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POLYCYSTIC ECHINOCOCCOSIS IN THE STATE OF ACRE, BRAZIL: CONTRIBUTION TO PATIENT DIAGNOSIS, TREATMENT AND PROGNOSIS
Polycystic hydatid disease
Echinococcus vogeli
Neotropical echinococcosis
Hepatic cysts
Autor
Afiliación
Universidade Federal do Acre. Rio Branco, AC, Brasil.
Fundação Hospital Estadual do Acre. Hospital das Clínicas. Rio Branco, AC, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Helmintos Parasitos de Vertebrados. Rio de Janeiro, RJ, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.
Fundação Hospital Estadual do Acre. Hospital das Clínicas. Rio Branco, AC, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Helmintos Parasitos de Vertebrados. Rio de Janeiro, RJ, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.
Resumen en ingles
The lack of knowledge regarding polycystic hydatid disease results in delayed or even incorrect diagnosis. The
lack of systematic information regarding treatment also makes it difficult to assess the results and prognosis in
patients with peritoneal and hepatic lesions caused by Echinococcus vogeli. Here we describe the clinical features
of patients, propose a radiological classification protocol and describe a therapeutic option for the treatment of
hydatid disease that previously had only been used for cases of cystic echinococcosis (Echinococcus granulosus).
A prospective cohort study was initiated in 1999 and by 2009 the study included 60 patients. These patients were
classified according to the PNM classification (parasite lesion, neighbouring organ invasion and metastases) and
placed in one of three therapeutic modalities: (i) chemotherapy with albendazole at a dose of 10 mg/kg/day, (ii)
surgical removal of cysts or (iii) percutaneous puncture of the cysts via puncture, aspiration, injection and reaspiration
(PAIR). The results were stratified according to therapeutic outcome: “cure”, “clinical improvement”,
“no improvement”, “death” or “no information”. The PNM classification was useful in indicating the appropriate
therapy in cases of polycystic hydatid disease. In conclusion, surgical therapy produced the best clinical results
of all the therapies studied based on “cure” and “clinical improvement” outcomes. The use of PAIR for treatment
requires additional study.
Palabras clave en ingles
Polycystic echinococcosisPolycystic hydatid disease
Echinococcus vogeli
Neotropical echinococcosis
Hepatic cysts
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