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Infection. 2017 Feb;45(1):107-110. doi: 10.1007/s15010-016-0918-7. Epub 2016 Jun 28.

Autochthonous human alveolar echinococcosis in a Hungarian patient.

Author information

1
Joint Hospital of St. Stephen and St. Ladislau, Budapest, Hungary.
2
National Institute of Oncology, Budapest, Hungary.
3
National Center for Epidemiology, Budapest, Hungary.
4
Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
5
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Rome, Italy.
6
Institute of Pathology, Ulm University, Ulm, Germany.
7
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Rome, Italy. adriano.casulli@iss.it.
8
European Reference Laboratory for Parasites, Rome, Italy. adriano.casulli@iss.it.
9
World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis (in Humans and Animals), Rome, Italy. adriano.casulli@iss.it.

Abstract

BACKGROUND:

Alveolar echinococcosis is a zoonotic parasitic disease causing a severe clinical condition and is known as the most deadly of all helminth infections. Moreover, this disease is also an increasing concern in Northern and Eastern Europe due to its spread in the wildlife animal host.

CASE PRESENTATION:

An asymptomatic 70-year-old woman from south-western Hungary was diagnosed with multiple liver lesions. Imaging techniques (ultrasound, computed tomography and magnetic resonance imaging), serology (ELISA, indirect hemagglutination and Western blot), and conventional staining methods (hematoxylin-eosin and periodic acid-Schiff) were used for the detection of the disease. A histopathological re-evaluation of formalin-fixed paraffin block by immunohistochemical staining with the monoclonal antibody Em2G11 definitively confirmed the diagnosis of alveolar echinococcosis.

CONCLUSIONS:

To our knowledge, this is the first confirmed autochthonous case of human alveolar echinococcosis in Hungary. To what extent diagnostic difficulties may contribute to underestimate this zoonosis in Eastern Europe is unknown. Differential diagnosis with alveolar echinococcosis should be considered for patients with multiple, tumor-like cystic lesions of the liver, in countries where this parasite is emerging.

KEYWORDS:

Alveolar echinococcosis; Case report; Differential diagnosis; Echinococcus multilocularis; Histopathological re-evaluation; Public health threat

PMID:
27352256
DOI:
10.1007/s15010-016-0918-7
[Indexed for MEDLINE]

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