Disseminated Alveolar Echinococcosis in a Patient Diagnosed by Metagenomic Next-generation Sequencing: A Case Report

Overview

Journal Front Public Health

Specialty Public Health

Date 2022 Sep 12

PMID 36091563

Authors

Junyan Qu

Huan Xu

Xiaoju Lv

Affiliations

Soon will be listed here.

Abstract

Background: Alveolar echinococcosis (AE) is a parasitic zoonosis with high mortality and disability rates. Diverse clinical manifestations and mimicking of differential diagnoses such as tuberculosis and malignancy pose a diagnostic dilemma. With the rapid development of molecular diagnostic techniques in recent years, metagenomic next-generation sequencing (mNGS) has become an attractive approach for the etiological diagnosis of infectious diseases.

Case Presentation: we report a case of 51-year-old Chinese Tibetan male presented with 3-year low-back pain and 4-month discomfort in the right upper quadrant of the abdomen. He had been in good health. He was diagnosed with tuberculosis and was given anti-tuberculosis treatment a month prior to the visit, but the symptoms were not relieved. Abdominal computerized tomography (CT) revealed a hypodense lesion with uneven enhancement in the liver, and two ring-enhancing cystic lesions in the right abdominal wall. Lumbar spine enhanced MRI showed lesions of mixed density with uneven enhancement in the L1 vertebra and paraspinal tissue. The pathological results of the liver biopsy revealed parasitic infection and possibly echinococcosis. The metagenomic next-generation sequencing (mNGS) of the puncture fluid of abdominal cysts using Illumina X10 sequencer revealed 585 sequence reads matching . Disseminated AE was diagnosed. Albendazole (400 mg, twice daily) was used, and the patient was in stable condition during follow-up.

Conclusions: mNGS may be a useful tool for the diagnosis of AE. The case would help clinicians to improve their diagnostic skills.

Citing Articles

Advances in Novel Diagnostic Techniques for Alveolar Echinococcosis.

Liu H, Xie Y, An X, Xu D, Cai S, Chu C Diagnostics (Basel). 2025; 15(5).

PMID: 40075832 PMC: 11898896. DOI: 10.3390/diagnostics15050585.

Rapid diagnosis of alveolar echinococcosis from lung puncture sample using metagenomic next-generation sequencing: a case report.

Zhou C, Li C, Deng Z, Yan X, Feng L, Yang Z BMC Infect Dis. 2024; 24(1):683.

PMID: 38982338 PMC: 11232253. DOI: 10.1186/s12879-024-09553-0.

References

Piarroux M, Piarroux R, Giorgi R, Knapp J, Bardonnet K, Sudre B . Clinical features and evolution of alveolar echinococcosis in France from 1982 to 2007: results of a survey in 387 patients. J Hepatol. 2011; 55(5):1025-33. DOI: 10.1016/j.jhep.2011.02.018. View

Reinehr M, Micheloud C, Grimm F, Kronenberg P, Grimm J, Beck A . Pathology of Echinococcosis: A Morphologic and Immunohistochemical Study on 138 Specimens With Focus on the Differential Diagnosis Between Cystic and Alveolar Echinococcosis. Am J Surg Pathol. 2019; 44(1):43-54. DOI: 10.1097/PAS.0000000000001374. View

Vuitton D, Azizi A, Richou C, Vuitton L, Blagosklonov O, Delabrousse E . Current interventional strategy for the treatment of hepatic alveolar echinococcosis. Expert Rev Anti Infect Ther. 2016; 14(12):1179-1194. DOI: 10.1080/14787210.2016.1240030. View

Meinel T, Gottstein B, Geib V, Keel M, Biral R, Mohaupt M . Vertebral alveolar echinococcosis-a case report, systematic analysis, and review of the literature. Lancet Infect Dis. 2017; 18(3):e87-e98. DOI: 10.1016/S1473-3099(17)30335-3. View

Ayles H, Corbett E, Taylor I, Cowie A, Bligh J, Walmsley K . A combined medical and surgical approach to hydatid disease: 12 years' experience at the Hospital for Tropical Diseases, London. Ann R Coll Surg Engl. 2002; 84(2):100-5. PMC: 2503771. View

Hemer S, Brehm K . In vitro efficacy of the anticancer drug imatinib on Echinococcus multilocularis larvae. Int J Antimicrob Agents. 2012; 40(5):458-62. DOI: 10.1016/j.ijantimicag.2012.07.007. View

Cai H, Guan Y, Ma X, Wang L, Wang H, Su G . Epidemiology of Echinococcosis Among Schoolchildren in Golog Tibetan Autonomous Prefecture, Qinghai, China. Am J Trop Med Hyg. 2017; 96(3):674-679. PMC: 5361544. DOI: 10.4269/ajtmh.16-0479. View

Qu J, Zong Z . Strongyloidiasis in a Patient Diagnosed by Metagenomic Next-Generation Sequencing: A Case Report. Front Med (Lausanne). 2022; 9:835252. PMC: 9022660. DOI: 10.3389/fmed.2022.835252. View

Kaltenbach T, Graeter T, Mason R, Kratzer W, Oeztuerk S, Haenle M . Determination of vitality of liver lesions by alveolar echinococcosis. Comparison of parametric contrast enhanced ultrasound (SonoVue®) with quantified 18F-FDG-PET-CT. Nuklearmedizin. 2014; 54(1):43-9. DOI: 10.3413/Nukmed-0670-14-05. View

10.

Srinivas M, Deepashri B, Lakshmeesha M . Imaging Spectrum of Hydatid Disease: Usual and Unusual Locations. Pol J Radiol. 2016; 81:190-205. PMC: 4868106. DOI: 10.12659/PJR.895649. View

11.

Shang J, Zhang G, Yu W, He W, Wang Q, Zhong B . Molecular characterization of human echinococcosis in Sichuan, Western China. Acta Trop. 2018; 190:45-51. DOI: 10.1016/j.actatropica.2018.09.019. View

12.

Chauchet A, Grenouillet F, Knapp J, Richou C, Delabrousse E, Dentan C . Increased incidence and characteristics of alveolar echinococcosis in patients with immunosuppression-associated conditions. Clin Infect Dis. 2014; 59(8):1095-104. DOI: 10.1093/cid/ciu520. View

13.

Zheng C, Xue C, Han S, Li Z, Wang H, Wang L . National Alveolar Echinococcosis Distribution - China, 2012-2016. China CDC Wkly. 2021; 2(1):1-7. PMC: 8422174. View

14.

Wen H, Vuitton L, Tuxun T, Li J, Vuitton D, Zhang W . Echinococcosis: Advances in the 21st Century. Clin Microbiol Rev. 2019; 32(2). PMC: 6431127. DOI: 10.1128/CMR.00075-18. View

15.

Gottstein B, Frey C, Campbell-Palmer R, Pizzi R, Barlow A, Hentrich B . Immunoblotting for the serodiagnosis of alveolar echinococcosis in alive and dead Eurasian beavers (Castor fiber). Vet Parasitol. 2014; 205(1-2):113-8. DOI: 10.1016/j.vetpar.2014.06.017. View

16.

Yu X, Zhang L, Ma W, Bi W, Ju S . An Overview of Hepatic Echinococcosis and the Characteristic CT and MRI Imaging Manifestations. Infect Drug Resist. 2021; 14:4447-4455. PMC: 8558428. DOI: 10.2147/IDR.S331957. View

17.

Torgerson P, Keller K, Magnotta M, Ragland N . The global burden of alveolar echinococcosis. PLoS Negl Trop Dis. 2010; 4(6):e722. PMC: 2889826. DOI: 10.1371/journal.pntd.0000722. View

18.

Eberhardt N, Peters L, Kapp-Schwoerer S, Beer M, Beer A, Gruner B . 18F-FDG-PET/MR in Alveolar Echinococcosis: Multiparametric Imaging in a Real-World Setting. Pathogens. 2022; 11(3). PMC: 8951377. DOI: 10.3390/pathogens11030348. View

19.

Zou Y, Guan H, Wu H, Bu H, Yan L, Zhu Y . Angiostrongyliasis detected by next-generation sequencing in a ELISA-negative eosinophilic meningitis: A case report. Int J Infect Dis. 2020; 97:177-179. DOI: 10.1016/j.ijid.2020.05.108. View

20.

Song X, Ding L, Wen H . Bone hydatid disease. Postgrad Med J. 2007; 83(982):536-42. PMC: 2600110. DOI: 10.1136/pgmj.2007.057166. View