Cystic echinococcosis is a zoonotic disease that is caused by the larval stages of the cestode Echinococcus granulosus. It is characterized by a highly variable localization and clinical presentation. Treatment for echinococcal cysts is still controversial. Medical therapy with benzimidazole derivatives such as albendazole (ABZ) is one of the different treatment options. The purpose of this study is to analyze the treatment outcomes and the incidence of side effects in patients with cystic echinococcosis managed with ABZ to evaluate its effectiveness and safety.
This is a prospective study. All patients were treated with one or more ABZ based cures. The duration of cures was between 3 and 36 months. Patients were followed for at least 24 months.
During the study period, 32 patients were included. They were divided into 22 women and 10 men (Sex-ratio: 2,2). The mean age was 37 (Extremes: 4-72) years. Twenty one patients (66%) had undergone one or more interventions for their cystic echinococcosis. Seven cases had a debilitating disease. Eighteen patients showed disseminated cystic ecchinococcosis. The most affected organ was the liver (72%) followed by the lung (47%). Indications for medical treatment were: inoperable patients (14 cases), as a complement of surgery (12 cases), preoperatively in order to decrease the cyst size and then facilitate its surgical approach (4 cases), refusal of surgery by the patient (1 case) and as a complement of the Puncture Aspiration Injection Re-aspiration technique (PAIR) (2 cases). Side effects were experienced by 14 patients: epigastralgia (5 cases), increased liver enzymes (7 cases) and alopecia (2 cases). Twenty one patients were evaluable. Regardless of the location of cysts, there was a benefic effect (cure and/or improvement of at least one among the cysts) in 15 patients (71,4%). An absence of effect (stabilization and/or aggravation of all cysts) was seen in 6 patients (28,6%).
Cystic echinococcosis (CE) is a serious health problem in endemic countries. Medical treatment is indicated in disseminated hydatidosis, severe localizations or inoperable cysts. ABZ is currently the drug of choice with proved remarkable treatment outcome.
M. Kouba‚, None
E. Elleuch, None
C. Marrakchi, None
I. Maaloul, None
B. Hammami, None
M. Ben Jemaa, None