AI Article Synopsis

  • Human alveolar echinococcosis (AE) is a serious parasitic infection that can be fatal if left untreated, with treatment options including surgery or ongoing antiparasitic drugs.
  • The disease has been increasing in frequency, especially in Europe and Asia, and recent studies reveal a new strain of the parasite causing AE in wildlife and humans in western Canada.
  • In Alberta, 17 cases of AE were diagnosed from 2013 to 2020, largely among those who lived with dogs and included immunocompromised patients, highlighting the need for awareness among clinicians regarding this condition in urban areas.

Article Abstract

Human alveolar echinococcosis (AE) is a zoonotic cestode infection which is usually fatal in the absence of treatment. Treatment involves major surgery or indefinite antiparasitic therapy. The incidence is rising in Europe and Asia, with an increased risk observed in immunocompromised individuals. Previously, AE acquisition in North America was extremely rare, except for one remote Alaskan Island. Recent studies have demonstrated a new European-like strain of Echinococcus multilocularis (Em) in wildlife and in human AE in western Canada. We report the experience of all AE patients diagnosed in Alberta. Each was diagnosed by histopathology, serology, and PCR-confirmed by a reference laboratory. Seventeen cases of human AE, aged 19-78 years, nine females, were diagnosed between 2013 and 2020: all definitely or probably acquired in Alberta. Six lived in urban areas, and 14 had kept dogs. In eight, the lesions were found incidentally on abdominal imaging performed for other indications. Six were immunocompromised to varying degrees. Six were first diagnosed at surgery. All have been recommended benzimidazole therapy. One died of surgical complications. Clinicians should be aware of this diagnostic possibility in patients presenting with focal nonmalignant hepatic mass lesions. Greater urbanization of coyotes, the predominant definitive host of Em in Alberta, and growing numbers of immune suppressed individuals in the human population may lead to increasing recognition of AE in North America.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103444PMC
http://dx.doi.org/10.4269/ajtmh.20-1577DOI Listing

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