Wang Xu, Xiao Zhan-Jun, Xue Chui-Zhao, Wu Wen-Ting, Yang Jiang-Hui, Yan Chun, Wang Ying, Kui Yan, Luo Wen-Bo, Du Xi, Zan Run-Na, Shang Rong-Jian, Li Sa, Na Rigen, Han Shuai, Li Shi-Zhu
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; Key Laboratory On Parasite and Vector Biology, Ministry of Health; World Health Organization Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China.
Xilingol League Central Hospital, Xilinhot, China.
Infect Dis Poverty. 2025 Jul 24;14(1):74. doi: 10.1186/s40249-025-01342-4.
Alveolar echinococcosis (AE), caused by the larval stage of Echinococcus multilocularis, poses a substantial global health challenge due to its high mortality profile. This study reports the inaugural human infection of echinococcosis caused by the Mongolian genotype of E. multilocularis in China, also the first reported indigenous AE case in Inner Mongolia.
A 58-year-old female pastoralist from Inner Mongolia, who had no endemic region exposure history but prolonged occupational contact with dogs, presented with severe AE. Clinical examinations revealed a massive hepatic lesion exceeding 10 cm in diameter, accompanied by elevated eosinophils (0.90 × 10/L) and basophils (0.08 × 10/L). Despite undergoing liver transplantation, the patient succumbed postoperatively. Histopathological confirmation and molecular phylogenetics identified the Mongolian genotype of E. multilocularis infection, distinct from the predominant Asian genotype in China. Potential evidence of zoonotic transmission was discovered through genotype-matched E. multilocularis detection in corsac fox (Vulpes corsac) feces from the grasslands along the shores of Hulun Lake (Hulun Buir City, northeastern Inner Mongolia, China).
This report provides the primary evidence of a locally acquired human AE infection in China caused by the Mongolian genotype of Echinococcus multilocularis. The discovery of this case challenges historical classifications of echinococcosis endemic areas. The findings call for revised AE-endemic identification criteria, improved AE diagnostic protocols, and enhanced AE surveillance in the Inner Mongolia region to generate further epidemiological evidence and information on disease progression.
泡型包虫病（AE）由多房棘球绦虫的幼虫阶段引起，因其高死亡率而对全球健康构成重大挑战。本研究报告了中国首例由多房棘球绦虫蒙古基因型引起的人体包虫病感染，也是内蒙古首例报告的本地AE病例。
一名来自内蒙古的58岁女性牧民，无疫区暴露史，但长期职业性接触犬类，出现严重AE。临床检查发现一个直径超过10厘米的巨大肝脏病变，伴有嗜酸性粒细胞（0.90×10/L）和嗜碱性粒细胞（0.08×10/L）升高。尽管接受了肝移植，患者术后仍死亡。组织病理学确认和分子系统发育学鉴定为多房棘球绦虫蒙古基因型感染，与中国主要的亚洲基因型不同。通过在呼伦湖（中国内蒙古东北部呼伦贝尔市）沿岸草原的沙狐（Vulpes corsac）粪便中检测到与基因型匹配的多房棘球绦虫，发现了人畜共患病传播的潜在证据。
本报告提供了中国首例由多房棘球绦虫蒙古基因型引起的本地获得性人体AE感染的主要证据。该病例的发现挑战了包虫病流行区的历史分类。这些发现呼吁修订AE流行区识别标准，改进AE诊断方案，并加强内蒙古地区的AE监测，以产生更多关于疾病进展的流行病学证据和信息。
