Division of Infectious Diseases and Clinical Immunology, Comprehensive Infectious Diseases Center, University Hospitals, Ulm, Germany.
Curr Opin Infect Dis. 2010 Oct;23(5):505-12. doi: 10.1097/QCO.0b013e32833d7516.
Human alveolar echinococcosis is caused by the larval stage of Echinococcus multilocularis, occurring in at least 42 countries of the northern hemisphere. Recent studies in Europe and Asia have shown that the endemic area of E. multilocularis is larger than previously known and the parasite has regionally expanded from rural to urban areas. Diagnosis of alveolar echinococcosis is supported by results from imaging studies, histopathology and/or nucleic acid detection, and serology. The present review summarizes current understanding of clinical features, knowledge on appropriate treatment, and discusses ways to improve standards of care.
High prevalences of this deadly disease have been discovered in surveys in parts of China. Clinical manifestations, diagnostic tools and the burden of disease were described, and are based on high case numbers. In Europe, excellent tools have been introduced, which improve disease management. Long-term observations in Switzerland provide an optimistic view, as the infection can be well controlled, if patients are cared for in specialized centres. An expert consensus summarizes the current recommendation for diagnosis and treatment of alveolar echinococcosis by the Informal Working Group on Echinococcosis of the WHO.
Diagnosis and treatment of alveolar echinococcosis remains a challenge for clinicians. The updated WHO-recommendations aim to support decisions on diagnosis and treatment of alveolar echinococcosis. Anti-infective therapy is the backbone of treatment; surgery should be restricted to patients at an early stage of the disease. For the majority of cases continuous chemoprophylaxis with benzimidazoles is cost-effective and leads to a good quality of life for patients with this chronic disease.
人体泡型包虫病是由细粒棘球绦虫的幼虫阶段引起的，至少发生在北半球的 42 个国家。最近在欧洲和亚洲的研究表明，细粒棘球绦虫的流行区域比以前所知的更大，寄生虫已从农村地区向城市地区局部扩散。泡型包虫病的诊断得到影像学研究、组织病理学和/或核酸检测以及血清学结果的支持。本综述总结了目前对临床特征、适当治疗方法的认识，并讨论了提高护理标准的方法。
在中国部分地区的调查中发现了这种致命疾病的高患病率。对临床表现、诊断工具和疾病负担进行了描述，并基于大量病例。在欧洲，引入了很好的工具，改善了疾病管理。瑞士的长期观察提供了一个乐观的看法，因为如果患者在专门中心接受治疗，感染可以得到很好的控制。世界卫生组织包虫病非正式工作组的专家共识总结了目前对泡型包虫病的诊断和治疗的建议。
泡型包虫病的诊断和治疗仍然是临床医生面临的挑战。更新的世卫组织建议旨在为泡型包虫病的诊断和治疗决策提供支持。抗感染治疗是治疗的基础；手术应仅限于疾病早期的患者。对于大多数病例，持续使用苯并咪唑类药物进行化学预防具有成本效益，并能提高患者慢性疾病的生活质量。
