Hidatidosis subcutánea primaria / Primary subcutaneous hydatid disease: a case report

La hidatidosis o equinococosis quística es una zoonosis parasitaria endémica causada por el estadio larvario del cestode Echinococcus granulosus. El hígado y el pulmón son los órganos con afección más frecuente. Su ubicación subcutánea es una entidad rara, poco descrita, y por ende un reto diagnóstico. Describimos el caso de una mujer, de 18 años de edad, procedente de un área endémica, que presentó un quiste hidatídico primario supraclavicular.

Hydatid disease or cystic echinococcosis is an endemic parasitic zoonosis caused by the larval stage of the cestode Echinococcus granulosus, the liver and lung being the most frequently affected organs. Its subcutaneous location is a rare entity, little described, and therefore a diagnostic challenge. We describe the case of an 18-year-old woman from an endemic area who presented with a primary supraclavicular hydatid cyst.

Laparoscopic Management of a Hydatid Cyst of the Adrenal Gland

Hydatid disease is endemic in parts of India, yet genitourinary involvement is rare. Laparoscopic management of such cases is uncommonly reported. We present a case of an adrenal hydatid and its management by laparoscopic aspiration, instillation of scolicidal solution, and partial excision of the cyst.

A rare case of renal hydatidosis in a child with congenital solitary kidney

Hydatid cyst of a solitary congenital kidney is a rare entity because of the small percentage of cases with renal hydatidosis and the reduced number of cases with this renal anomaly. We report a case presenting this extremely rare combination and having a favorable outcome. The diagnosis was confirmed based on an association of imagistic techniques and positive serology. The case was managed using a minimal invasive surgical technique (PAIR) that reduced the operative risks. Additionally, an antihelminthic agent (albendazole) was administered. To our knowledge, this is the first case with such comorbidity and treated through percutaneous approach.

Polycystic echinococcosis in the state of Acre, Brazil: contribution to patient diagnosis, treatment and prognosis

The lack of knowledge regarding polycystic hydatid disease results in delayed or even incorrect diagnosis. The lack of systematic information regarding treatment also makes it difficult to assess the results and prognosis in patients with peritoneal and hepatic lesions caused by Echinococcus vogeli. Here we describe the clinical features of patients, propose a radiological classification protocol and describe a therapeutic option for the treatment of hydatid disease that previously had only been used for cases of cystic echinococcosis (Echinococcus granulosus). A prospective cohort study was initiated in 1999 and by 2009 the study included 60 patients. These patients were classified according to the PNM classification (parasite lesion, neighbouring organ invasion and metastases) and placed in one of three therapeutic modalities: (i) chemotherapy with albendazole at a dose of 10 mg/kg/day, (ii) surgical removal of cysts or (iii) percutaneous puncture of the cysts via puncture, aspiration, injection and re-aspiration (PAIR). The results were stratified according to therapeutic outcome: "cure", "clinical improvement", "no improvement", "death" or "no information". The PNM classification was useful in indicating the appropriate therapy in cases of polycystic hydatid disease. In conclusion, surgical therapy produced the best clinical results of all the therapies studied based on "cure" and "clinical improvement" outcomes. The use of PAIR for treatment requires additional study.

Determinación simultánea por cromatografía líquida de alta resolución de albendazol y triclabendazol en triclazol 22 suspensión, para uso veterinario / Simultaneous determination of Albendazol and Triclabendazol in Triclazol 22 suspension for veterinary purposes

Introducción: la suspensión de triclazol 22 se emplea con fines veterinarios como antiparasitario pues contiene triclabendazol y albendazol.Objetivo: validar el método analítico para la determinación simultánea del triclabendazol y albendazol en la suspensión de triclazol 22 aplicable al control de la calidad.Métodos: para cuantificar el principio activo en el producto terminado, la separación se realizó a través de una columna cromatográfica Lichrosorb RP-18 (5 µm) (250 x 4 mm), con detección ultravioleta a 298 nm, empleando una fase móvil compuesta por acetonitrilo: solución amortiguadora de acetato de amonio pH 6,6 (70:30) y la cuantificación de este frente a una muestra de referencia con el método del estándar externo.Resultados: los resultados de los parámetros evaluados en la validación realizada del método se encontraron dentro de los límites establecidos.Conclusiones: el método analítico validado resultó lineal, preciso, exacto y específico en el rango de concentraciones estudiadas

Introduction: triclazol 22 suspension containing triclabendazol and albendazol is used as parasiticide for veterinary purposes. Objective: to validate the analytical method for simultaneous determination of triclabendazol and albendazol in triclazol 22 suspension for quality control. Methods: for quantitation of the active principle in the final product, the separation was performed through a liquid chromatographic column Lichrosorb RP-18 (5 Ám) (250 x 4 mm), with ultraviolet detection range of 298 nm, by using a mobile phase of acetonitrile: ammonium acetate buffer solution of ph 6.6 (70:30); the quantitation was made against a reference sample by means of the external standard method. Results: the results of the evaluated parameters in this validation yielded that they were within the set limits. Conclusions: The validated analytical method was linear, precise, exact and specific in the range of studied concentrations

Neurocisticercosis intraventricular tratada eficazmente con agentes anticéstodos / Intraventricular Neurocysticercosis effectively treated with anticestodal agents

Antecedentes: La neurocisticercosis se produce cuando el hombre se convierte en huésped intermediario de la Taenia solium al ingerir sus huevecillos. Esto ocurre al consumir carne de cerdo (principal huésped intermediario) con una cocción incompleta. Estas condiciones son comunes en áreas rurales sobre todo en países en vías de desarrollo, como Honduras; en donde, la prevalencia es desconocida, pero se ha demostrado que una de las zonas más endémicas de neurocisticercosis en el país es el Occidente, zona en la cual el ganado porcino constituye una de las principales fuentes de alimentación. Con respecto al tratamiento, los agentes anticéstodos han modificado el pronóstico de esta entidad; sin embargo, a pesar de ello, algunos enfermos evolucionan de forma desfavorable, particularmente en quistes ventriculares en el cerebro. Con éste reporte se pretende demostrar que el uso de agentes anticéstodos, como el albendazol es una opción terapéutica eficaz en el manejo de la neurocisticercosis intraventricular. Caso Clínico: paciente femenino procedente de Santa Rosa de Copán, al occidente del país, con historia de cefalea bitemporal de 5 años de evolución, asociada a fiebre no cuantificada y episodios de vómito. Estudios radiológicos reportaron imagen quística en IV ventrículo, que correspondía a probable quiste neurocisticercósico sin hidrocefalia, la paciente recibió tratamiento con Albendazol a dosis de 15 mg/kg/día por 14 días, con lo cual se obtuvo remisión de los síntomas, además, de reducción en el tamaño del quiste. Conclusión: Puede considerarse el uso de albendazol como una opción terapéutica eficaz en pacientes con neurocisticercosis intraventricular no complicada con hidrocefalia...

Herculean appearance due to disseminated cysticercosis: case report

Cysticercosis is a common tropical disease. Disseminated form is one of the uncommon manifestations and a rare complication of this disease. We report an immunocompetent patient with disseminated cysticercosis who had involvement of the brain and skeletal muscles giving rise to Herculean appearance.

Human cystic echinococcosis: epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects

This review represents an updated scenario on the transmission cycle, epidemiology, clinical features and pathogenicity, diagnosis and treatment, and prevention and control measures of a cestode parasite Echincoccus granulosus (E. granulosus) infection causing cystic echinococcosis (CE) in humans. Human CE is a serious life-threatening neglected zoonotic disease that occurs in both developing and developed countries, and is recognized as a major public health problem. The life cycle of E. granulosus involves a definitive host (dogs and other canids) for the adult E. granulosus that resides in the intestine, and an intermediate host (sheep and other herbivores) for the tissue-invading metacestode (larval) stage. Humans are only incidentally infected; since the completion of the life cycle of E. granulosus depends on carnivores feeding on herbivores bearing hydatid cysts with viable protoscoleces, humans represent usually the dead end for the parasite. On ingestion of E. granulosus eggs, hydatid cysts are formed mostly in liver and lungs, and occasionally in other organs of human body, which are considered as uncommon sites of localization of hydatid cysts. The diagnosis of extrahepatic echinococcal disease is more accurate today because of the availability of new imaging techniques, and the current treatments include surgery and percutaneous drainage, and chemotherapy (albendazole and mebendazole). But, the wild animals that involve in sylvatic cycle may overlap and interact with the domestic sheep-dog cycle, and thus complicating the control efforts. The updated facts and phenomena regarding human and animal CE presented herein are due to the web search of SCI and non-SCI journals.

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.

Diagnosis and treatment of pulmonary cystic hydatidosis.

OBJECTIVE: Hydatidosis is a parasitic infection that is still an important public health problem in Turkey. In the present study, it was planned to review the diagnostic and treatment options. METHODS: The study was conducted in pediatric pulmonary chest ward of Izmir Chest Diseases and Surgery Training Hospital, a referral tertiary hospital for pulmonary diseases in Western Turkey. Cases were evaluated in clinical presentations, radiological, histopathologic and serological features retrospectively. RESULTS: Consecutive 17 (11 male and 6 female; mean age 11.29 + 2.44) pediatric cases between 1996 and 2001 were evaluated. Liver involvement was found in 8 (47%) cases. Casoni skin test and IHA test were found positive in 7 (63.6%) and 8 (72.7%) out of 11 cases, respectively. Surgical treatment was performed only in 7 (41.1%) cases as well as surgical plus medical treatment was given in 3 (17.6%) cases. Seven (41.1%) cases were treated just medically. CONCLUSION: Hydatidosis should be considered in the existence of appropriate clinical and radiological findings as a probable diagnosis in all children in our region. Surgery should be the first choice for treatment but, medical therapy was considered as effective for treatment complicated and/or nonsurgical pediatric cases.

Human neurocysticercosis managed at Nepalganj Medical College, Teaching Hospital, Kohalpur, Nepal.

INTRODUCTION: Neurocysticercosis is the most common parasitic infection of the central nervous system. It is endemic in Central Europe, South Africa, South America and parts of Asia including Nepal. OBJECTIVE: This study has been conducted with the objectives to know the diagnostic criteria for neurocysticercosis and the outcome of treated cases. METHODOLOGY: This retrospective study was done at Nepalganj Medical College, Teaching Hospital, Kohalpur, by reviewing the record of the patients managed as case of neurocysticercosis in one financial year. RESULTS: All patients presented with seizure as a main symptom started in adult life. The mean age was 21 years; 80% were male and 20% female. The diagnosis seemed to be based on clinical presentation, CT scan findings and high index of suspicion. All were put on albendazole, steroids and anticonvulsant drugs; 93% was discharged when fits got controlled, one patient left against medical advice. Follow up record was not available to comment on resolution. CONCLUSION: Neurocysticercosis is difficult to diagnose and has a significant socioeconomic impact because of chronic morbidity, variable mortality, decreased productivity of affected persons, and high cost of medical diagnosis and treatment. It is therefore suggested to develop criteria for diagnosis of neurocysticercosis to be followed at national level.

Therapeutic effects of Sophora moorcroftiana alkaloids in combination with albendazole in mice experimentally infected with protoscolices of Echinococcus granulosus

The objective of the present study was to determine if the combination of alkaloids from Sophora moorcroftiana seeds and albendazole might be effective in the treatment of experimental echinococcosisin female NIH mice (6 weeks old and weighing 18-20 g, N = 8 in each group) infected withprotoscolices of Echinococcus granulosus. Viable protoscolices (N = 6 x 103) were cultured in vitro in 1640 medium and mortality was calculated daily. To determine the in vivo efficacy, mice were inoculated intraperitoneally with viable protoscolices and then treated once daily by gavage for three months with the alkaloids (50 mg kg-1 day-1) and albendazole (50 mg kg-1 day-1), separately and in combination (both alkaloids at 25 mg kg-1 day-1 and albendazole at 25 mg kg-1 day-1). Next, the hydatid cysts collected from the peritoneal cavity of the animals were weighed and serum IL-4, IL-2, and IgE levels were analyzed. Administration of alkaloids to cultured protoscolices showed significant dose- and time-dependent killing effects. The weight of hydatid cysts was significantly decreased upon treatment with each drug (P < 0.01), but the decrease was more prominent and the rate of hydatid cyst growth inhibition was much higher (76.1 percent) in the group receiving the combined treatments (18.3 ± 4.6 mg). IL-4 and total IgE were decreased (939 ± 447 pg/mL and 2.03 ± 0.42 IU/mL, respectively) in serum from mice treated with alkaloids and albendazole compared with the untreated control (1481 ± 619 pg/mL and 3.31 ± 0.37 IU/mL; P < 0.01). These results indicate that S. moorcroftiana alkaloids have protoscolicidal effects and the combination of alkaloids and albendazole has significant additive effects.

Hemichorea resulting from single enhancing computed tomography lesion.

A single small enhancing computerized tomographic lesion is a common finding in Indian patients with seizures, particularly focal seizures. A small single enhancing computed tomography lesion also presents with varied non-epileptic manifestations viz. focal neurological deficits, episodic vascular headache, syndrome of increased intracranial pressure, etc. Here we present a case of hemichorea resulting from single enhancing CT lesion. A 12-year-old female presented with acute onset abnormal movements involving right side of body. A clinical diagnosis of right hemichorea was made and patient was subjected to neuroimaging along with other investigations. CT scan showed a single ring-enhancing lesion with perifocal edema in left thalamic area suggestive of neurocysticercosis. Patient was treated with albendazole, steroids and haloperidol therapy. Patient showed marked improvement at follow-up after one month. Repeat CT scan revealed resolution of lesion. This case has been reported because hemichorea in young female is usually caused by post-streptococcal infection and it is quite rare presentation of small ring enhancing lesion.

Bioresidual efficacy and phytotoxicity of certain systemic nematicides against root-knot nematode infesting tomato plants

The bioresidual efficacy and phytotoxic effects of four systemic nematicides: akldicarb, carbofluran, oxamyl and fenamiphos against root-knot nematodes infesting tomao plants were evaluated in laboratory and greenhouses. The obtained results indicated the important role of nematicide type on the studied nematodes and tomato plants. Fenamiphos proved more effectiveness than the other nematicides tested against the root-knot nematode larvae, followed by akldicarb. The highest inhibition of gall formation was obtained by fenamiphos, while oxamyl was the lowest inhibitor. General, for all tested nematicides at the evaluated concentrations, the best inhibition was achieved when the nematicide was applied at the time of inoculation. The nematicides tested except fenamiphos showed clear phytotoxic symptoms on treated tomato plants characterized by significantly reduction in the dry weight of plant roots and shoots. Among the tested nematicides only carbofuran decreased significantly the height of treated tomato plants

The first human infection with Bertiella studeri in Vietnam.

This is the first case report of Bertiella studeri infection in Vietnam. The patient was a 4 year old boy in Cai Lay district of Tien Giang Province, noting some proglottids in his feces. The time and mode of infection were unknown, but anorexia, weight loss, and intermittent diarrhea were noted. Niclosamide (Yomesan) 1 gram was prescribed, and then albendazole (Zentel) 400mg daily for 3 days. Proglottids were found in the feces three months after the first treatment, and 1 month after the second course.

Hidatidose policística: relato de dois casos procedentes de Sena Madureira, Acre, na Amazônia brasileira / Polycystic hydatid disease: report of two cases from the city of Sena Madureira, Acre, in Brazilian Amazon

Dois casos de hidatidose policística (HP) säo relatados, oriundos do mesmo município da regiäo amazônica brasileira (Sena Madureira, Acre). Ambos tiveram a mesma apresentaçäo e evoluçäo clínica ao longo de dois anos de acompanhamento. Inicialmente os pacientes queixaram-se de dor abdominal no andar superior ou no hipocôndrio direito e apresentaram icterícia obstrutiva, febre, aumento de volume abdominal e emagrecimento. Por exame de imagem, além de esplenomegalia, cistos múltiplos e coalescentes foram detectados no fígado. Amostras de soro foram reagentes por contraimunoeletroforese. O tratamento com albendazol resultou em melhora parcial, com alívio sintomático e reduçäo no tamanho das lesöes. Este relato reforça a importância de estudos clínico-epidemiológicos da hidatidose policística na regiäo amazônica brasileira, especialmente no município de Sena Madureira, onde outros pacientes com HP podem estar sem diagnóstico