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Treatment of Hydatid Disease

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Abstract

Hydatid disease caused by Echinococcus granulosus presents medical, veterinary and economic problems worldwide. Hydatidosis can be treated by medical, surgical and percutaneous modalities. Benzoimidazole carbamates are effective against E. granulosus. Although mebendazole, the first benzoimidazole used, has some beneficial effects on the disease in selected patients, it has also been associated with treatment failure in some cases, perhaps because of its poor absorption. Albendazole, a more recently developed benzoimidazole, is more effective than mebendazole. Praziquantel, an isoquinoline derivative, has recently shown value in the treatment of human echinococcal disease and its use in combination with albendazole is recommended in some patients. Ultrasound guided cyst puncture is another choice of treatment which has been used successfully in selected patients, although anaphylactic and allergic reactions due to spillage of the cyst contents have occurred. Surgical therapy in echinococcal hydatid disease is indicated for large cysts with multiple daughter cysts, superficially located single liver cysts which have a risk of rupture, complicated cysts such as those accompanied by infection, compression or obstruction, and cysts located in vital organs or which are exerting pressure on adjacent vital organs. However, surgical therapy carries high risk of mortality, morbidity or recurrence. Therefore, medical therapy may be an alternative option in uncomplicated cysts and in patients at high risk from surgery. The adjuvant use of drugs with surgery and percutaneous treatment can also be recommended for some patients.

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References

  1. Tuazon AO, Pasterkamp H. Hydatid disease of the lung (pulmonary hydatidosis). In: Chernick V, Boat TF, Kendig EL, editors. Kendig’s disorders of the respiratory tract in children. Philadelphia (PA): WB Saunders, 1998: 1050–7

    Google Scholar 

  2. WHO Informal Working Group on Echinococcosis. Guidelines for treatment of cystic and alveolar echinococcosis in humans. Bull World Health Organ 1996; 74: 231–42

    Google Scholar 

  3. Mutaf O, Arikan A, Yazici M, et al. Pulmonary hydatidosis in children. Eur J Pediatr Surg 1994; 4: 70–3

    Article  PubMed  CAS  Google Scholar 

  4. Solak H, Yeniterzi M, Yüksek T, et al. The hydatid cysts of the lung in children and results of surgical treatment. Thorac Cardiovasc Surg 1990; 38: 45–7

    Article  PubMed  CAS  Google Scholar 

  5. Aytac A, Yurdakul Y, Ikizler C, et al. Pulmonary hydatid disease: report of 100 patients. Ann Thorac Surg 1977; 23: 145–51

    Article  PubMed  CAS  Google Scholar 

  6. Anadol D, Göçmen A, Kiper N, et al. Hydatid disease in childhood: a retrospective analysis of 376 cases. Pediatr Pulmonol 1998; 26: 190–6

    Article  PubMed  CAS  Google Scholar 

  7. Chaouachi B, Nouri A, Ben Salah S, et al. Hydatid cyst of the lung in children: diagnosis and therapeutic aspects based upon a series of 643 cases [in French]. Pediatrie 1988; 43: 769–73

    PubMed  CAS  Google Scholar 

  8. McIntyre A. Hydatid disease in children in South Australia. Med J Aust 1971; 1: 1064–5

    PubMed  CAS  Google Scholar 

  9. Blanton R. Echinococcosis (Echinococcus granulosus and E. multilocularis). In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. Philadelphia (PA): Saunders, 2000: 1079–81

    Google Scholar 

  10. Turner JA. Cestodes. In: Feigin RD, Cherry JD, editors. Textbook of pediatric infectious diseases. Philadelphia (PA): Saunders, 1998: 2513–29

    Google Scholar 

  11. Ammann RW, Eckert J. Cestodes: echinococcus [published erratum appears in Gastroenterol Clin North Am 1996; 25 (4): vii]. Gastroenterol Clin North Am 1996; 25: 655–89

    Article  PubMed  CAS  Google Scholar 

  12. Gottstein B. Molecular and immunological diagnosis of echinococcosis. Clin Microbiol Rev 1992; 5: 248–61

    PubMed  CAS  Google Scholar 

  13. Nutman TB, Weller PF. Cestodes. In: Faucu AS, Braunwald E, Isselbacher KJ, et al., editors. Harrison’s principles of internal medicine. New York (NY): McGraw Hill, 1998: 1224–7

    Google Scholar 

  14. Teggi A, Lastilla MG, De Rosa F. Therapy of human hydatid disease with mebendazole and albendazole. Antimicrob Agents Chemother 1993; 37: 1679–84

    Article  PubMed  CAS  Google Scholar 

  15. Todorov T, Vutova K, Mechkov G, et al. Experience in the chemotherapy of severe, inoperable echinococcosis in man. Infection 1992; 20: 19–24

    Article  PubMed  CAS  Google Scholar 

  16. Keshmiri M, Baharvahdat H, Fattahi SH, et al. A placebo controlled study of albendazole in the treatment of pulmonary echinococcosis. Eur Respir J 1999; 14: 503–7

    Article  PubMed  CAS  Google Scholar 

  17. Morris DL, Dykes PW, Marriner S, et al. Albendazole: objective evidence of response in human hydatid disease. JAMA 1985; 253(14): 2053–7

    Article  PubMed  CAS  Google Scholar 

  18. Singounas EG, Leventis AS, Sakas DE, et al. Successful treatment of intracerebral hydatid cysts with albendazole: case report and review of the literature. Neurosurgery 1992; 31: 571–4

    Article  PubMed  CAS  Google Scholar 

  19. Gil-Grande LA, Boixeda F, Garcia-Hoz F, et al. Treatment of liver hydatid disease with mebendazole: a prospective study of thirteen cases. Am J Gastroenterol 1983; 78: 584–7

    PubMed  CAS  Google Scholar 

  20. Kammerer W, Schantz PM. Long term follow-up of human hydatid disease (Echinococcus granulosus) treated with a high-dose mebendazole regimen. Am J Trop Med Hyg 1984; 33: 132–7

    PubMed  CAS  Google Scholar 

  21. Luder PJ, Siffert P, Witassek F, et al. Treatment of hydatid disease with high oral doses of mebendazole. Eur J Clin Pharmacol 1986; 31: 443–8

    Article  PubMed  CAS  Google Scholar 

  22. Davis A, Dixon H, Pawlowski ZS. Multicentre clinical trials of benzimidazole-carbamates in human cystic echinococcosis (phase 2). Bull World Health Organ 1989; 67: 503–8

    PubMed  CAS  Google Scholar 

  23. Göçmen A, Toppare MF, Kiper N. Treatment of hydatid disease in childhood with mebendazole. Eur Respir J 1993; 6: 253–7

    PubMed  Google Scholar 

  24. Messaritakis J, Psychou P, Nicolaidou P, et al. High mebendazole doses in pulmonary and hepatic hydatid disease. Arch Dis Child 1991; 66: 532–3

    Article  PubMed  CAS  Google Scholar 

  25. Rowley AH, Shulman ST, Donaldson JS, et al. Albendazole treatment of recurrent echinococcosis. Pediatr Infect Dis J 1988 Sep; 7(9): 666–7

    Article  PubMed  CAS  Google Scholar 

  26. Steiger U, Cotting J, Reichen J. Albendazole treatment of echinococcosis in humans: effects of microsomal metabolism and drug tolerance. Clin Pharmacol Ther 1990; 47: 347–53

    Article  PubMed  CAS  Google Scholar 

  27. Gil-Grande LA, Rodriguez-Caabeiro F, Prieto JG, et al. Randomized controlled trial of efficacy of albendazole in intra-abdominal hydatid disease. Lancet 1993; 342: 1269–72

    Article  PubMed  CAS  Google Scholar 

  28. Taylor DH, Morris DL, Richards KS. Echinococcus granulosus: in vitro maintenance of whole cysts and the assessment of the effects of albendazole sulphoxide and praziquantel on the germinal layer. Trans R Soc Trop Med Hyg 1989; 83: 535–8

    Article  PubMed  CAS  Google Scholar 

  29. Aggarwal P, Wali JP. Albendazole in the treatment of pulmonary echinococcosis. Thorax 1991; 46: 599–600

    Article  PubMed  CAS  Google Scholar 

  30. Morris DL, Dykes PW, Dickson B, et al. Albendazole in hydatid disease. BMJ 1983; 286: 103–4

    Article  PubMed  CAS  Google Scholar 

  31. Mohamed AE, Yasawy MI, Al Karawi MA. Combined albendazole and praziquantel versus albendazole alone in the treatment of hydatid disease. Hepatogastroenterology 1998; 45: 1690–4

    PubMed  CAS  Google Scholar 

  32. Pearson RD. Agents active against parasites and pneumocystis carinii. In: Mandell GL, Benett JE, Dolin R, editors. Principles and practice of infectious diseases. Philadelphia (PA): Churchill Livingstone, 2000: 2956–65

    Google Scholar 

  33. Taketomo CK, Hodding JH, Kraus DM. Pediatric dosage handbook. Hudson (OH): Lexi-Comp Inc, 1999; 745–6

    Google Scholar 

  34. Yasawy MI, Al Karawi MA, Mohamed ARE. Combination of praziquantel and albendazole in the treatment of hydatid disease. Trop Med Parasital 1993; 44: 192–4

    CAS  Google Scholar 

  35. Redzic B, Radulovic S, Stankovic N, et al. Praziquantel in the treatment of human echinococcosis [in Roman]. Vojnosanit Pregl 1995; 52: 155–9

    PubMed  CAS  Google Scholar 

  36. Salto E, Juarez E, Roiz MP, et al. Combined chemotherapy (mebendazole plus praziquantel) in patients with hydatidosis [in Spanish]. Enferm Infec Microbiol Clin 1991; 9: 527–9

    CAS  Google Scholar 

  37. Cobo F, Yarnoz C, Sesma B, et al. Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus. Trop Med Int Health 1998; 3: 462–6

    Article  PubMed  CAS  Google Scholar 

  38. Akhan O, Özmen MN, Dinçer A, et al. Percutaneous treatment of pulmonary hydatid cysts. Cardiovasc Intervent Radiol 1994; 17: 271–5

    Article  PubMed  CAS  Google Scholar 

  39. Akhan O, Özmen MN. Percutaneous treatment of liver hydatid cysts. Eur J Radiol 1999; 32: 76–85

    Article  PubMed  CAS  Google Scholar 

  40. Akhan O, Özmen MN, Dinçer A, et al. Liver hydatid disease: Long-term results of percutaneous treatment. Radiology 1996; 198: 259–64

    PubMed  CAS  Google Scholar 

  41. Üstünsöz B, Akhan O, Kamiloglu MA, et al. Percutaneous treatment of hydatid cysts of the liver: long-term results. AJR Am J Roentgenol 1999; 172: 91–6

    PubMed  Google Scholar 

  42. Akhan O, Üstünsöz B, Somuncu I, et al. Percutaneous renal hydatid cyst treatment: long-term results. Abdom Imaging 1998; 23: 209–13

    Article  PubMed  CAS  Google Scholar 

  43. Akhan O, Bilgiç S, Akata D, et al. Percutaneous treatment of an orbital hydatid cyst: a new approach. J Ophthalmol 1998; 125: 877–9

    CAS  Google Scholar 

  44. Schantz PM, Bossche VH, Eckert J. Chemotherapy of larval echinococcosis in animals and humans: report of a workshop. Z Parasitenkd 1982; 67: 5–26

    Article  PubMed  CAS  Google Scholar 

  45. Sayek I, Yalin R, Sanac Y. Surgical treatment of hydatid disease of the liver. Arch Surg 1980; 115: 847–50

    Article  PubMed  CAS  Google Scholar 

  46. Al Karawi MA, el-Shiekh Mohamed AR, Yasawy MI. Advances in diagnosis and management of hydatid disease. Hepatogastroenterology 1990; 37: 327–31

    PubMed  CAS  Google Scholar 

  47. Mottaghian H, Saidi F. Postoperative recurrence of hydatid disease. Br J Surg 1978; 65: 237–42

    Article  PubMed  CAS  Google Scholar 

  48. Morris DL. Pre-operative albendazole therapy for hydatid cyst. Br J Surg 1987; 74(9): 805–6

    Article  PubMed  CAS  Google Scholar 

  49. Amir-Jahed AK, Fardin R, Farzad A, et al. Clinical echinococcosis. Ann Surg 1975; 182: 541–6

    Article  PubMed  CAS  Google Scholar 

  50. Besim H, Karayalcin K, Hamamci O, et al. Scolicidal agents in hydatid cyst surgery. HPB Surg 1998; 10: 347–51

    Article  PubMed  CAS  Google Scholar 

  51. Garcia L, Alonso E, Gonzalez-Uriarte J, et al. Evaluation of scolicidal agents in an experimental hydatid disease model. Eur Surg Res 1997; 29: 202–8

    Article  Google Scholar 

  52. Rebhandl W, Turnbull J, Felberbauer FX, et al. Pulmonary echinococcosis (hydatidosis) in children: results of surgical treatment. Pediatr Pulmonol 1999; 27: 336–40

    Article  PubMed  CAS  Google Scholar 

  53. Erzurumlu K, Hokelek M, Gonlusen L, et al. The effect of albendazole on the prevention of secondary hydatidosis. Hepatogastroenterology 2000; 47: 247–50

    PubMed  CAS  Google Scholar 

  54. Turkcapa AG, Ersoz S, Gungor C, et al. Surgical treatment of hepatic hydatidosis combined with perioperative treatment with albendazole. Eur J Surg 1997; 163: 923–8

    Google Scholar 

  55. Gollackner B, Langle F, Auer H, et al. Radical surgical therapy of abdominal cystic hydatid disease: factors of recurrence. World J Surg 2000; 24: 717–21

    Article  PubMed  CAS  Google Scholar 

  56. Behrns KE, Van Heeden JA. Surgical management of hepatic hydatid disease. Mayo Clin Proc 1991; 66: 1193–5

    Article  PubMed  CAS  Google Scholar 

  57. Safioleas M. Surgical treatment for lung hydatid disease. World J Surg 1999; 23: 1181–5

    Article  PubMed  CAS  Google Scholar 

  58. Yalcinkaya I, Er M, Ozbay B, et al. Surgical treatment of hydatid cyst of the lung; review of 30 cases. Eur Respir J 1999; 13:441–4

    Article  PubMed  CAS  Google Scholar 

  59. Salih OK, Topcuoglu MS, Celik SK, et al. Surgical treatment of hydatid cysts of the lung: analysis of 405 patients. Can J Surg 1998; 41: 131–5

    PubMed  CAS  Google Scholar 

  60. Ammann RW. Improvement of liver resectional therapy by adjuvant chemotherapy in alveolar hydatid disease. Parasital Res 1991; 77: 290–3

    Article  CAS  Google Scholar 

  61. Wilson JF, Rausch RL, Wilson FR. Alveolar hydatid disease: review of surgical experience in 42 cases of active disease among Alaskan Eskimos. Ann Surg 1995; 221: 316–23

    Article  Google Scholar 

  62. Ammann RW. Long-term mebendazole therapy may be parasitocidal in alveolar echinococcosis. J Hepatol 1998; 29: 994–8

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Deniz Anadol.

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Anadol, D., Özçelik, U., Kiper, N. et al. Treatment of Hydatid Disease. Paediatr Drugs 3, 123–135 (2001). https://doi.org/10.2165/00128072-200103020-00005

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