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Título
Recurrence of cystic echinococcosis in an endemic area: a retrospective study
Autor(es)
Palabras clave
Microbiology, immunology, infectious diseases
Cystic echinococcosis
Echinococcus granulosus
Hydatidosis
Recurrence
Treatment
Fecha de publicación
2017
Citación
Velasco-Tirado, V., Romero-Alegría, Á., Belhassen-García, M., Alonso-Sardón, M., Esteban-Velasco, C., López-Bernús, A., … Muñoz-Bellvis, L. (2017). Recurrence of cystic echinococcosis in an endemic area: a retrospective study. BMC Infectious Diseases, 17, 455.
Abstract
[EN]Background: Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs
worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic
infection to fatal disease. Clinical management procedures have evolved over decades without adequate
evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the
major problems in the management of hydatid disease. The aim of this study was to determine the frequency of
CE recurrence and the risk factors involved in recurrence.
Methods: A descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE
according to ICD-9 (code 122–0 to 122–9) criteria admitted at Complejo Asistencial Universitario de Salamanca,
Spain, between January 1998 and December 2015.
Results: Among the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment.
Median duration of recurrence’s diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher
[OR = 2.7; 95% CI, 1.1–7.1; p < 0.05] when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs
14.2% (31/217) in the cohort. We detected a chance of recurrence [OR = 2.3; 95% CI, 1.4–6.5; p > 0.05] that was two
times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention
(20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%).
Conclusions: Despite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of
the major problems in the management of hydatid disease. The current management and treatment of recurrences is
still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and
multicenter studies will be needed to provide definitive recommendations for its clinical management.
URI
ISSN
1471-2334
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