Cambier A, Giot J B, Leonard P, Bletard N, Meunier P, Hustinx R, Delwaide J, Meurisse N, Honore P, Losson B, Hayette M P, Detry O
ULg, Liège, Belgique.
Service d'Infectiologie, CHU Sart Tilman, Liège, Belgique.
Rev Med Liege. 2018 Mar;73(3):135-142.
Alveolar echinococcosis is a zoonotic disease due to the tapeworm Echinococcus multilocularis. The definitive host is the red fox. Until recently, Belgium was considered a country at very low risk for alveolar echinococcosis. However, recent studies carried out in southern Belgium have revealed, through post-mortem examination, high prevalences (up to 62 %) in foxes. Cats and dogs can act as definitive hosts. Human are accidentally infected by ingestion of food contaminated by the feces. After a long incubation period, invasive hepatic lesions may appear, as well as extra-hepatic lesions. The disease may be fatal. The diagnosis is based on imaging techniques, serology and nucleic acid detection in tissues. Early diagnosis may allow surgical removal of the lesion associated with at least 2 years of albendazole postoperative treatment. In case of contraindication to surgery, a long term treatment with albendazole is necessary. Liver transplantation is sometimes necessary. This article presents the epidemiologic, clinical, diagnostic and therapeutics features of this zoonotic disease.
泡型包虫病是一种由多房棘球绦虫引起的人畜共患病。终末宿主是赤狐。直到最近，比利时仍被认为是泡型包虫病低风险国家。然而，最近在比利时南部开展的研究通过尸检发现，狐狸中的患病率很高（高达62%）。猫和狗也可作为终末宿主。人类因误食被粪便污染的食物而意外感染。经过长时间的潜伏期后，可能会出现侵袭性肝脏病变以及肝外病变。该病可能致命。诊断基于影像学技术、血清学以及组织中的核酸检测。早期诊断可使病变得以手术切除，并术后至少接受两年的阿苯达唑治疗。若有手术禁忌证，则需要长期使用阿苯达唑治疗。有时需要进行肝移植。本文介绍了这种人畜共患病的流行病学、临床、诊断和治疗特征。
