{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:09:51Z","timestamp":1771661391252,"version":"3.50.1"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Parasitology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In the endemic countries, human cystic echinococcosis (CE) poses a serious medical and social problem. Because it most often affects the liver and lungs we aimed to define the proportion of cases with different organ localization, the diagnostic and therapeutic approaches in such cases, and the outcome of them. For a period 2010\u20132019, a total of 2863 cases of CE were registered in Bulgaria, of which 148 (5.17%) with organ localization other than liver and\/or lung. The majority of patients with extra-hepatopulmonary localization of CE were adults. The distribution by gender showed predominance of female patients (57.43%) over those of males and primary cases (85.14%) exceeded the cases of recurrence. According to our study most common is the spleen involvement, followed by involvement of the abdominal cavity, kidneys and muscle\/subcutaneous tissue. Other extra-hepatopulmonary organ localizations are significantly less common. This study shows that the extra-hepatopulmonary localization of CE is not so rare, and in most cases it is a primary disease. In respect of this, clinicians should consider hydatidosis in the differential diagnosis when cystic formation(s) is found, regardless of the organ involved.<\/jats:p>","DOI":"10.1017\/s0031182020002206","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T07:18:06Z","timestamp":1605856686000},"page":"562-565","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Extra-hepatopulmonary cystic echinococcosis in Bulgaria: frequency, management and outcome of the disease"],"prefix":"10.1017","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2745-3344","authenticated-orcid":false,"given":"Rumen N.","family":"Harizanov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iskra G.","family":"Rainova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iskren T.","family":"Kaftandjiev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"S0031182020002206_ref5","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.1.0001"},{"key":"S0031182020002206_ref6","first-page":"14625","article-title":"Hydatid cyst disease with extra hepatic localizations","volume":"19","author":"Bart\u0131n","year":"2019","journal-title":"Biomedical Journal of Scientific and Technical Research"},{"key":"S0031182020002206_ref15","doi-asserted-by":"publisher","DOI":"10.1080\/000164702753671858"},{"key":"S0031182020002206_ref14","first-page":"5500","article-title":"The European Union summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in 2017","volume":"16","year":"2018","journal-title":"EFSA Journal"},{"key":"S0031182020002206_ref7","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2014.3521"},{"key":"S0031182020002206_ref9","doi-asserted-by":"publisher","DOI":"10.5152\/tpd.2016.4529"},{"key":"S0031182020002206_ref20","unstructured":"World Health Organization (2020) Echinococcosis fact sheet. Retrieved from WHO website: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/echinococcosis (Accessed 29 June 2020)."},{"key":"S0031182020002206_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900343"},{"key":"S0031182020002206_ref10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1563-2571.2003.30081.x"},{"key":"S0031182020002206_ref8","first-page":"1766","article-title":"Unusual localization of a primary hydatid cyst: a subcutaneous mass in the paraumbilical region","volume":"17","author":"Burgazli","year":"2013","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"S0031182020002206_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-013-2303-5"},{"key":"S0031182020002206_ref1","doi-asserted-by":"publisher","DOI":"10.2478\/s11687-010-0015-x"},{"key":"S0031182020002206_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s003300000468"},{"key":"S0031182020002206_ref19","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v5.i4.185"},{"key":"S0031182020002206_ref16","doi-asserted-by":"publisher","DOI":"10.5455\/im.42614"},{"key":"S0031182020002206_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsha.2013.08.001"},{"key":"S0031182020002206_ref4","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2014.508"},{"key":"S0031182020002206_ref13","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-13-00138.1"},{"key":"S0031182020002206_ref3","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v6.i10.190"},{"key":"S0031182020002206_ref11","volume-title":"WHO\/OIE Manual on Echinococcosis in Humans and Animals: A Public Health Problem of Global Concern","author":"Eckert","year":"2001"}],"container-title":["Parasitology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0031182020002206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T11:20:31Z","timestamp":1628680831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0031182020002206\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,20]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["S0031182020002206"],"URL":"https:\/\/doi.org\/10.1017\/s0031182020002206","relation":{},"ISSN":["0031-1820","1469-8161"],"issn-type":[{"value":"0031-1820","type":"print"},{"value":"1469-8161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,20]]},"assertion":[{"value":"Copyright \u00a9 The Author(s) 2021. 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