In-vitro evaluation of Nigella sativa and Punica granatum effect on protoscolices of hydatid cysts / Avaliação in vitro do efeito de Nigella sativa e Punica granatum em protoescólices de cistos hidáticos

Abstract Cystic echinococcosis (CE) are commonly found in the liver and lungs of affected hosts. The treatment approach is usually surgical, or giving drugs in conjunction before surgery to kill protoscolices, to avoid anaphylactic shock from leakage of hydatid fluid into the peritoneum and to decrease opportunities for recurrences. The present study was to evaluate the in vitro scolicidal efficacy of hydroalcoholic extract of Punica granatum peel and Nigella sativa, on the protoscolices of CE that collected from the lungs of infected camels. Different concentrations of extracts with different exposure times were used and a viability assay was applied to measure the scolicidal effect. N. sativa showed its highest scolicidal efficacy at 100 mg/mL and 10 mg/mL concentrations after 30 and 60 min. P. granatum peel extract showed its maximum scolicidal efficacy at 100 mg/mL concentration after 120 min. All experiments of the current study revealed that the extracts of both N. sativa and P. granatum had a scolicidal effects on the protoscolices of camel hydatid cysts. It could be concluded that N. sativa extract is more potent than P. granatum peel extract regarding scolicidal effect, but the efficacies of both extracts were of moderate significant correlation to exposure time and concentrations.

Resumo Os cistos hidáticos (equinococose cística, CE) são comumente encontrados no fígado e nos pulmões dos hospedeiros afetados. A abordagem do tratamento geralmente é cirúrgica, e algumas drogas são administradas em conjunto antes da cirurgia para matar protoscólices e evitar choque anafilático devido ao vazamento de fluido hidático no peritônio e diminuir as oportunidades de recorrência. O presente estudo foi avaliar a eficácia in-vitro do extrato hidroalcoólico de casca de Punica granatum e Nigella sativa, sobre os protoescólices de cistos hidáticos, que foram coletados dos pulmões de camelos infectados. Concentrações dos extratos com diferentes tempos de exposição foram utilizados e um ensaio de viabilidade foi aplicado para medir o efeito escolicida. A N. sativa apresentou sua maior eficácia escolicida nas concentrações de 100 mg/mL e 10 mg/mL após 30 e 60 min. O extrato de casca de P. granatum mostrou sua máxima eficácia escolicida na concentração de 100 mg/mL após 120 min. Todos os experimentos do presente estudo revelaram que os extratos de N. sativa e P. granatum tiveram efeito escolicida dependente da dose e do tempo nos protoescólices dos cistos hidáticos de camelo. Pode-se concluir que o extrato de N. sativa é mais potente que o extrato de casca de P. granatum em relação ao efeito escolicida, mas a eficácia de ambos os extratos foi de correlação significativa moderada com o tempo de exposição e as concentrações.

Genetic diversity of Echinococcus vogeli in the western Brazilian Amazon

Human polycystic echinococcosis is a parasitic infection caused by the larval stage of Echinococcus vogeli, which occurs in rural areas of Central and South America. Until now, little information on the genetic variability of E. vogeli is available. Here, 32 samples from human-excised E. vogeli cysts had a 396-bp sequence of the mitochondrial cytochrome oxidase I (COI) gene sequenced and compared to another 17 COI sequences representing nine Echinococcus species. A Bayesian COI tree revealed that all E. vogeli sequences formed a monophyletic and well-supported clade with an E. vogeli reference sequence. The occurrence of geographically restricted E. vogeli COI haplotypes suggests retention of ancestral polymorphisms with little migration in Acre, Brazil.

Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation

ABSTRACTINTRODUCTION: Hydatid cysts are rarely detected in muscle tissue (0.7-0.9%), even in endemic countries. The aim of this study was to present information regarding the clinical manifestations, diagnosis, and management of muscle echinococcosis.METHODS: Twenty-two patients with hydatid cysts in the muscle were followed from January 2006 through December 2014.RESULTS: Twenty-four sites of muscle involvement were observed in the 22 patients. Fifteen (68%) of our patients were women, while seven (32%) were men. The mean age was 28.1 ± 15.4 (6-61) years. The most frequent locations were the thigh (27.2%) and the paravertebral region (13.6%). Most patients reported a painless slow-growing mass with normal overlying skin. Most (90.2%) cases were treated by surgical excision and fine-needle aspiration.CONCLUSIONS: Primary muscle hydatid cyst should be considered in the differential diagnosis in cystic masses of the muscular system without pain and localized enlargement of soft tissue, especially in endemic areas. Hydatid cyst should be investigated using serological tests and imaging modalities. If possible, total surgical excision of hydatid cyst in the muscle should be performed.

Primera identificación de Echinococcus vogeli en una paca en la provincia de Misiones, Argentina / [First report of Echinococcus vogeli in a paca in Misiones province, Argentina].

We report the first finding of Echinococcus vogeli in a paca, Cuniculus paca, in the tropical forest of Misiones, in the north of Argentina. The presence of the bush dog, Speothos venaticus, E. vogelís only natural definitive host, was also reported. The polycystic hydatids, 2 to 3 cm in diameter, were only found in the liver of an adult paca. The size range of the hooks and the relative proportion blade/handle did not show significant differences with respect to the ones reported for E. vogeli. The size of E. granulosus hooks, measured for comparison purposes, was significantly smaller (p E. vogeli in Argentina. The probability of finding neotropical echinococcosis in humans reinforces the need to expand the search for E. vogeli in Argentina. Echinococcosis due to E. vogeli is very aggressive and may cause death in about a third of the human population affected.

Hidatidose policística no norte do Brasil: abordagem parasitológica e histopatológica de pacas e casos humanos / Polycystic hydatid in northern Brazil: parasitological and histopathological approach from human and pacas cases

A hidatidose policística é uma zoonose causada pelo cestóide Echinococcus vogeli, amplamente distribuído no norte do Brasil. Os hospedeiros definitivos são Speothos venaticus (cachorro-vinagre) e Canis familiaris (cães domésticos), enquanto Agouti paca (paca) é hospedeiro intermediário. Tanto as pacas quanto o homem (hospedeiro acidental) desenvolvem a forma larvar (metacestóide), principalmente na superfície e no interior do fígado. Esta tese tem como objetivo geral estudar as características parasitológicas e histopatológicas de metacestóides de E. vogeli, originários de pacas e humanos da região norte do Brasil, visto o conhecimento insuficiente ou mesmo o seu desconhecimento. Os fígados e mesentérios foram obtidos de oito pacientes com hidatidose policística durante ato cirúrgico na Fundação Hospital Estadual do Acre. Pacas foram capturadas no Município de Bujari, Floresta Estadual do Antimary, Acre. Durante a necropsia das pacas, foram observadas lesões macroscópicas (massas esbranquiçadas ou amareladas, semelhantes a bolhas na superfície dos fígados). Para a análise parasitológica foram aplicadas as microscopias de luz, contraste interferencial de Normaski (DIC) e varredura laser confocal. A análise morfométrica foi realizada com o auxílio do Programa Image Pro Plus Media Cybernetics. Os órgãos de pacas e humanos foram submetidos à análise histopatológica. Os pequenos e grandes ganchos rostelares apresentaram polimorfismo morfológico, enquanto a organização dos protoescólices acompanhou o padrão descrito para Echinococcus sp. Todas as pacas apresentavam cistos hepáticos, porém em apenas duas encontramos líquido hidático, comprovados pela presença dos ganchos e protoescólices. A análise histopatológica dos tecidos hepáticos das pacas confirmou a hidatidose policística e evidenciou, pela presença de agrupamentos de ovos, a coinfecção com Calodium hepaticum. As características morfológicas dos ganchos rostelares dos casos humanos não diferiram...

Polycystic hydatidosis is a zoonotic disease caused by the cestode Echinococcus vogeli, largely distributed in northern Brazil. The definitive hosts are Speothos venaticus (bush dogs) and Canis familiaris (domestic dogs), while Agouti paca (paca) is the intermediate host. Both the pacas and man (accidental host) develop the larval form (metacestodes), mainly on the surface and inside the liver. This thesis aims to study histopathological and parasitological characteristics of metacestodes of E. vogeli, from pacas and humans of the north region of Brazil, seen the insufficient knowledge or lack of it. The mesentery and livers were recovered from eight patients with polycystic hydatidosis during surgery in the Acre State Hospital Foundation. Pacas were captured in the municipality of Bujari, Antimary State Forest, Acre. During the pacas necropsy, macroscopic lesions were observed (whitish or yellowish masses, similar to blisters on the surface of the liver). Identification analyses were applied to light microscopy, interferential contrast microscopy of Normaski (DIC) and confocal laser scanning microscopy. Morphometric analysis was performed by Image Pro Plus Media Cybernetics program. The pacas and human organs were subjected to histopathological analysis. The small and large rostellar hooks presented morphological polymorphism while protoscoleces organisation accompanied the pattern described in Echinococcus sp. All pacas presented liver cysts, however in only two found proven by the presence of hydatid fluid, hooks and protoscoleces. Histopathological analysis of pacas’ hepatic tissues confirmed polycystic hydatidosis and evidenced by the presence of eggs clusters the Calodium hepaticum coinfection. The morphological characteristics of human cases rostellar hooks did not differ from described to the pacas; however, the hooks were greater than the mesenteric ones. Already in relation to protoscoleces, the mesenteric ones were larger than the liver...

Unusual localization of an hydatid cyst: first reported case in Buenos Aires, Argentina

Hydatidosis is a parasitic infection caused by the tapeworm larva of Echinococcus spp. Its relevance lies in its wide distribution, great number of clinical cases and outstanding morbility. Hydatid infection of the orbit comprises far less than 1 percent of the total incidence. This is a case of a patient from Argentina complaining of a two-week evolution proptosis of the right eye. A microscopic examination revealed the presence of protoscolices of Echinococcus spp. in the fluid obtained during the surgical proceedings. The patient was treated with oral albendazole. To our knowledge, this is the first case of occular hydatidosis diagnosed in the city of Buenos Aires, Argentina.

Recurrent Hepatic Alveolar Echinococcosis: Report of The First Case in Korea with Unproven Infection Route

Human alveolar echinococcosis (AE), a hepatic disorder that resembles liver cancer, is a highly aggressive and lethal zoonotic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. E. multilocularis is widely distributed in the northern hemisphere; the disease-endemic area stretches from north America through Europe to central and east Asia, including northern parts of Japan, but it has not been reported in Korea. Herein, we represent a first case of AE in Korea. A 41-year-old woman was found to have a large liver mass on routine medical examination. The excised mass showed multinodular, necrotic, and spongiform appearance with small irregular pseudocystic spaces. Microscopically, the mass was composed of chronic granulomatous inflammation with extensive coagulation necrosis and parasite-like structure, which was revealed as parasitic vesicles and laminated layer delineated by periodic acid-Schiff (PAS) stain. Clinical and histologic features were consistent with AE. After 8 years, a new liver mass and multiple metastatic pulmonary nodules were found and the recurred mass showed similar histologic features to the initial mass. She had never visited endemic areas of AE, and thus the exact infection route is unclear.

First Successful Puncture, Aspiration, Injection, and Re-Aspiration of Hydatid Cyst in the Liver Presenting with Anaphylactic Shock in Korea

Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst.

Análise da associação da escolaridade com renda e com cuidados de saúde e ectoparasitismo em cães na cidade de Araguaína, Tocantins / Analysis of the association of the schooling with income and with cares of health and ectoparasitism in dogs in the city of Araguaína, Tocantins

Um inquérito epidemiológico realizado em 2005, na cidade de Araguaína, Estado do Tocantins, revelou existir associação entre escolaridade e renda de proprietários de cães (p<0,01). A escolaridade destes proprietários também teve associação com confinamento, vacinação (exceto contra a raiva) e vermifugação dos animais (p<0,01).O ectoparasitismo e a vacinação dos cães contra a raiva foram independentes da escolaridade dos proprietários (p>0,05). No grupo de proprietários com menor escolaridade, o aumento da instrução formal, para nove ou mais anos, pode reduzir o número de cães sem confinamento, vacinação (exceto contra a raiva) ou vermifugação em 23,3% (IC95%=10,9-35,2), 30,5% (IC95%=18,7-41,1) e 22,3% (IC95%=10,7-33,2), respectivamente; no conjunto de proprietários de cães esta redução pode ser, na mesma ordem, de 10,7%(IC95%=0,8-19,3), 14,3% (IC95%=3,9-24,3) e 10,7% (IC95%=1,0-19,5). A promoção sócio-econômica regional, com mais ações de educação sanitária e aumento da escolaridade, é condição essencial para a melhoria da saúde dos cães e, conseqüentemente, da saúde pública

An epidemiological survey carried out in 2005, in the city of Araguaína, State of the Tocantins, revealed to exist association between school in gand income of dogs’ owners (p<0,01). The schooling of these owners also had association with confinement, vaccination (except against the rabies) and deworming (p<0.01). The ectoparasitism and the dogs’ vaccination against the rabies were independent of the schooling of the owners (p>0,05). In the group of owners with smaller schooling, the increase of the formal instruction, for nine or more years, can reduce the number of dogs without confinement, vaccination (except against the rabies) or deworming in 23,3% (IC95%=10,9-35,2), 30,5% (IC95%=18,7-41,1) and 22,3% (IC95%=10,7-33,2),respectively; in the assembly of all of the owners of dogs this reduction can be, in the same order, of 10.7% (IC95%=0,8-19,3),14.3% (IC95%=3,9-24,3) and 10.7% (IC95%=1,0-19,5). The regional socio-economic promotion, with more actions of sanitary education and increase of the schooling, is essential condition to the improvement of the health of the dogs and, consequently, of the public health

A Case of Multiple Intraperitoneal Cysts from Ruptured Hepatic Hydatid Cysts / 대한소화기학회지

Hydatid disease is a parasitic infestation caused by the larval form of the cestode worms Echinococcus. In humans, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. The incidence of hydatid disease is high in the Middle East, Australia, East and South Africa and Central Europe. In Korea, hydatid disease is rare and has been reported in a few cases. We experienced a case of multiple intraperitoneal cysts from ruptured hepatic hydatid cysts in a 35-year old man. His complaint was palpable abdominal mass and discomfort. Abdominal ultrasound and CT scan revealed multiple hepatic and intraperitoneal cysts. The surgical findings showed multiple cysts and daughter cysts. The pathologic finding of resected cyst was the characteristic pattern of outer thick laminated membrane and inner thin germinal layer. Albendazole was administrated for prophylatic purpose.

Hidatidosis hepatopulmonar en una preescolar, caso clínico: case report / Hepatopulmonary hydatidosis in a preschool female: case report

Se denomina Hidatidosis a la zoonosis parasitaria que causa la infección de herbívoros o del hombre con el estado larval (hidátide) de parásitos del género Echinococcus. Objetivo: Revisión del tema y presentación del primer caso en Chile estudiado mediante técnicas de biología molecular. Caso Clínico: Preescolar de 3 años 9 meses procedente de Punta Arenas portadora de una hidatidosis múltiple de 6 quistes (4 pulmonares y 2 hepáticos), trasladada a la V Región para su tratamiento. Se realizó 3 cirugías y tratamiento médico asociado (Albendazol en dosis de 15 mg/kg/día vía oral) durante 73 días. Las hidátides extraídas fueron medidas, se efectuó estudio de fertilidad y vitalidad e identificación de cepa de Echinococcus granulosus mediante técnicas de biología molecular. La paciente mostró notable mejoría clínica e imagenológica, y mantuvo serología positiva. El tratamiento fue bien tolerado no presentando reacciones adversas. El tamaño de las hidátides fluctuó entre 6 y 11 cm de diámetro, todas fueron fértiles y vitales en diferente porcentaje y en todas se identificó cepa oveja de E. granulosus. De regreso en Punta Arenas, a los 4 meses se le detecta una nueva hidátide hepática que fue extirpada. El complejo manejo de este caso resultó exitoso.

Observation of hydatid cyst infection in kordestan province [West of Iran] using epidemiological and seroepidemiological criteria

Echinococcosis is the major helminthic parasitic infection in Iran. The health hazard and economic loss in man and livestock is significant. In this study 3 major topics as the prevalence of hydatid cyst in human population, in livestock and echinococcosis in stray dogs, were studied. Total of 1114 serum samples in different age groups in Sanandaj and Divandareh area of Kurdestan province in west of Iran were examined by indirect immunoflurecent test [IFA]. In Sanandaj area 3.3% and in Divandareh 9.5% of serum samples were positive for hydatidosis. In livestock using abattoir inspection the rate of infection was 51.9% and 28.02% for sheep and cattle, respectively. Nine stray dogs [44%] autopsied in Sanandaj were positive for Echinococcosis

First report of a human case of polycystic echinococcosis due to Echinococcus vogeli from neotropical area of Peru, South America

Reportamos un caso humano de hidatidosis poliquística debido a Echinococcus vogeli procedente de Contamana (Departamento de Loreto), localidad ubicada en la selva central del Perú. La paciente es una mujer de 44 años de edad, profesora, quien portaba una hepatomegalia no dolorosa de un año de evolución. Sometida a intervención quirúrgica, se removió la masa hepática que macroscópicamente mostró múltiples quistes conteniendo líquido incoloro. El examen microscópico correspondió a una hidatidosis poliquística. El examen y medida de los ganchos obtenidos del contenido de los quistes correspondieron a Echinococcus vogeli. Es el primer reporte de este parasitismo en el Perú.

Equinococose policística na Amazônia oriental brasileira: atualização da casuística / Polycystic echinococcosis in the eastern brazilian Amazon: an update

Mediante critérios epidemiológicos, clínicos e laboratoriais, foi levantada a casuística de equinococose policística no período de 1962 a 2003, no âmbito da Amazônia oriental brasileira, incluindo casos inéditos e aqueles já publicados. Dessa forma, foram identificados 40 casos da doença no referido período, compreendendo casos procedentes dos estados do Pará e Amapá, Brasil. A amplitude das idades foi de 10 a 72 anos. Do total 47,5% pertenciam ao sexo masculino. O fígado foi o órgão mais acometido (82,5% dos casos). O Echinococcus vogeli (Rausch e Bernstein, 1972), apresentou-se como o principal agente etiológico envolvido. A partir do reconhecimento da importância e das implicações do manejo da equinococose para a região tropical, acredita-se que deverá ocorrer uma implementação do diagnóstico precoce, tratamento adequado e de um melhor registro da doença.

By means of epidemiological and clinical-laboratorial approaches was consolidated an update of polycystic echinococcosis in the Eastern Brazilian Amazon, period from 1962 to 2003, including unpublished cases and those already published. In that way, they were identified 40 cases of the disease in referred period, understanding cases coming from the States of Pará and Amapá, Brazil. The width of the ages went from 10 to 72 years and 47,5% belonged to the masculine sex. The liver was the attacked organ (82,5% of the cases). The Echinococcus vogeli (Rausch and Bernstein, 1972), comes as the main agent involved. Starting from the recognition of the importance and of the implications of the handling of the echinococcosis for the tropical area, it is believed that should happen an improvement of the diagnosis, appropriate treatment and of a better registration of the disease.

Primary hydatid cyst of the breast: report of two cases

Hydatid disease is caused by the tapeworm ecchinococcus. The larval stage of which can thrive in many parts of the body, most frequently in the liver. Primary breast location is very rare. We report two cases, the first was in 23 years old woman presented with right painless mammary mass of two years duration, second case in 30 years old woman presented with left breast mass. The pathological examination confirmed the diagnosis of a hydatid disease in two cases. Clinical and mammographic evaluations of both patients after seven years were uneventful

Immunological follow-up of hydatid cyst cases

Hydatid disease is caused by Echinococcus granulosus. In this study, we aimed to investigate the benefit of monitoring cases with hydatid cyst by means of immune components in patients in a long-term follow-up after surgery. Eighty-four preoperative and postoperative serum samples from 14 cases undergoing surgery for hydatid disease were evaluated in terms of immune parameters, such as total and specific IgE, IgG, IgM, IgA and complement. Total and specific IgE were determined by ELISA. Specific IgG levels were measured by indirect hemaglutination.Total IgG, IgM, IgA and complement (C3 and C4) were detected by nephelometry. Imaging studies were also carried out during the follow-up. In none of the patients hydatid cysts were detected during the follow-up. Total IgE levels in the sera of the patients decreased to normal six months after surgery. Although specific IgE against echinococcal antigens decreased one year after operation, levels were still significantly high. There were no changes in the levels of anti-Echinococcus IgG and total IgG in follow-up period. Additionally, other parameters, such as IgA, IgM, C3 and C4, were not affected

Estudio de viabilidad de escólices de quistes hidatídicos hepáticos humanos / Viability study of scolices of human hydatid liver cysts

El adecuado control de la hidatidosis en general, requiere conocer algunos aspectos relacionados con la supervivencia de los agentes infectantes, especialmente de los escólices. El objetivo de este trabajo, es evaluar la viabilidad de los escólices de quistes hidatídicos humanos de localización hepática. Estudiar la asociación entre las características clínicas al momento de la cirugía y el porcentaje de viabilidad de los escólices. Los criterios de viabilidad utilizados fueron: forma ovoide, invaginados, ganchos rostrales y corpúsculos calcáreos intactos, movimientos vibratorios presentes y ausencia de tinción con colorantes vitales. Los criterios para certificar mortalidad de los escólices fueron dos o más de los siguientes hechos: inmovilidad, alteración de los ganchos rostrales y de los corpúsculos calcáreos, rotura de membrana y pérdida de la forma ovoide y fácil tinción con el colorante vital (azul de tripan al 1,5 por ciento). Se estudiaron de esta forma 16 quistes, con un diámetro promedio de 16,2 cm. Siete lesiones (44 por ciento) de tipo univesicular, 5 (31 por ciento) multivesiculares y 4 (25 por ciento) quistes abscedados. En 7 oportunidades (44 por ciento), se evidenció comunicación a la vía biliar; y se constató viabilidad en 9 de los 16 quistes (56 por ciento). Las muestras con mayor porcentaje de escólices viables fueron los quistes multivesiculares, principalmente a expensas de las vesículas hijas. Se constató que los quistes multivesiculares eran viables en el 100 por ciento de los casos, a diferencia de los univesiculares con un 57 pir ciento y los abscedados con 0 por ciento (p= 0,01)