced disease received chemotherapy with albendazole along with praziquantel. Patients showed clinical improvement on a median follow-up of 12 months (range 1 to 60 months); however, MRI T2-weighted images and 18F-FDG-PET-CECT scans in two patients showed active disease on follow-up at one and five years, respectively. A systematic review detected 146 cases of AE in India from 1980 to April 2024. Twenty cases were from foreign countries, mostly from Central Asian republics, and 118 (93.65%) of the remaining 126 Indian patients were permanent residents of Kashmir Valley. The disease affected a population of 79,197 residing in 22 villages from 5 border districts of the valley. These villages were either high in or adjacent to the Himalayan mountain range. Disease prevalence in the affected population was 146.47/105 (males 131.53/105 and females 163.18/105) and the incidence was 12.41/105/year (males 11.16/105/year and females 13.81/105/year). Possible causes of the emergence of AE are discussed, and future directions for research to face this challenge arebeen identified.

Echinococcosis poses a significant concern in the fields of public health and veterinary care as it can be transmitted between animals and humans. The primary endemic subtypes are cystic echinococcosis (CE) and alveolar echinococcosis (AE), which result from infestation by Echinococcus granulosus and Echinococcus multilocularis, respectively. A prominent epidemic of echinococcosis greatly affects the Tibet Autonomous Region (TAR) in China. A new technique called the loop-mediated isothermal amplification–lateral flow dipstick (LAMP-LFD) test is introduced in this research to differentiate between E. granulosus and E. multilocularis using their repetitive genetic sequences. The test is characterized by its portable nature, simple operation, quick result production, high sensitivity, and low susceptibility to aerosol contamination. The LAMP-LFD method demonstrated an exceptional minimal detection limit, reaching levels as low as approximately 1 fg/μL (femtogram per microliter) of genomic DNA. The assay’s specificity was assessed, and no cross-reactivity was seen. A total of 982 dog fecal samples were collected from 54 counties in the TAR region between July 2021 and June 2022. The established method underwent validation using a commercially available ELISA kit. The agreement rate between the LAMP-LFD and ELISA methods was 97.25%, with a sensitivity of 96.05% and a specificity of 97.35%. The assay described in this study improves specificity by using a double-labeled probe, and it reduces the risk of false-positive results caused by aerosol contamination through the use of a sealed device. This makes it a suitable choice for quickly and accurately identifying the two main types of Echinococcus in field settings.

Abstract Background Cystic Hydatid disease is a parasitic infection with a worldwide distribution. It is caused by the larval stages of a species of tapeworms known as Echinococcus granulosus. Even in endemic areas; Cardiac involvement by hydatidiosis is very rare and has atypical presentations as well as localization which make it undiagnosed in about 10% of cases. The left ventricle is the most Common chamber involved by the hydatid cyst and isolated involvement of the right ventricle is very rare, especially in children. The aim of the present study was to describe hydatid cardiac cyst of the right ventricle of a child. Case presentation We present a rare case of an 8 year-old boy, living in a rural area, who was diagnosed with a cardiac hydatid cyst in the right ventricle. He also had multiple pulmonary hydatid cysts and presented with dyspnea, cough and atypical chest pain. The patient underwent surgery for the resection of pulmonary cysts and, subsequently, cardiac hydatid cyst. The outcome was favorable seven weeks after surgery and there was no clinical and echocardiographic recurrence. Conclusion Cardiac Echinococcosis must be suspected in endemic areas, diagnosed with appropriate imaging techniques, and treated appropriately.

Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.

Ghrelin widely exists in the central nervous system and peripheral organs, and has biological activities such as maintaining energy homeostasis, regulating lipid metabolism, cell proliferation, immune response, gastrointestinal physiological activities, cognition, memory, circadian rhythm and reward effects. In many benign liver diseases, it may play a hepatoprotective role against steatosis, chronic inflammation, oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress and apoptosis, and improve liver cell autophagy and immune response to improve disease progression. However, the role of Ghrelin in liver Echinococcosis is currently unclear. This review systematically summarizes the molecular mechanisms by which Ghrelin regulates liver growth metabolism, immune-inflammation, fibrogenesis, proliferation and apoptosis, as well as its protective effects in liver fibrosis diseases, and further proposes the role of Ghrelin in liver Echinococcosis infection. During the infectious process, it may promote the parasitism and survival of parasites on the host by improving the immune-inflammatory microenvironment and fibrosis state, thereby accelerating disease progression. However, there is currently a lack of targeted in vitro and in vivo experimental evidence for this viewpoint.

The lethal zoonosis alveolar echinococcosis is caused by tumour-like growth of the metacestode stage of the tapeworm Echinococcus multilocularis within host organs. We previously demonstrated that metacestode proliferation is exclusively driven by somatic stem cells (germinative cells), which are the only mitotically active parasite cells that give rise to all differentiated cell types. The Echinococcus gene repertoire required for germinative cell maintenance and differentiation has not been characterised so far. We herein carried out Illumina sequencing on cDNA from Echinococcus metacestode vesicles, from metacestode tissue depleted of germinative cells, and from Echinococcus primary cell cultures. We identified a set of ~1,180 genes associated with germinative cells, which contained numerous known stem cell markers alongside genes involved in replication, cell cycle regulation, mitosis, meiosis, epigenetic modification, and nucleotide metabolism. Interestingly, we also identified 44 stem cell associated transcription factors that are likely involved in regulating germinative cell differentiation and/or pluripotency. By in situ hybridization and pulse-chase experiments, we also found a new general Echinococcus stem cell marker, EmCIP2Ah, and we provide evidence implying the presence of a slow cycling stem cell sub-population expressing the extracellular matrix factor Emkal1. RNA-Seq analyses on primary cell cultures revealed that metacestode-derived Echinococcus stem cells display an expanded differentiation capability and do not only form differentiated cell types of the metacestode, but also cells expressing genes specific for protoscoleces, adult worms, and oncospheres, including an ortholog of the schistosome praziquantel target, EmTRPMPZQ. Finally, we show that primary cell cultures contain a cell population expressing an ortholog of the tumour necrosis factor α receptor family and that mammalian TNFα accelerates the development of metacestode vesicles from germinative cells. Taken together, our analyses provide a robust and comprehensive characterization of the Echinococcus germinative cell transcriptome, demonstrate expanded differentiation capability of metacestode derived stem cells, and underscore the potential of primary germinative cell cultures to investigate developmental processes of the parasite. These data are relevant for studies into the role of Echinococcus stem cells in parasite development and will facilitate the design of anti-parasitic drugs that specifically act on the parasite germinative cell compartment.

Key Clinical Message The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences. Abstract We report a unique case of a 26‐year‐old male who presented with acute urinary retention and abdominal distention. Later, CT‐urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.

Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.