National Referral Unit of Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain.
PLoS Negl Trop Dis. 2019 Feb 19;13(2):e0007006. doi: 10.1371/journal.pntd.0007006. eCollection 2019 Feb.
Cystic echinococcosis (CE) is present in all continents, except for the Antarctica. Characteristically, CE lesions are found in the liver and the lungs, but virtually any part of the body may be affected (the spleen, kidneys, heart, central nervous system, bones, among others). It is estimated that the incidence of bone involvement in CE is 0.5% to 4%.
A retrospective study was performed of patients with osseous CE treated at the National Reference Unit of Tropical Diseases of the Ramon y Cajal Hospital, Madrid, Spain, between 1989 and December 2017. Epidemiological, clinical, diagnostic and therapeutic data of patients with long-term follow-up were collected.
During the study period, of the 104 patients with CE, 27 exhibited bone involvement (26%). The bones most frequently affected were the spine, followed by the ribs, pelvis, femur, tibia and the scapula. The most common symptom was pain followed by medullar syndrome and pathologic fracture. In total, 81.5% of patients underwent surgery for osseous CE at least once. As many as 96% received albendazol either in (mostly long-term) monotherapy or in combination with praziquantel.
The diagnosis and management of osseous CE is challenging. In many cases osseous CE should be considered a chronic disease and should be managed on a case-by-case basis. Lifelong follow-up should be performed for potential recurrence and sequels.
包虫病（CE）存在于所有大陆，除南极洲以外。CE 病变通常发生在肝脏和肺部，但实际上身体的任何部位都可能受到影响（脾脏、肾脏、心脏、中枢神经系统、骨骼等）。据估计，CE 骨骼受累的发生率为 0.5%至 4%。
对 1989 年至 2017 年 12 月在西班牙马德里 Ramón y Cajal 医院热带病国家参考单位治疗的骨骼包虫病患者进行了回顾性研究。收集了长期随访患者的流行病学、临床、诊断和治疗数据。
在研究期间，104 例 CE 患者中有 27 例（26%）出现骨骼受累。最常受累的骨骼是脊柱，其次是肋骨、骨盆、股骨、胫骨和肩胛骨。最常见的症状是疼痛，其次是骨髓综合征和病理性骨折。共有 81.5%的骨骼包虫病患者至少接受过一次手术治疗。多达 96%的患者接受阿苯达唑（大多为长期）单药治疗或联合使用吡喹酮治疗。
骨骼包虫病的诊断和治疗具有挑战性。在许多情况下，骨骼包虫病应被视为一种慢性疾病，应根据具体情况进行个体化管理。应进行终身随访，以发现潜在的复发和后遗症。
