Disseminated Alveolar Echinococcosis.
AJTES Vol. 5, No 2, July 2021.
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Alveolar echinococcosis
Echinococcus multilocularis

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Çuko, L., Bilaj, F., Çela, D., Hysenj, A., Bakeri, B., Babameto, A., Kurti, F., Tafaj, I., & Çeliku, E. (2021). Disseminated Alveolar Echinococcosis. Albanian Journal of Trauma and Emergency Surgery, 5(2), 904-907. https://doi.org/10.32391/ajtes.v5i2.244


Alveolar echinococcosis (AE) is caused by the larval form of the tapeworm Echinococcus multilocularis. In humans, E. alveolaris metacestode cells proliferate in the liver inducing a hepatic disorder that mimics liver cancer and can spread to other organs. From 1960 to 1972 mortality was at 70% and 94% after 5 and 10 years of follow-up, respectively. Since then, studies have shown an increasing trend towards improving survival rates [1]. As AE is also spreading to new areas of Eastern Europe, researchers seek to better understand the clinical presentation of pathology, including asymptomatic forms. Clinical case; One 36-year-old woman from Peshkopia has been admitted to the Gastrohephatology department on 20.07.2011 with fatigue, anorexia, dull pain in right hypochondrium, mild epigastric pain, bloating, and weight loss. The epidemiological anamnesis showed that the patient lived in the village and had pets. On physical examination, the patient appeared severely ill with jaundice, massive hepatomegaly, massive mass in the mesogastric area, and anxiety. Laboratory examinations were as follows: Hb 11.1 g/dl, sediment 25 mm/h; leukocytes 6700/mm3; platelets 127000/mm3; prothrombin level 60%, uremia 12.7 mmol/l; creatinine 0.78 mmol /l; ALP 127 U/I; AST 15 U/I; ALT 37 U/I; GGT 131 U/I; bilirubin 3.7 mg/l, albumin 2.8 gr / l, total protein 8.1 gr / l, HbsAg negative, anti-HCV negative. Regarding serology, the titer of anti-echinococcal antibodies was positive (22, n = 11) Conclusions: Clinical presentation and radiologic imaging findings of disseminated alveolar echinococcosis can mimic metastatic malignancy, and diagnosis can be challenging in atypically advanced cases. As the incidence of human alveolar echinococcosis appears to be increasing and, physicians should be aware of alveolar echinococcosis, its epidemiology, and its clinical features.

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Oksanen A, Siles-Lukas M, Karamon J, Conraths FJ, Roming T et al.The geographical distribution and prevalence of Echinococcus multilocular in animals in the European Union and adjacent countries: a systemic review and meta-analysis. Parasit Vectors.2016:9:519

Torgerson PR, Robertson LJ, Enemark HL, Foehr J, Van der Giessen JWB, Kapel CMO, Klun I, Trevisan C. Source attribution of human echinochoccosis: a systematic review and meta-analisis: Dis. 2020:14(6)e0008382.

Brunett E, Kern P, Vuitton Da. Writing panel for the WHO IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans.Acta.Trop.2009,114:10.

Bresson-Hadni S, Delabrousse E, Blagosklonov O, Bartholomot B, Koch S, Miguet JP, Mantion GA, Vuitton DA. Imaging aspects and non-surgical interventional treatment in human alveolar echinococcosis. Parasitol Int. 2006;55(Supple): S267.

Graeter T, Kratzer W, Oeztuerk S, Haenle MM, Mason RA, Hillenbrand A, Kull T, Barth TF, Kern P, Gruener B. Proposal of a computed tomography classification for hepatic alveolar echinococcosis. World J Gastroenterol. 2016;22(13):3621.

Logar J, Soba B, Lejko-Zupanc T, Kotar T. Human alveolar echinococcosis in Slovenia. Clin Microbiol Infect. 2007;13(5):544.

Fischer I, Graeter T, Kratzer W, Stark K, Schlingeloff P, Schmidberger J. Echinococcosis working group Ulm. Distribution of alveolar echinococcosis according to environmental and geographical factors in Germany, 1992-2018. Acta Trop. 2020; 212:105654.

KOtawa JD. Isaksson M, Jardine CM, et al Echinococcus multilocularis infection, Southern Ontario, Canada.Emerg Infect Dis 2019;25.265-72.

Brunetti E, Kern P, Vuitton DA.Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114:1–6.

Torgerson PR, Keller K, Magnotta M, Ragland N. The global burden of alveolar echinococcosis. PLoS Negl Trop Dis. 2010 Jun;4(6): e722.

Pohnan R, Ryska M, Hytych V, Matej R, Hrabal P, Pudil J. Echinococcosis mimicking liver malignancy: A case report. Int J Surg Case Rep. 2017; 36:55–8.

Marrero JA, Ahn J, Rajender Reddy K; American College of Gastroenterology. ACG clinical guideline: the diagnosis and management of focal liver lesions. Am J Gastroenterol. 2014 Sep;109(9):1328–47; quiz 1348.

Neumayr A, Troia G, de Bernardis C, Tamarozzi F, Goblirsch S, Piccoli L, et al. Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis – a systematic literature review. PLoS Negl Trop Dis. 2011 Jun;5(6): e1154.

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