{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:50:49Z","timestamp":1787727049970,"version":"build-2784847793"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,4]]},"abstract":"<jats:p>\n                    Cystic echinococcosis (CE) is a chronic, complex, and overlooked zoonotic disease caused by\n                    <jats:italic>Echinococcus granulosus<\/jats:italic>\n                    . In humans, it may result in a wide spectrum of clinical manifestations depending on the type of complications, ranging from asymptomatic infection to fatal disease. The primary complications and risk factors associated with CE are not well defined. We performed a retrospective, observational study of inpatients diagnosed with CE from January 1998 to December 2017 in the public health-care system of western Spain. Five hundred and six cases were analyzed. More than half of the patients (302 [59.7%]) were asymptomatic, and the diagnoses were made incidentally. A total of 204 (40.3%) patients had complications associated with CE; 97 (47.5%) were mechanical, 62 (30.4%) were infectious, 15 (7.3%) were immunoallergic, and 30 (14.7%) involved a combination of complications. Mortality was higher in patients with mechanical complications (9.4%) than in patients with infectious complications (5.6%) and in patients with allergic complications (0%) (odds ratio = 19.7, 95% CI, 4.3\u201389.1,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). In summary, CE frequently results in complications, especially in the liver in younger patients and, regardless of other variables, such as size or stage of cyst. Mechanical problems and superinfection are the most frequent complications. CE is an obligatory diagnosis in patients with urticarial or anaphylactoid reactions of unknown cause in endemic areas.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.19-0019","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T03:00:42Z","timestamp":1564455642000},"page":"628-635","source":"Crossref","is-referenced-by-count":32,"title":["Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis"],"prefix":"10.4269","volume":"101","author":[{"given":"Javier","family":"Collado-Aliaga","sequence":"first","affiliation":[{"name":"Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Romero-Alegr\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Alonso-Sard\u00f3n","sequence":"additional","affiliation":[{"name":"\u00c1rea de Medicina Preventiva y Salud P\u00fablica, Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Muro","sequence":"additional","affiliation":[{"name":"Laboratorio de Inmunolog\u00eda Parasitaria y Molecular, Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"L\u00f3pez-Bernus","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Velasco-Tirado","sequence":"additional","affiliation":[{"name":"Servicio de Dermatolog\u00eda, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Luis","family":"Mu\u00f1oz Bellido","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Pardo-Lledias","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna, General Hospital of Palencia \u201cR\u00edo Carri\u00f3n\u201d, C\/Donantes de Sangre, Palencia, Spain;"},{"name":"Departamento de Medicina Interna. Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, IDIVAL, Cantabria, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moncef","family":"Belhassen-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna, Secci\u00f3n de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL), Centro de Investigaci\u00f3n de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente, Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Trends Parasitol","first-page":"452","article-title":"Towards a taxonomic revision of the genus Echinococcus","volume":"18","author":"Thompson","year":"2002"},{"key":"b2","series-title":"World J Gastroenterol","first-page":"9351","article-title":"Epidemiology and clinical features of cystic hydatidosis in western Sicily: a ten-year review","volume":"19","author":"Cappello","year":"2013"},{"key":"b3","series-title":"Zoonoses Public Health","first-page":"156","article-title":"Echinococcus granulosus infection in Spain","volume":"55","author":"Carmena","year":"2008"},{"key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e893","article-title":"Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe","volume":"5","author":"Rojo-Vazquez","year":"2011"},{"key":"b5","series-title":"Rev Esp Enferm Apar Dig","first-page":"1","article-title":"Hepatic hydatidosis. Study of a series of 7,435 cases. I: general aspects, epidemiology and diagnosis","volume":"71","author":"Hidalgo Pascual","year":"1987"},{"key":"b6","series-title":"Med Cl\u00edn (Barc)","first-page":"773","article-title":"Epidemiologic study of human hydatidosis in Asturias (1975\u20131984)","volume":"89","author":"Pozo","year":"1987"},{"key":"b7","series-title":"Lancet","first-page":"861","article-title":"Cyst growth and spontaneous cure in hydatid disease","volume":"1","author":"Romig","year":"1986"},{"key":"b8","series-title":"Rev Esp Quimioter","first-page":"116","article-title":"Hydatidosis: epidemiological, clinical, diagnostic and therapeutic aspects","volume":"28","author":"Armi\u00f1anzas","year":"2015"},{"key":"b9","series-title":"BMC Infect Dis","first-page":"455","article-title":"Recurrence of cystic echinococcosis in an endemic area: a retrospective study","volume":"17","author":"Velasco-Tirado","year":"2017"},{"key":"b10","series-title":"Bol Chil Parasitol","first-page":"63","article-title":"Cysticercosis and hydatidosis do not always bring about detectable pathology in humans","volume":"44","author":"Schenone","year":"1989"},{"key":"b11","series-title":"PLoS One","first-page":"e91342","article-title":"Study of hydatidosis-attributed mortality in endemic area","volume":"9","author":"Belhassen Garcia","year":"2014"},{"key":"b12","series-title":"AJR Am J Roentgenol","first-page":"878","article-title":"Comparison of long-term results of percutaneous treatment techniques for hepatic cystic echinococcosis types 2 and 3b","volume":"208","author":"Akhan","year":"2017"},{"key":"b13","series-title":"Trans R Soc Trop Med Hyg","first-page":"207","article-title":"Management of cystic echinococcosis in the last two decades: what have we learned?","volume":"112","author":"Velasco-Tirado","year":"2018"},{"key":"b14","author":"Ine.Es","year":"2015"},{"key":"b15","series-title":"PLoS Negl Trop Dis","first-page":"e0004154","article-title":"Surveillance of human echinococcosis in Castilla-Leon (Spain) between 2000\u20132012","volume":"9","author":"Lopez-Bernus","year":"2015"},{"key":"b16","series-title":"Hum Pathol","first-page":"231","article-title":"Satellite cysts and biliary fistulas in hydatid liver disease. A retrospective study of 17 liver resections","volume":"39","author":"Stamm","year":"2008"},{"key":"b17","series-title":"Hepatogastroenterology","first-page":"1094","article-title":"Management of intrabiliary ruptured hydatid disease of the liver","volume":"48","author":"K\u00f6ksal","year":"2001"},{"key":"b18","series-title":"Dig Surg","first-page":"25","article-title":"Rupture of the hydatid disease of the liver into the biliary tracts","volume":"15","author":"Paksoy","year":"1998"},{"key":"b19","series-title":"Int Surg","first-page":"239","article-title":"Liver hydatid cyst rupture into the peritoneal cavity after abdominal trauma: case report and literature review","volume":"97","author":"Yilmaz","year":"2012"},{"key":"b20","series-title":"Ann Med Surg (Lond)","first-page":"18","article-title":"Cardiac hydatid cysts; presentation and management. A case series","volume":"30","author":"Oraha","year":"2018"},{"key":"b21","series-title":"Neurol Res","first-page":"245","article-title":"Hydatid disease of the central nervous system: a review of literature with an emphasis on Latin American countries","volume":"32","author":"Nourbakhsh","year":"2010"},{"key":"b22","series-title":"Gastroenterol Hepatol Bed Bench","first-page":"331","article-title":"Hydatid liver cyst causing portal vein thrombosis and cavernous transformation: a case report and literature review","volume":"9","author":"Kirmizi","year":"2016"},{"key":"b23","series-title":"Radiographics","first-page":"795","article-title":"Hydatid disease: radiologic and pathologic features and complications","volume":"20","author":"Pedrosa","year":"2000"},{"key":"b24","series-title":"Scand J Surg","first-page":"171","article-title":"Complicated liver echinococcosis: 30 years of experience from an endemic area","volume":"102","author":"Symeonidis","year":"2013"},{"key":"b25","series-title":"Gastroenterology Res","first-page":"139","article-title":"Complications of hydatid cysts of the liver: spiral computed tomography findings","volume":"5","author":"Alexiou","year":"2012"},{"key":"b26","series-title":"Am J Trop Med Hyg","first-page":"376","article-title":"Primary super-infection of hydatid cyst\u2014clinical setting and microbiology in 37 cases","volume":"82","author":"Garc\u00eda","year":"2010"},{"key":"b27","series-title":"Int J Infect Dis","first-page":"248","article-title":"A retrospective study on the coexistence of hydatid cyst and aspergillosis","volume":"12","author":"Ko\u00e7er","year":"2008"},{"key":"b28","series-title":"Clin Rev Allergy Immunol","first-page":"93","article-title":"Echinococcosis and allergy","volume":"26","author":"Vuitton","year":"2004"},{"key":"b29","series-title":"N Engl J Med","first-page":"808","article-title":"Activation of alternative complement pathway by fluid from hydatid cysts","volume":"302","author":"Perrigone","year":"1980"},{"key":"b30","series-title":"Exp Parasitol","first-page":"473","article-title":"Echinococcus granulosus: interactions with host complement in secondary infection in mice","volume":"80","author":"Di\u00e1z","year":"1995"},{"key":"b31","series-title":"Exp Parasitol","first-page":"405","article-title":"Dirofilaria immitis: diethylcarbamazine-induced anaphylactoid reactions in infected dogs","volume":"61","author":"Hamilton","year":"1986"},{"key":"b32","series-title":"Clin Exp Immunol","first-page":"110","article-title":"Elongation factor 1 beta\/delta of Echinococcus granulosus and allergic manifestations in human cystic echinococcosis","volume":"125","author":"Ortona","year":"2001"},{"key":"b33","series-title":"Clin Exp Immunol","first-page":"456","article-title":"Production of IL-5 and IL-6 by peripheral blood mononuclear cells (PBMC) from patients with Echinococcus granulosus infection","volume":"105","author":"Rigan\u00f2","year":"1996"},{"key":"b34","series-title":"Clin Exp Immunol","first-page":"317","article-title":"Immune response and in vivo production of cytokines in patients with liver hydatidosis","volume":"106","author":"Torcal","year":"1996"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/3\/article-p628.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/3\/article-p628.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/3\/article-p628.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:30:14Z","timestamp":1722447014000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/3\/article-p628.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,4]]},"references-count":34,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.19-0019","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,4]]}}}