scholarly journals Importance of complex diagnostic approach in differential diagnosis of alveolar echinococcosis

2015 ◽  
Vol 52 (4) ◽  
pp. 298-302 ◽  
Author(s):  
M. Szilágyiová ◽  
Ľ. Laca ◽  
D. Antolová ◽  
E. Nováková ◽  
R. Rosoľanka ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cystic Echinococcosis ◽  
Alveolar Echinococcosis ◽  
Clinical Laboratory ◽  
Molecular Techniques ◽  
Positive Serology ◽  
Surgical Biopsy ◽  
Serological Tests ◽  
Larval Stages ◽  
Long Time

Summary Alveolar and cystic echinococcosis, serious parasitic diseases caused by larval stages of Echinococcus multilocularis and E. granulosus has been diagnosed in Slovakia for a long time. Study presents case of 49-years old patient with accidentally diagnosed one big (60 mm) and multiple small (2 - 24 mm) hypoechogenic structures localised in right liver lobe. According to positive serology to E. granulosus antigen and results of imaging examinations the patient was classifi ed as possible case of cystic echinococcosis and treated with mebendazole. Later, due to the worsening of clinical, laboratory and CT fi ndings surgical biopsy was performed and surgical biopsy and subsequent PCR examination of liver tissue confi rmed the diagnosis of alveolar echinococosis. Clinical picture of disease imitating cystic echinococcosis in presented case report, together with results of serological tests confi rmed importance of accurate differential diagnosis of echinococcosis. Each aspect of clinical and laboratory results should be considered responsibly, however, sometimes only molecular techniques can solve the problem of differential diagnosis.

scholarly journals Biological, Epidemiological, and Clinical Aspects of Echinococcosis, a Zoonosis of Increasing Concern

2004 ◽  
Vol 17 (1) ◽  
pp. 107-135 ◽  
Author(s):  
Johannes Eckert ◽  
Peter Deplazes
Keyword(s):  
Alveolar Echinococcosis ◽  
Treatment Options ◽  
Epidemiological Studies ◽  
Host Population ◽  
Molecular Techniques ◽  
Clinical Aspects ◽  
Red Foxes ◽  
Larval Stages ◽  
Northern And Southern Hemispheres ◽  
Human Echinococcosis

SUMMARY Echinococcosis in humans is a zoonotic infection caused by larval stages (metacestodes) of cestode species of the genus Echinococcus. Cystic echinococcosis (CE) is caused by Echinococcus granulosus, alveolar echinococcosis (AE) is caused by E. multilocularis, and polycystic forms are caused by either E. vogeli or E. oligarthrus. In untreated cases, AE has a high mortality rate. Although control is essentially feasible, CE remains a considerable health problem in many regions of the northern and southern hemispheres. AE is restricted to the northern hemisphere regions of North America and Eurasia. Recent studies have shown that E. multilocularis, the causative agent of AE, is more widely distributed than previously thought. There are also some hints of an increasing significance of polycystic forms of the disease, which are restricted to Central and South America. Various aspects of human echinococcosis are discussed in this review, including data on the infectivity of genetic variants of E. granulosus to humans, the increasing invasion of cities in Europe and Japan by red foxes, the main definitive hosts of E. multilocularis, and the first demonstration of urban cycles of the parasite. Examples of emergence or reemergence of CE are presented, and the question of potential spreading of E. multilocularis is critically assessed. Furthermore, information is presented on new and improved tools for diagnosing the infection in final hosts (dogs, foxes, and cats) by coproantigen or DNA detection and the application of molecular techniques to epidemiological studies. In the clinical field, the available methods for diagnosing human CE and AE are described and the treatment options are summarized. The development of new chemotherapeutic options for all forms of human echinococcosis remains an urgent requirement. A new option for the control of E. granulosus in the intermediate host population (mainly sheep and cattle) is vaccination. Attempts are made to reduce the prevalence of E. multilocualaris in fox populations by regular baiting with an anthelmintic (praziquantel). Recent data have shown that this control option may be used in restricted areas, for example in cities, with the aim of reducing the infection risk for humans.

scholarly journals A comparative study of different immunoassays to detect specific antibodies to Echinococcus spp. in human sera

2020 ◽  
Vol 57 (3) ◽  
pp. 219-225
Author(s):  
M. Fecková ◽  
D. Antolová ◽  
K. Reiterová
Keyword(s):  
Echinococcus Granulosus ◽  
Cystic Echinococcosis ◽  
Correct Diagnosis ◽  
Cross Reactivity ◽  
Serological Tests ◽  
Specific Antibodies ◽  
Larval Stages ◽  
Diagnostic Potential ◽  
Human Sera ◽  
Parasitic Zoonoses

SummaryHuman echinococcosis, one of the most serious of parasitic zoonoses, is caused by the larval stages of taeniid cestodes of the genus Echinococcus. The study aimed to assess the reliability of the detection of specific antibodies to E. multilocularis and E. granulosus s.l. in human sera and to compare their diagnostic potential for their utilization in the practice. In the study, the somatic antigen of E. multilocularis (AgEm), antigen B (AgB), and the hydatid fluid antigen of E. granulosus and two commercial ELISA kits – Echinococcus granulosus (Bordier Affinity Products, Crissier, Switzerland) and NovaLisaTMEchinococcus IgG (NovaTec Immunodiagnostica, Germany) – were compared. Sera of patients with alveolar and cystic echinococcosis, and with different parasitic/other infections were used to evaluate the sensitivity, specificity and cross-reactivity of in-house and commercial ELISA methods. AgEm presented the highest values regarding the diagnostic indicators, showing 100 % specificity and 90.0 % sensitivity. The tests for serological diagnostics of cystic echinococcosis were less sensitive and specific. The Echinococcus granulosus kit had 83.8 % specificity and 88.2 % sensitivity, while AgB and AgHF showed 85.0 % and 86.3 % specificity, and 76.5 % and 100 % sensitivity, respectively. NovaLisaTMEchinococcus IgG proved to have 95.7 % specificity and 77.8 % sensitivity. The results point out that the combination of different serological tests and approaches in accordance with clinical and imaging findings is still essential to prove the correct diagnosis in suspected patients.

scholarly journals Evaluation of the sensitivity and specificity of GST-tagged recombinant antigens 2B2t, Ag5t and DIPOL in ELISA for the diagnosis and follow up of patients with cystic echinococcosis

2020 ◽  
Vol 14 (11) ◽  
pp. e0008892
Author(s):  
Carlos Sánchez-Ovejero ◽  
Eylem Akdur ◽  
Raúl Manzano-Román ◽  
Ana Hernández-González ◽  
María González-Sánchez ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Cystic Echinococcosis ◽  
Alveolar Echinococcosis ◽  
High Specificity ◽  
Cross Reactivity ◽  
Response To Treatment ◽  
Confirmatory Test ◽  
Positive Serology ◽  
Elisa Format

Cystic echinococcosis (CE) is a neglected zoonotic disease caused by Echinococcus granulosus sensu lato. Diagnosis and monitoring of CE rely primarily on imaging while serology is used as a confirmatory test. However, imaging is not always conclusive and currently available serological assays have suboptimal sensitivity and specificity, lack standardization, and are not useful for patients´ follow-up. Seroassays for CE are usually based on hydatid fluid (HF), a complex, variable antigenic mixture, and cross-reactivity exists especially with alveolar echinococcosis. Recombinant proteins based on immunogenic antigens most abundant in HF, such as AgB1, AgB2 and Ag5, have been used to overcome these limitations. None of them so far showed potential to replace HF; however, their performance have been largely tested on a limited number of samples, and comparison of different antigens using the same cohort has been rarely performed. The combination of several immunogenic epitopes in a single recombinant protein could enhance test sensitivity. For the diagnosis and follow-up of patients with CE, we compared the performance of the crude HF, previously described recombinant 2B2t antigen, and GST-tagged version of 2B2t, and novel designed recombinants (GST-Ag5t and the GST-DIPOL chimera containing AgB1, AgBB2 and Ag5 epitopes) by IgG-ELISA format. Samples belong to a retrospective cohort of 253 well-characterized patients with CE, previously described for the evaluation of the 2B2t antigen, 92 patients with alveolar echinococcosis, and 82 healthy donors. The reference standard for CE diagnosis was the presence of a CE lesion as diagnosed by ultrasonography. The highest sensitivity was obtained with HF [86.7%, 95% confidence interval (CI): 81.2–91.0], followed by GST-2B2t (70.0%, 95% CI: 63.1–76.2), 2B2t (65.5%, 95% CI: 58.5–72.0), GST-Ag5t (64.5%, 95% CI: 57.5–71.1) and GST-DIPOL (63.1%, 95% CI: 56.0–69.7). The GST-2B2t had the best specificity (95.8%, 95% CI: 88.3–99.1) and the lowest cross-reactivity (38.7%, 95% CI: 27.6–50.6). Good response to treatment also correlated to negative test results in the GST-2B2t ELISA. While none of the tested recombinant antigen appears suitable to replace HF for the diagnosis of CE, GST-2B2t should be further explored as a confirmation test, based on its high specificity and low cross-reactivity, and for the follow-up after treatment in those patients with positive serology for this antigen.

scholarly journals Evaluation of patients diagnosed with fascioliasis: A six-year experience at a university hospital in Turkey

2016 ◽  
Vol 10 (04) ◽  
pp. 389-394 ◽  
Author(s):  
Vuslat Keçik Boşnak ◽  
İlkay Karaoğlan ◽  
Handan Haydaroğlu Sahin ◽  
Mustafa Namiduru ◽  
Mustafa Pehlivan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Fasciola Hepatica ◽  
Clinical Laboratory ◽  
Chronic Phase ◽  
University Hospital ◽  
Serological Tests ◽  
Laboratory Findings ◽  
Treatment Responses ◽  
One Year

Introduction: In this study, clinical, laboratory, radiological, and serological examinations of fascioliasis patients were analyzed, and data with a significant impact on differential diagnosis were evaluated. Methodology: Clinical, radiological, and laboratory findings and treatment responses of a total of 22 fascioliasis patients, treated between October 2009 and September 2014, were evaluated. Nineteen patients were diagnosed with fascioliasis at the invasive phase and three patients at the chronic phase. Patients were followed up for clinical, laboratory, and radiology findings for a period of three months to one year after treatment. Results: The most frequent complaints in both groups were abdominal pain, and the most common physical examination finding was epigastric tenderness. In the performed examination, an eosinophil elevation in whole blood count was detected in 19 patients (100%) in the hepatic phase, and in 2 patients (66.6%) in the biliary phase. The results of the Fasciola hepatica indirect hemagglutination assay (IHA) test ordered in the diagnosis were positive in all patients. Treatment with 10 mg/kg/day triclabendazole for two consecutive days was effective. Live parasites were extracted from patients in the biliary phase with endoscopic retrograde cholangiopancreatography. In the follow-ups, remission in IHA titer and clinical and radiological improvement was achieved in all patients. Conclusions: If hypereosinophilia is detected by peripheral smear in patients who are admitted with complaints such as abdominal pain, weakness, nausea, myalgia, and weight loss, radiological evaluation and serological tests should be performed and fascioliasis should be considered in the differential diagnosis.

CLINICAL LABORATORY DIFFERENTIAL DIAGNOSIS OF ENCEPHALITIS, DISSEMINATED ENCEPHALOMYELITIS AND MULTIPLE SCLEROSIS IN CHILDREN

2017 ◽  
Vol 96 (4) ◽  
pp. 34-42
Author(s):  
N. V. Skripchenko ◽  
◽  
G. P. Ivanova ◽  
E. Y. Skripchenko ◽  
A. V. Surovtseva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Differential Diagnosis ◽  
Clinical Laboratory

scholarly journals Human and animal cystic echinococcosis in Tataouine governorate: hypoendemic area in a hyperendemic country, myth or reality?

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Selim M’rad ◽  
Raja Chaâbane-Banaoues ◽  
Massaouda Ghrab ◽  
Hamouda Babba ◽  
Myriam Oudni-M’rad
Keyword(s):  
Environmental Contamination ◽  
Cystic Echinococcosis ◽  
Mediterranean Area ◽  
Control Programme ◽  
Effective Control ◽  
Contamination Rate ◽  
Hydatid Cysts ◽  
African Countries ◽  
Serological Tests ◽  
Sera Samples

Abstract Background Cystic echinococcosis (CE) has a worldwide distribution and is especially prevalent in North African countries. With a mean annual surgical incidence (ASI) of CE of 12.7 per 100,000 inhabitants, Tunisia is one of the most CE endemic countries in the Mediterranean area. Tataouine governorate is considered to be the most CE hypoendemic region in Tunisia (ASI = 0.92) despite favourable socioeconomic conditions that enable maintenance of the Echinococcus granulosussensu lato (s.l.) life-cycle and a significant environmental contamination with E. granulosuss.l. eggs. The aim of this study was to assess human CE seroprevalence, prevalence of CE in food animals and environmental contamination by E. granulosus s.l. eggs in different districts of Tataouine governorate. Methods This study was conducted from January to December 2018. A total of 374 human sera samples were tested for the presence of immunoglobulin G antibodies against E. granulosus using a commercial ELISA kit. Specimens were also collected from animals slaughtered at the Tataouine abattoir (n = 8609) and examined for the presence of hydatid cysts; 111 hydatid cysts were genotyped. Eggs of E. granulosuss.l. were identified by PCR and DNA sequencing from dog faecal samples (n = 288). Results Serological tests showed that 8.5% of the sera samples tested were positive for E. granulosus-specific antibodies. The average prevalence of hydatidosis in livestock was 1.6%, and CE infection was more prevalent in cattle than in sheep, goats and dromedaries. The contamination rate of dog faeces by E. granulosus sensu stricto eggs varied significantly from 0 to 23.5% depending on the collection area. Molecular analyses only revealed the presence of the G1 genotype for cysts and eggs. Conclusions Based on our findings, CE is likely to be more endemic in the Tataouine governorate than previously described. Thus, to implement an effective control programme against CE, a national survey should be carried out to determine human CE prevalence in the different Tunisian governorates. Graphic Abstract

scholarly journals Large multicystic spinal lesion in a young African migrant: a problem of differential diagnosis

2021 ◽  
Vol 14 (7) ◽  
pp. e242690
Author(s):  
Tamara Ursini ◽  
Paola Rodari ◽  
Geraldo Badona Monteiro ◽  
Valeria Barresi ◽  
Carmelo Cicciò ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cystic Echinococcosis ◽  
Bone Cyst ◽  
Spinal Tuberculosis ◽  
Final Diagnosis ◽  
Lower Limbs ◽  
Migration Flow ◽  
Spinal Lesion ◽  
African Migrant ◽  
Expansive Lesion

We describe a rare case of large, fully cystic spinal schwannoma in a young adult from The Gambia. The initial clinical suspicion was spinal cystic echinococcosis. He came to our attention reporting progressive walking impairment and neurological symptoms in the lower limbs. An expansive lesion extending from L2 to S1 was shown by imaging (ie, CT scan and MRI). Differential diagnoses included aneurysmal bone cyst and spinal tuberculosis and abscess; the initial suggested diagnosis of spinal cystic echinococcosis was discarded based on contrast enhancement results. The final diagnosis of cystic schwannoma was obtained by histopathology of the excised mass. Cystic spinal lesions are rare and their differential diagnosis is challenging. Awareness of autochthonous and tropical infectious diseases is important, especially in countries experiencing consistent migration flow; however, it must be kept in mind that migrants may also present with ‘non-tropical’ pathologies.

Application of Mycobacterium Leprae -specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses

2016 ◽  
Vol 86 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Aline Araújo Freitas ◽  
Emerith Mayra Hungria ◽  
Maurício Barcelos Costa ◽  
Ana Lúcia Osório Maroccolo Sousa ◽  
Mirian Lane Oliveira Castilho ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Mycobacterium Leprae ◽  
Serological Tests

Clostridium botulinum and the Clinical Laboratorian: A Detailed Review of Botulism, Including Biological Warfare Ramifications of Botulinum Toxin

2004 ◽  
Vol 128 (6) ◽  
pp. 653-662 ◽  
Author(s):  
James G. Caya ◽  
Rashmi Agni ◽  
Joan E. Miller
Keyword(s):  
Health Care ◽  
Differential Diagnosis ◽  
Health Care Professionals ◽  
Clinical Laboratory ◽  
Therapeutic Approaches ◽  
Data Synthesis ◽  
Literature Searches ◽  
Pertinent Data ◽  
Prompt Diagnosis ◽  
Timely Treatment

Abstract Objective.—This review article is designed to thoroughly familiarize all health care professionals with the history, classification, epidemiology, clinical characteristics, differential diagnosis, diagnostic evaluation (including laboratory-based testing), treatment, and prognosis of botulism. It is especially targeted toward clinical laboratorians and includes a detailed enumeration of the important clinical laboratory contributions to the diagnosis, treatment, and monitoring of patients with botulism. Finally, the bioterrorism potential for botulism is discussed, with an emphasis on the clinical laboratory ramifications of this possibility. Data Sources.—Included medical periodicals and textbooks accessioned from computerized and manual medical literature searches. More than 1000 medical works published from the 1800s through 2003 were retrieved and reviewed in this process. Data Synthesis.—Pertinent data are presented in textual and tabular formats, the latter including 6 tables presenting detailed information regarding the clinical parameters, differential diagnosis, diagnostic studies, laboratory testing, and therapeutic approaches to botulism. Conclusions.—Because botulism is such a rare disease, a keen awareness of its manifestations and prompt diagnosis are absolutely crucial for its successful treatment. The bioterrorism potential of botulism adds further urgency to the need for all health care professionals to be familiar with this disease, its proper evaluation, and timely treatment; the need for such urgency clearly includes the clinical laboratory.

scholarly journals Triatomine Fauna and Recent Epidemiological Dynamics of Chagas Disease in an Endemic Area of Northeast Brazil

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Cláudia M. Melo ◽  
Ana Carla F. G. Cruz ◽  
Antônio Fernando V. A. Lima ◽  
Luan R. Silva ◽  
Rubens R. Madi ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Disease Control ◽  
Chagas Disease ◽  
Control Program ◽  
The State ◽  
Positive Serology ◽  
Serological Tests ◽  
Systemic Analysis ◽  
South Central ◽  
Disease Control Program

Updated information of the dispersion dynamics of Chagas disease (CD) and a systemic analysis of these data will aid the early identification of areas that are vulnerable to transmission and enable efficient intervention. This work synthesized spatiotemporal information regarding triatomine fauna and analyzed this information in combination with the results from serological tests to elucidate the epidemiological panorama of CD in the state of Sergipe, Brazil. This is a retrospective analytical study that utilized information from the database of the National Chagas Disease Control Program. Between 2010 and 2016, 838 triatomines of eight species, namely, Panstrongylus geniculatus, which was first recorded in the state of Sergipe, Panstrongylus lutzi, P. megistus, Triatoma brasiliensis, T. pseudomaculata, T. tibiamaculata, T. melanocephala, and Rhodnius neglectus, were collected. Optical microscopy revealed that 13.2% of triatomines examined were infected by Trypanosoma cruzi-like flagellates. The distribution of triatomines exhibits an expanding south-central to northern dispersion, with a preference for semiarid and agreste areas and occasional observations in humid coastal areas due to anthropogenic actions reflected in the environment. Of the human cases analyzed from 2012 to 2016, 8.3% (191/2316) presented positive serology for Trypanosoma cruzi, and this proportion showed a gradual increase in the southern center of the state and new notifications in coastal regions. There is a need for intensification and continuity of the measures adopted by the Chagas Disease Control Program in Sergipe, identifying new priority areas for intervention and preferential ecotopes of the vectors, considering the occurrence of positive triatomines intradomicilliary and a source of new triatomines in the peridomiciles.

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