Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

An Imported Case of Disseminated Echinococcosis in Korea

  • Shin, Dong Hoon (Department of Internal Medicine, Seoul National University Hospital) ;
  • Jo, Hae Chan (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Jeong-Han (Department of Internal Medicine, Seoul National University Hospital) ;
  • Jun, Kang Il (Department of Internal Medicine, Seoul National University Hospital) ;
  • Park, Wan Beom (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Nam-Joong (Department of Internal Medicine, Seoul National University Hospital) ;
  • Choi, Min-Ho (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center) ;
  • Kang, Chang Kyung (Department of Internal Medicine, Seoul National University Hospital) ;
  • Oh, Myoung-don (Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2019.03.29
  • Accepted : 2019.07.15
  • Published : 2019.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

A complicated case of echinococcosis with multiple organ involvement is reported in a 53-year-old businessman who frequently traveled overseas, including China, Russia, and Kazakhstan from 2001 to 2007. The patient was first diagnosed with a large liver cyst during a screening abdomen ultrasonography in 2011, but he did not follow up on the lesion afterwards. Six years later, dizziness, dysarthria, and cough developed, and cystic lesions were found in the brain, liver and lungs. The clinical course was complicated when the patient went through multiple surgeries and inadequate treatment with a short duration of albendazole without a definite diagnosis. The patient visited our hospital for the first time in August 2018 due to worsening symptoms; he was finally diagnosed with echinococcosis using imaging and serologic criteria. He is now on prolonged albendazole treatment (400 mg twice a day) with gradual clinical and radiological improvement. A high index of suspicion is warranted to early diagnose echinococcosis in a patient with a travel history to endemic areas of echinococcosis.

Keywords

References

  1. Lightowlers MW. Cysticercosis and echinococcosis. Curr Top Microbiol Immunol 2013; 365: 315-335.
  2. Hald T, Aspinall W, Devleesschauwer B, Cooke R, Corrigan T, Havelaar AH, Gibb HJ, Torgerson PR, Kirk MD, Angulo FJ, Lake RJ, Speybroeck N, Hoffmann S. World Health Organization estimates of the relative contributions of food to the burden of disease due to selected foodborne hazards: a structured expert elicitation. PLoS One 2016; 11: e0145839. https://doi.org/10.1371/journal.pone.0145839
  3. Chung KY, Lee DY, Hong PW, Chung HJ, Choi IJ, Min DY. Surgical treatment of pulmonary hydatid cysts: two cases report. Korean J Thorac Cardiovasc Surg 1983; 16: 518-525 (in Korean).
  4. Byun SJ, Moon KC, Suh KS, Han JK, Chai JY. An imported case of echinococcosis of the liver in a Korean who traveled to western and central Europe. Korean J Parasitol 2010; 48: 161-165. https://doi.org/10.3347/kjp.2010.48.2.161
  5. Kim SJ, Kim JH, Han SY, Kim YH, Cho JH, Chai JY, Jeong JS. Recurrent hepatic alveolar echinococcosis: report of the first case in Korea with unproven infection route. Korean J Parasitol 2011; 49: 413-418. https://doi.org/10.3347/kjp.2011.49.4.413
  6. Ahn MH. Imported parasitic diseases in Korea. Infect Chemother 2010; 42: 271-279 (in Korean). https://doi.org/10.3947/ic.2010.42.5.271
  7. Cho SY, Kim SI, Kang SY, Choi DY, Suk JS, Choi KS, Ha YS, Chung CS, Myung HJ. Evaluation of enzyme-linked immunosorbent assay in serological diagnosis of human neurocysticercosis using paired samples of serum and cerebrospinal fluid. Korean J Parasitol 1986; 24: 25-41. https://doi.org/10.3347/kjp.1986.24.1.25
  8. Jin Y, Anvarov K, Khajibaev A, Hong SM, Hong ST. Serodiagnosis of echinococcosis by ELISA using cystic fluid from Uzbekistan sheep. Korean J Parasitol 2013; 51: 313-317. https://doi.org/10.3347/kjp.2013.51.3.313
  9. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114: 1-16. https://doi.org/10.1016/j.actatropica.2009.11.001
  10. Kim SJ, Jung KH, Jo WM, Kim YS, Shin C, Kim JH. A case of pleural hydatid cyst mimicking malignancy in a non-endemic country. Tuberc Respir Dis 2011; 70: 338-341. https://doi.org/10.4046/trd.2011.70.4.338
  11. Ahn KS, Hong ST, Kang YN, Kwon JH, Kim MJ, Park TJ, Kim YH, Lim TJ, Kang KJ. An imported case of cystic echinococcosis in the liver. Korean J Parasitol 2012; 50: 357-360. https://doi.org/10.3347/kjp.2012.50.4.357
  12. Kim AR, Park SJ, Gu MJ, Choi JH, Kim HJ. Fine needle aspiration cytology of hepatic hydatid cyst: a case study. Korean J Pathol 2013; 47: 395-398. https://doi.org/10.4132/KoreanJPathol.2013.47.4.395
  13. Choi H, Park JY, Kim JH, Moon DG, Lee JG, Bae JH. Primary Renal Hydatid Cyst: Mis-Interpretation as a Renal Malignancy. Korean J Parasitol 2014; 52: 295-298. https://doi.org/10.3347/kjp.2014.52.3.295
  14. Kwon BW, Park SJ, Kong JH, Song IH. Daughter cysts in a cyst of the liver: hepatic echinococcosis. Korean J Intern Med 2016; 31: 197-198. https://doi.org/10.3904/kjim.2016.31.1.197
  15. Jung BH, Kim TH, Kang JS, Chang K, Jeong ET, Chae KM, Choi SH, Moon HB. A case of pulmonary and hepatic hydatid cystic disease. Korean J Med 1993; 45: 550-556 (in Korean).
  16. Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis 2009; 13: 125-133. https://doi.org/10.1016/j.ijid.2008.03.037
  17. Beaver PC, Jung RC, Cupp EW. Clinical Parasitology. 9th ed. Philadelphia, USA. Lea & Febiger 1984; 527-537.
  18. Gripper LB, Welburn SC. Neurocysticercosis infection and disease-a review. Acta Trop 2017; 166: 218-224. https://doi.org/10.1016/j.actatropica.2016.11.015
  19. Bulakci M, Kartal MG, Yilmaz S, Yilmaz E, Yilmaz R, Sahin D, Asik M, Erol OB. Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update. Diagn Interv Radiol 2016; 22: 247-256. https://doi.org/10.5152/dir.2015.15456
  20. Del Brutto OH, Rajshekhar V, White AC Jr, Tsang VC, Nash TE, Takayanagui OM, Schantz PM, Evans CA, Flisser A, Correa D, Botero D, Allan JC, Sarti E, Gonzalez AE, Gilman RH, Garcia HH. Proposed diagnostic criteria for neurocysticercosis. Neurology 2001; 57: 177-183. https://doi.org/10.1212/WNL.57.2.177
  21. Giri S, Parija SC. A review on diagnostic and preventive aspects of cystic echinococcosis and human cysticercosis. Trop Parasitol 2012; 2: 99-108. https://doi.org/10.4103/2229-5070.105174
  22. Garcia HH, Castillo Y, Gonzales I, Bustos JA, Saavedra H, Jacob L, Del Brutto OH, Wilkins PP, Gonzalez AE, Gilman RH. Low sensitivity and frequent cross-reactions in commercially available antibody detection ELISA assays for Taenia solium cysticercosis. Trop Med Int Health 2018; 23: 101-105. https://doi.org/10.1111/tmi.13010
  23. Nabarro LE, Amin Z, Chiodini PL. Current management of cystic echinococcosis: a survey of specialist practice. Clin Infect Dis 2015; 60: 721-728. https://doi.org/10.1093/cid/ciu931
  24. Dogru D, Kiper N, Ozcelik U, Yalcin E, Gocmen A. Medical treatment of pulmonary hydatid disease: for which child? Parasitol Int 2005; 54: 135-138. https://doi.org/10.1016/j.parint.2005.02.003
  25. Todorov T, Mechkov G, Vutova K, Georgiev P, Lazarova I, Tonchev Z, Nedelkov G. Factors influencing the response to chemotherapy in human cystic echinococcosis. Bull World Health Organ 1992; 70: 347-358.
  26. Chen S, Li N, Yang F, Wu J, Hu Y, Yu S, Chen Q, Wang X, Wang X, Liu Y, Zheng J. Medical treatment of an unusual cerebral hydatid disease. BMC Infect Dis 2018; 18: 12. https://doi.org/10.1186/s12879-017-2935-2
  27. Gana R, Skhissi M, Maaqili R, Bellakhdar F. Multiple infected cerebral hydatid cysts. J Clin Neurosci 2008; 15: 591-593. https://doi.org/10.1016/j.jocn.2006.11.019
  28. Ntusi NA, Horsfall C. Severe disseminated hydatid disease successfully treated medically with prolonged administration of albendazole. QJM 2008; 101: 745-746. https://doi.org/10.1093/qjmed/hcn058

Cited by

  1. Hepatic Hydatid Cyst: A Case Report vol.77, pp.1, 2019, https://doi.org/10.4166/kjg.2020.129