{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:04:35Z","timestamp":1768460675803,"version":"3.49.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Parasites Vectors"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Human alveolar echinococcosis (AE) is caused by the accidental ingestion of the eggs of the fox tapeworm <jats:italic>Echinococcus multilocularis<\/jats:italic>. AE occurs frequently in rural western China due to the poor levels of hygiene, the close contact of people with dogs, and the lack of appropriate facilities for the correct and rapid diagnosis of the disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Findings<\/jats:title>\n            <jats:p>We describe a case of a patient with hepatic AE, and AE metastases of the brain. She was mistakenly diagnosed with suspected undifferentiated metastatic cancer of the liver and brain, and with a pulmonary bacterial infection, but was subsequently correctly diagnosed during a follow-up field survey for echinococcosis. The diagnosis of brain AE was confirmed by pathological examination of tissue biopsies removed during neurosurgery. We also briefly describe other symptomatic and asymptomatic AE cases, identified by chance, likely due to the inadequate facilities available in rural communities in China for AE diagnosis and management, since the rapid and accurate diagnosis of metastatic AE requires a high level of expertise in the appropriate diagnostic procedures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This report highlights the necessity for an upgrade in the diagnosis, treatment, prevention and control of AE in rural China.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1756-3305-4-196","type":"journal-article","created":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T06:47:43Z","timestamp":1319179663000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Case studies emphasising the difficulties in the diagnosis and management of alveolar echinococcosis in rural China"],"prefix":"10.1186","volume":"4","author":[{"given":"Donald P","family":"McManus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengzhi","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shukun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren J","family":"Gray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu Rong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2011,10,9]]},"reference":[{"key":"436_CR1","doi-asserted-by":"publisher","first-page":"1866","DOI":"10.3201\/eid1112.050079","volume":"11","author":"L Tiaoying","year":"2005","unstructured":"Tiaoying L, Jiamin Q, Wen Y, Craig PS, Xingwang C, Ning X, Ito A, Giraudoux P, Wulamu M: Echinococcosis in Tibetan populations, western Sichuan Province, China. Emerg Infect Dis. 2005, 11: 1866-1873.","journal-title":"Emerg Infect Dis"},{"key":"436_CR2","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4269\/ajtmh.1999.60.188","volume":"60","author":"A Ito","year":"1999","unstructured":"Ito A, Ma L, Schantz PM, Gottstein B, Liu YH, Chai JJ, Abdel-Hafez SK, Altintas N, Joshi DD, Lightowlers MW, Paulowski ZS: Differential serodiagnosis for cystic and alveolar echinococcosis using fractions of Echinococcus granulosus cyst fluid (antigen B) and E. multilocularis protoscolex (EM18). Am J Trop Med Hyg. 1999, 60: 188-192.","journal-title":"Am J Trop Med Hyg"},{"key":"436_CR3","first-page":"470","volume":"111","author":"C Jiang","year":"1998","unstructured":"Jiang C: Alveolar echinococcosis in China. Chin Med J (Engl). 1998, 111: 470-475.","journal-title":"Chin Med J (Engl)"},{"key":"436_CR4","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1111\/j.1365-3156.2007.01834.x","volume":"12","author":"YR Yang","year":"2007","unstructured":"Yang YR, Craig PS, Ito A, Vuitton DA, Giraudoux P, Sun T, Williams GM, Huang Z, Li Z, Wang Y, Teng J, Li Y, Huang L, Wen H, Jones MK, McManus DP: A correlative study of ultrasound with serology in an area in China co-endemic for human alveolar and cystic echinococcosis. Trop Med Int Health. 2007, 12: 637-646. 10.1111\/j.1365-3156.2007.01834.x.","journal-title":"Trop Med Int Health"},{"key":"436_CR5","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/j.trstmh.2005.04.020","volume":"99","author":"YR Yang","year":"2005","unstructured":"Yang YR, Vuitton DA, Jones MK, Craig PS, McManus DP: Brain metastasis of alveolar echinococcosis in a hyperendemic focus of Echinococcus multilocularis infection. Trans R Soc Trop Med Hyg. 2005, 99: 937-941. 10.1016\/j.trstmh.2005.04.020.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"436_CR6","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.actatropica.2005.12.001","volume":"97","author":"YR Yang","year":"2006","unstructured":"Yang YR, Cheng L, Yang SK, Pan X, Sun T, Li X, Hu S, Zhao R, Craig PS, Vuitton DA, McManus DP: A hospital-based retrospective survey of human cystic and alveolar echinococcosis in Ningxia Hui Autonomous Region, PR China. Acta Trop. 2006, 97: 284-291. 10.1016\/j.actatropica.2005.12.001.","journal-title":"Acta Trop"},{"key":"436_CR7","first-page":"20","volume-title":"WHO\/OIE Manual on Echinococcosis in Humans and Animals: a Public Health Problem of Global Concern","author":"Z Pawlowski","year":"2001","unstructured":"Pawlowski Z, Echert J, Vuitton DA, Ammann R, Kern P, Craig PS, Dar K, De Rosa F, Filice C, Gottstein B, Wen H: Echinococcosis in humans: clinical aspects, diagnosis and treatment. WHO\/OIE Manual on Echinococcosis in Humans and Animals: a Public Health Problem of Global Concern. Edited by: Echert J, Gemmell M, meslin F-X, Pawlowski Z. 2001, World Organisation for Animal Health, Paris, 20-71."},{"issue":"Suppl","key":"436_CR8","doi-asserted-by":"publisher","first-page":"S283","DOI":"10.1016\/j.parint.2005.11.041","volume":"55","author":"P Kern","year":"2006","unstructured":"Kern P, Wen H, Sato N, Vuitton DA, Gruener B, Shao Y, Delabrousse E, Kratzer W, Bresson-Hadni S: WHO classification of alveolar echinococcosis: principles and application. Parasitol Int. 2006, 55 (Suppl): S283-287.","journal-title":"Parasitol Int"},{"key":"436_CR9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s150100050079","volume":"28","author":"S Reuter","year":"2000","unstructured":"Reuter S, Seitz HM, Kern P, Junghanss T: Extrahepatic alveolar echinococcosis without liver involvement: a rare manifestation. Infection. 2000, 28: 187-192. 10.1007\/s150100050079.","journal-title":"Infection"},{"key":"436_CR10","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1148\/rg.244035719","volume":"24","author":"KJ Mortele","year":"2004","unstructured":"Mortele KJ, Segatto E, Ros PR: The infected liver: radiologic-pathologic correlation. Radiographics. 2004, 24: 937-955. 10.1148\/rg.244035719.","journal-title":"Radiographics"},{"key":"436_CR11","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/0016-5085(95)90350-X","volume":"109","author":"P Kern","year":"1995","unstructured":"Kern P, Frosch P, Helbig M, Wechsler JG, Usadel S, Beckh K, Kunz R, Lucius R, Frosch M: Diagnosis of Echinococcus multilocularis infection by reverse-transcription polymerase chain reaction. Gastroenterology. 1995, 109: 596-600. 10.1016\/0016-5085(95)90350-X.","journal-title":"Gastroenterology"},{"key":"436_CR12","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/S0140-6736(01)05754-3","volume":"358","author":"M Beach","year":"2001","unstructured":"Beach M: China's rural health care gradually worsens. Lancet. 2001, 358: 567-10.1016\/S0140-6736(01)05754-3.","journal-title":"Lancet"},{"key":"436_CR13","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1111\/j.1365-3156.2006.01633.x","volume":"11","author":"YR Yang","year":"2006","unstructured":"Yang YR, Williams GM, Craig PS, Sun T, Yang SK, Cheng L, Vuitton DA, Giraudoux P, Li X, Hu S, Liu X, Pan X, McManus DP: Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China. Trop Med Int Health. 2006, 11: 880-888. 10.1111\/j.1365-3156.2006.01633.x.","journal-title":"Trop Med Int Health"},{"issue":"6","key":"436_CR14","first-page":"359","volume":"12","author":"SY Chen","year":"2004","unstructured":"Chen SY, Du XL, Yan W: [A case of liver multiple hydatidosis complicated by tuberculosis in liver and abdominal cavity]. Zhonghua Gan Zang Bing Za Zhi. 2004, 12 (6): 359-","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"436_CR15","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/1756-3305-2-53","volume":"2","author":"YR Yang","year":"2009","unstructured":"Yang YR, Gray DJ, Ellis MK, Yang SK, Craig PS, McManus DP: Human cases of simultaneous echinococcosis and tuberculosis-significance and extent in China. Parasit Vectors. 2009, 2: 53-10.1186\/1756-3305-2-53.","journal-title":"Parasit Vectors"},{"key":"436_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","volume":"114","author":"E Brunetti","year":"2010","unstructured":"Brunetti E, Kern P, Vuitton DA: Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010, 114: 1-16. 10.1016\/j.actatropica.2009.11.001.","journal-title":"Acta Trop"},{"key":"436_CR17","first-page":"53","volume":"46","author":"E Brunetti","year":"2004","unstructured":"Brunetti E, Maiocchi L, Garlaschelli AL, Gulizia R, Filice C: [Overview of therapeutic options for cystic echinococcosis]. Parassitologia. 2004, 46: 53-55.","journal-title":"Parassitologia"},{"key":"436_CR18","doi-asserted-by":"publisher","first-page":"e1146","DOI":"10.1371\/journal.pntd.0001146","volume":"5","author":"E Brunetti","year":"2011","unstructured":"Brunetti E, Garcia HH, Junghanss T: Cystic Echinococcosis: Chronic, Complex, and Still Neglected. PLoS Negl Trop Dis. 2011, 5: e1146-10.1371\/journal.pntd.0001146.","journal-title":"PLoS Negl Trop Dis"},{"key":"436_CR19","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.trstmh.2008.01.007","volume":"102","author":"YR Yang","year":"2008","unstructured":"Yang YR, Craig PS, Sun T, Vuitton DA, Giraudoux P, Jones MK, Williams GM, McManus DP: Echinococcosis in Ningxia Hui Autonomous Region, northwest China. Trans R Soc Trop Med Hyg. 2008, 102: 319-328. 10.1016\/j.trstmh.2008.01.007.","journal-title":"Trans R Soc Trop Med Hyg"}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1756-3305-4-196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T17:17:25Z","timestamp":1630516645000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/1756-3305-4-196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,9]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["436"],"URL":"https:\/\/doi.org\/10.1186\/1756-3305-4-196","relation":{},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,9]]},"assertion":[{"value":"3 August 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"196"}}