Alveolar echinococcosis in a patient without hepatic disturbance and with unusual humoral immune response

Excerpt

Human alveolar echinococcosis (AE) is a parasitosis caused by the larval stage of Echinococcus multilocularis, a tapeworm belonging to the family Taeniidae [1]. The adult parasites reside in fox intestines where they produce eggs released in feces. Eggs are usually ingested by rodents, the intermediate hosts of the parasite, or accidentally by humans. After the eggs hatch in the intestine, the embryos make their way to other organs, especially the liver, and develop into the larval stage. AE is a highly pathogenic and potentially fatal chronic liver infestation that is characterized by a tumor-like multivesicular, infiltrating structure [2]. Early diagnosis can improve the management and the treatment of affected patients, and it relies on complementary procedures such as clinical findings, imaging techniques, hepatic metabolic marker analysis and immunodiagnosis. Serological tests to detect AE are similar to those used for cystic echinococcosis (CE) caused by Echinococcus granulosus. These tests have recently been improved and are generally known to be more reliable for AE than for CE infection [1]. Nevertheless, we report a case of asymptomatic hepatic AE in a patient with normal liver enzymes in which serological tests resulted negative for conventional E. multilocularis antibodies. …