Recurrence of cystic echinococcosis in an endemic area: a retrospective study

Autor: Adela Carpio-Pérez, Miguel Cordero-Sánchez, Amparo López-Bernus, Carmen Esteban-Velasco, Antonio Muro, Moncef Belhassen-García, Montserrat Alonso-Sardón, Marcelo F. Jiménez López, Luis Muñoz-Bellvís, Juan Luis Muñoz Bellido, Javier Pardo-Lledias, Virginia Velasco-Tirado, Ángela Romero-Alegría
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Pediatrics
medicine.medical_treatment
Kaplan-Meier Estimate
Disease
0302 clinical medicine
Medical microbiology
Risk Factors
Recurrence
Longitudinal Studies
Child
Echinococcus granulosus
Aged
80 and over
Anthelmintics
hidantoínas
biology
Microbiology
immunology
infectious diseases
Middle Aged
Echinococcosis
3205.05 Enfermedades Infecciosas
Infectious Diseases
Child
Preschool
Female
030211 gastroenterology & hepatology
medicine.symptom
Research Article
Adult
medicine.medical_specialty
Adolescent
030231 tropical medicine
Hydatidosis
Asymptomatic
lcsh:Infectious and parasitic diseases
03 medical and health sciences
medicine
Animals
Humans
lcsh:RC109-216
Aged
Retrospective Studies
Chemotherapy
business.industry
Hydantoins
Retrospective cohort study
biology.organism_classification
medicine.disease
Surgery
Treatment
Cystic echinococcosis
Spain
Tropical medicine
business
Zdroj: BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-8 (2017)
GREDOS: Repositorio Institucional de la Universidad de Salamanca
Universidad de Salamanca (USAL)
GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname
BMC Infectious Diseases
Universitat Politècnica de Catalunya (UPC)
ISSN: 1471-2334
Popis: [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.
Databáze: OpenAIRE
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