Altin Nilgun, Acar Ali, Ergun Onur, Kuzi Semanur, Ulusoy Tülay Ünver, Habiloğlu Arif Doğan, Kara Ongay Kulirkin
Department of Infectious Diseases and Clinical Microbiology, Ankara Etlik City Hospital, Ankara, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Bayindir Hospital Sogutozu, Ankara, Turkey.
Medicine (Baltimore). 2025 Jun 20;104(25):e42861. doi: 10.1097/MD.0000000000042861.
Cystic echinococcosis (CE) is an endemic zoonotic disease in Turkey. Despite advances in treatment approaches, full eradication is not always possible. So, recurrence remains a major concern with a long-lasting silent-course necessitating close follow-up. Recurrence has higher morbidity and mortality requiring more complex treatment approaches. We aimed to evaluate the epidemiologic, laboratory data, treatment approaches, and their relationship with recurrence. This retrospective, cross-sectional study assessed patients with CE who were admitted to a training and research hospital between January 2015 and August 2021. Demographic, clinical characteristics, and laboratory findings of the patients were examined, and comparisons were made between those with and without recurrence. Multivariable logistic regression analysis was conducted to identify potential risk factors for CE recurrence. Of the total 214 patients with a mean age was 50.4 ± 16.5 years; 62.6% (n = 134) were female and 60.2 % (129) had a history of living in a rural area. The most common cyst localization was in the liver in 167 (78%). Although the diagnosis was confirmed by imaging methods in all patients, serological test positivity was found only in 72% (n = 140). Recurrence was seen in 17.8% (n = 38) of the patients, and recurrence most commonly occurred within the first 3 years in 25 patients (65.7%), 12 of whom (31.6%) experienced recurrence in the 1st year after treatment. The recurrence rate was higher in the patients with multiorgan involvement (odds ratios [OR] 2.5, 95% confidence interval [CI]: 1.1-5.6, P = .019), a hydatid cyst duration of more than 5 years (OR 5.5, 95% CI: 2.6-11.8, P < .001), and those who underwent invasive procedure (OR 4.6, 95% CI: 1.3-15.7, P = .014). Hydatid cyst duration > 5 years was an independent risk factor for the recurrence of CE (OR 3.5, 95% CI: 1.5-8.1, P = .003). CE is frequently seen in females, especially living in rural areas. It is difficult to diagnose with routine serological testing, so imaging techniques are needed for diagnosis. Although longer duration of the disease, multiorgan involvement, and invasive treatment were more in patients with recurrences, only the long duration of the disease was independently associated with recurrences. In addition, due to presence of very late recurrences, long-term follow-up is important.
囊型包虫病(CE)是土耳其的一种地方性人畜共患病。尽管治疗方法有所进步,但并非总能完全根除。因此,复发仍然是一个主要问题,其病程漫长且隐匿,需要密切随访。复发具有更高的发病率和死亡率,需要更复杂的治疗方法。我们旨在评估其流行病学、实验室数据、治疗方法及其与复发的关系。这项回顾性横断面研究评估了2015年1月至2021年8月期间入住一家培训和研究医院的CE患者。检查了患者的人口统计学、临床特征和实验室检查结果,并对复发患者和未复发患者进行了比较。进行多变量逻辑回归分析以确定CE复发的潜在风险因素。在总共214例患者中,平均年龄为50.4±16.5岁;62.6%(n = 134)为女性,60.2%(129例)有农村居住史。最常见的囊肿部位是肝脏,有167例(78%)。尽管所有患者均通过影像学方法确诊,但仅72%(n = 140)的患者血清学检测呈阳性。17.8%(n = 38)的患者出现复发,复发最常发生在最初3年内,有25例(65.7%),其中12例(31.6%)在治疗后第1年复发。多器官受累的患者复发率更高(比值比[OR] 2.5,95%置信区间[CI]:1.1 - 5.6,P = 0.019),包虫囊肿持续时间超过5年(OR 5.5,95% CI:2.6 - 11.8,P < 0.001),以及接受侵入性手术的患者(OR 4.6,95% CI:1.3 - 15.7,P = 0.014)。包虫囊肿持续时间>5年是CE复发的独立危险因素(OR 3.5,95% CI:1.5 - 8.1,P = 0.003)。CE在女性中常见,尤其是居住在农村地区的女性。常规血清学检测难以诊断,因此需要影像学技术进行诊断。尽管复发患者的病程更长、多器官受累和接受侵入性治疗的情况更多,但只有病程长与复发独立相关。此外,由于存在非常晚的复发情况,长期随访很重要。