Echinococcus granulosus (Batsch, 1786), a cestode of the Teniidae family, causes human cystic echinococcosis (CE) also known as hydatid disease. Echinococcus granulosus sensu lato includes the G1, G3, G4, G5, G6/7 and G8/10 genotypes which are known to cause human CE. This study aimed to differentiate genotypes of E. granulosus s.l. complex by employing EmsB, a tandemly repeated multilocus microsatellite, using next-generation sequencing (MIC-NGS). Human and animal histopathology-confirmed hydatid cyst tissue samples and reference DNA samples of E. granulosus G1, G3, G4, G5, G6/7 and G10 underwent MIC-NGS assay with custom primers amplifying a 151 bp EmsB DNA fragment. NGS data were analysed using online Galaxy analysis pipeline, a phylogenetic tree was constructed by MEGA software, and haplotype networking was performed with PopArt 1.7. All sixty samples (49 from animals and 11 from humans) included were successfully identified and genotyped with a 100 % success rate. The study showed improved discrimination power to distinguish all study samples including closely related E. granulosus s.s. genotypes G1-G3. The maximum likelihood tree reaffirmed the monophyly of E. granulosus s.l. The median-joining haplotype networking revealed 12 distinct haplotypes. In conclusion, MIC-NGS assay was shown to be sensitive, specific and simple to apply to clinical samples offering a powerful discriminatory tool for the genotyping of E. granulosus s.l.

• MeSH
• Echinococcus granulosus * genetics   MeSH
• Echinococcosis * veterinary   parasitology   MeSH
• Phylogeny MeSH
• Genotype * MeSH
• Genotyping Techniques veterinary   MeSH
• Humans MeSH
• Microsatellite Repeats * MeSH
• High-Throughput Nucleotide Sequencing * MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Albendazole administration & dosage   therapeutic use   MeSH
• Echinococcus granulosus MeSH
• Echinococcosis * diagnosis   parasitology   therapy   MeSH
• Humans MeSH
• Young Adult MeSH
• Orbital Diseases MeSH
• Neurosurgical Procedures methods   MeSH
• Tomography, X-Ray Computed MeSH
• Prednisolone administration & dosage   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Alveolárna echinokokóza (AE) je agresívna a potenciálne fatálna parazitárna zoonóza. Jejpôvodcom je Echinococcus multilocularis.U človeka býva primárne postihnutá pečeň. Ocho-renie je typické svojím infiltratívnym rastom a metastatickým šírením, čím napodobňuje ma-lignitu. Multiorgánová invázia je pozorovaná v približne 13 % prípadov. Lokálne môže infil-trovať vaskulárne štruktúry, biliárny systém a hilus pečene. Imunosupresívna liečba podporujeprogresiu tohto infekčného ochorenia. V prípade postihnutia vaskulárnych štruktúr dokážeimitovať a podporovať trombotický proces. V kazuistike prezentujeme prípad pacientky sosclerosis multiplex na biologickej liečbe alemtuzumabom spojenej s opakovanou pulznoulieč bou kortikoidmi, u ktorej došlo ku závažnej lokálnej progresii echinokokózy s prerastanímdo dolnej dutej žily.

Alveolar echinococcosis (AE) is an aggressive and potentially fatal parasite zoonosis. It iscaused by Echinococcus multilocularis. It primarily affects liver in humans. The disease is typi -cally manifested by an infiltrative growth and a metastatic spread that imitates malignancy.The multiorgan invasion is observed in about 13 % of cases. It may locally infiltrate vascularstructures, biliary system and hepatic hilus. The immunosuppressive treatment acceleratesthe progression of this infective disease. When vascular system is affected the disease mayimitate and accelerate the thrombotic process. We present a case report of a patient with mul-tiple sclerosis treated with a biologic treatment alemtuzumab and repeated pulses of corti-costeroid therapy who experienced a severe local progression of echinococcosis with a spreadto the inferior vena cava.

• MeSH
• Alemtuzumab pharmacology   immunology   therapeutic use   MeSH
• Adult MeSH
• Echinococcus granulosus isolation & purification   MeSH
• Echinococcosis, Hepatic * diagnostic imaging   epidemiology   complications   MeSH
• Humans MeSH
• Multiple Sclerosis drug therapy   MeSH
• Iliac Vein diagnostic imaging   microbiology   pathology   MeSH
• Venous Thrombosis surgery   diagnostic imaging   etiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Cystic echinococcosis (CE) is a zoonotic disease caused by the tapeworms of the Echinococcus granulosus sensu lato complex, which have worldwide distribution. No data on the circulation of genotypes of the E. granulosus complex in intermediate hosts in endemic areas in Calabria are available. The aims of our study were to evaluate the dispersal of genotypes of the E. granulosus complex in Calabria and to characterise parasite isolates by Sanger sequencing and phylogenetic analysis. We collected 71 animal samples from pigs, wild boars, sheep, cattle and goats. The first PCR screening analysis targeted three partial genomic regions: the cytochrome c oxidase subunit 1 (cox1), calreticulin protein (cal) and NADH dehydrogenase subunit 1 (nad1); this identified 28 parasitic cysts. Bidirectional sequencing of cox1 amplicons and phylogenetic analysis allowed us to characterise all isolates. Molecular analyses of 28 newly generated cox1 sequences revealed that most wild boars (n = 16) and three pigs were parasitised by the larval stage of Taenia hydatidena Pallas, 1766, called cysticercus tenuicollis. Two isolates from wild boars were identified as Echinococcus canadensis Webster and Cameron, 1961 (G7), while five sheep and two goats were infected with E. granulosus G1 (sheep strain) and G1 microvariant (previously reported as G2 genotype or Tasmanian sheep strain), respectively. These molecular findings should prompt further and more extensive studies, to elucidate regional transmission patterns and to guide control programs.

• MeSH
• Echinococcus granulosus classification   genetics   isolation & purification   MeSH
• Echinococcosis parasitology   veterinary   MeSH
• Phylogeny MeSH
• Genotype MeSH
• Calreticulin analysis   MeSH
• Goats MeSH
• NADH Dehydrogenase analysis   MeSH
• Goat Diseases parasitology   MeSH
• Sheep Diseases parasitology   MeSH
• Swine Diseases parasitology   MeSH
• Cattle Diseases parasitology   MeSH
• Sheep MeSH
• Swine MeSH
• Helminth Proteins analysis   MeSH
• Electron Transport Complex IV analysis   MeSH
• Animal Distribution MeSH
• Cattle MeSH
• Animals MeSH
• Check Tag
• Cattle MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Italy MeSH

• MeSH
• Headache etiology   MeSH
• Adult MeSH
• Echinococcus granulosus MeSH
• Echinococcosis * surgery   diagnosis   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Neuroimaging methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Diagnostic Imaging MeSH
• Adult MeSH
• Echinococcus granulosus pathogenicity   drug effects   MeSH
• Epstein-Barr Virus Infections diagnosis   therapy   MeSH
• Humans MeSH
• Lymphatic Diseases diagnostic imaging   diagnosis   microbiology   therapy   MeSH
• Lymph Nodes * diagnostic imaging   microbiology   pathology   MeSH
• Thermography MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Úvod: Alveolární echinokokóza (AE) je zoonóza, jejíž příčinou je Echinococcus multilocularis. Její primární výskyt je téměř výhradně v játrech. Svým chováním alveokok imituje nádorové bujení. Krevním či lymfatickým řečištěm je schopen metastazovat do vzdálených orgánů. Vzhledem k dlouhé inkubační době a nevýrazným příznakům je průběh echinokokózy zpočátku asymptomatický. Další klinické příznaky odpovídají uložení parazita. Diagnostika echinokokózy je založena na anamnéze, klinické symptomatologii, laboratorních vyšetřeních a sérologii, výsledcích zobrazovacích metod a definitivních histologických závěrech. Terapeutickou metodou volby je chirurgické odstranění parazitární hmoty s dostatečným lemem okolní zdravé tkáně, doplněnou pooperační chemoterapií. Kazuistika: Předkládáme případ onemocnění alveolární echinokokózou u 30ti leté ženy, u které bylo provedeno operační odstranění mnohočetných jaterních ložisek alveokoka. Po 2 letech od operace došlo k recidivě onemocnění s dalším následným operačním řešením. Závěr: Alveolární echinokokóza je onemocnění, které má vysoký potenciál úplného vyléčení, v případě včasné diagnostiky a přísného dodržení doporučených terapeutických postupů.

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

• MeSH
• Surgical Procedures, Operative methods   MeSH
• Diagnostic Imaging methods   MeSH
• Adult MeSH
• Echinococcus granulosus MeSH
• Echinococcus multilocularis MeSH
• Echinococcosis, Hepatic * diagnosis   surgery   MeSH
• Liver surgery   microbiology   pathology   MeSH
• Humans MeSH
• Serologic Tests methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

An IgM murine monoclonal antibody (MAb) was obtained against the excretory-secretory antigen (ES-Ag) of in vitro reared protoscoleces of Echinococcus granulosus (Batsch, 1786). Western blotting revealed that the MAb recognised a 20.6 kDa protein of this ES-Ag. The MAb was used in sandwich enzyme-linked immunosorbent assay (s-ELISA) for selective sensitisation of the solid phase with the protoscolex-specific protein from its ES-Ag and somatic antigen (S-Ag) to examine serum samples of 108 cows from a cystic echinococcosis (CE) endemic area for specific antibodies and to compare the results with those from necropsies and an indirect ELISA (i-ELISA). The sensitivity of s-ELISA/ES-Ag, s-ELISA/S-Ag and i-ELISA/S-Ag was 48%, 52% and 62%, respectively. The low sensitivity of the ELISA was probably caused by the fact that 13 cows (62%) were infected with sterile cysts (acephalocysts and/or calcified foci) only. A relatively high specificity (80%) of s-ELISA/ES-Ag was observed in cows with fertile cysts. It also detected antibodies in the serum of two cows that had recovered from the disease according to the necropsy. The i-ELISA/S-Ag gave false results in testing sera from a healthy animal and from a cow with tubercular foci. Further analysis will be necessary to define more precisely the value of this study, because the duration of antibody elimination from the bloodstream of recovered cattle remains unknown. The solution of this problem will increase the specificity of the proposed test in monitoring herbivorous animals for CE.

• MeSH
• Antigens, Helminth immunology   MeSH
• Echinococcus granulosus immunology   isolation & purification   MeSH
• Echinococcosis diagnosis   parasitology   veterinary   MeSH
• Enzyme-Linked Immunosorbent Assay veterinary   MeSH
• Immunoglobulin M immunology   MeSH
• Antibodies, Monoclonal immunology   MeSH
• Cattle Diseases diagnosis   parasitology   MeSH
• Sensitivity and Specificity MeSH
• Cattle MeSH
• Animals MeSH
• Check Tag
• Cattle MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Echinokokóza (hydatidóza) je závažná tkáňová parazitóza v České Republice vzácná, vyvolána Echinococcus granulosus nebo Echinococcus multilocularis. Oba druhy původců se liší v obvyklých druzích hostitelů během životního cyklu a i typickou formou léze. V obou případech bývají nejčastěji u člověka primárně postižena játra. V našem případě při pitvě 81letého muže bylo prokázáno rozsáhlé postižení jater parazitární masou spongiózního vzhledu a navíc ještě ložiska echinokoka v pravé nadledvině prorůstáním per continuitatem a metastaticky v obou plicích. Mikroskopicky byly zachycené drobné cystické útvary s PAS-pozitivními laminárními membránami a v periferii jater a nadledviny s četnými protoskolexy. Diagnóza echinokokózy byla určena až v mikroskopickém rozboru autoptického materiálu. Celkový vzhled a postup šíření masy odpovídal charakteristice aleveolární echinokokózy, avšak hojný výskyt protoskolexů v jaterních ložiscích je pro tento druh parazita vzácný. Přítomnost protoskolexů je obvyklá u E. granulosus, jehož typická jaterní ložiska jsou tvořena jednou větší cystou nebo i větším počtem menších cyst s výrazným ohraničením. Pro nedostupnost molekulárně diagnostických metod (PCR, imunohistochemie), které by zcela jednoznačně druhově určili původce, byl případ uzavřen pouze na základě typického histologického nálezu jako diseminovaná alveolární echinokokóza s raritním výskytem protoskolexů s možnou souvislostí s imunosupresivní terapií. V posledních deseti letech bylo popsáno v České republice asi deset případů alveolární echinokokózy u žijících pacientů, většina s předpokládaným původem nákazy na našem území.

Echinococcosis (hydatidosis) is a rare severe tissue parasitosis. In the Czech Republic it is caused by two species of tapeworm: Echinococcus granulosus or Echinococcus multilocularis. The species differ in both their usual hosts during their life cycle as well as in the typical form of lesions in infested tissues. In both cases the liver is the most common primary infested organ. We describe an autopsy case of a massive hepatic parasitic lesion in an 81 year-old man. There were metastatic parasitic cysts in both lungs and the hepatic mass spread per continuitatem in the right adrenal gland. The lesion was microscopically represented by small cystic forms with PAS positive laminar membranes and frequent occurrence of protoscoleces in the peripheral parts of the liver and the adrenal gland. The diagnosis of echinococcosis was settled after microscopic exploration of necroptic material. The overall appearance and pattern of spreading corresponded to alveolar echinococcosis, however the massive presence of protoscoleces in the liver is very rare for E. multilocularis. Protoscoleces are usually found in infections caused by E. granulosus. Cystic echinococcosis typically presents with one larger cyst or a small number of bigger cysts with prominent fibrous rim. Because of the unavailability of molecular diagnostic methods (PCR, immunohistochemistry), that are able to distinguish individual species of parasite, the case was closed according to the typical histological findings as disseminated alveolar echinococcosis with the rare appearance of protoscoleces with possible association with immunosuppressive therapy. We have found about ten other cases of alveolar echinococcosis published in last ten years in the Czech Republic. All these cases were diagnosed in living patients. It is assumed that most of these patients were infected in the vicinity of their homes.

• MeSH
• Echinococcus granulosus MeSH
• Echinococcus multilocularis MeSH
• Echinococcosis, Hepatic * pathology   MeSH
• Humans MeSH
• Adrenal Glands pathology   MeSH
• Adrenal Gland Diseases pathology   MeSH
• Autopsy MeSH
• Aged, 80 and over MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Publication type
• Case Reports MeSH

Hydatid disease is caused by tapeworm Echinococcus granulosus. E. granulosus forms hydatid cysts in human body, mostly in the liver and the lung. However, isolated primary hydatid cyst of the pancreas is rarely seen. Hereby, we report a 40-year-old Caucasian female with a hydatid cyst in the body of the pancreas. The patient, complaining of vague abdominal pain was examined with abdominal ultrasound. The ultrasound scan of abdomen revealed an exophytic cystic lesion in the body of the pancreas, approximately 7.5x5 cm in size. The defined lesion was thought to be compatible with hydatid cyst stage 4-5. The surgical team informed the patient about all possible treatment options. The patient was put on albendazole treatment, 400 mg twice daily, for two months. Despite the medical treatment, the patient complained about abdominal pain and discomfort affecting her daily life. Therefore, she decided for surgical intervention. Following the intraoperative application of scolicidal hypertonic 20% NaCl solution, partial cystectomy with capitonnage was performed. The patient did well postoperatively. Isolated primary hydatid cyst of the pancreas is rarely seen, however, it should be taken into account in the differential diagnosis of abdominal pain, especially in endemic areas.

• MeSH
• Adult MeSH
• Echinococcus granulosus MeSH
• Echinococcosis * diagnosis   therapy   MeSH
• Humans MeSH
• Pancreatic Cyst * diagnosis   etiology   therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH