Treatment challenges associated with bone echinococcosis.

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Etat: Public
Version: Final published version
Licence: Non spécifiée
ID Serval
serval:BIB_6A58CB9E4276
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Treatment challenges associated with bone echinococcosis.
Périodique
The Journal of antimicrobial chemotherapy
Auteur(s)
Steinmetz Sylvain, Racloz Guillaume, Stern Richard, Dominguez Dennis, Al-Mayahi Mohamed, Schibler Manuel, Lew Daniel, Hoffmeyer Pierre, Uçkay Ilker
ISSN
1460-2091 (Electronic)
ISSN-L
0305-7453
Statut éditorial
Publié
Date de publication
03/2014
Peer-reviewed
Oui
Volume
69
Numéro
3
Pages
821-826
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
In this literature review, we concentrate on epidemiology and therapy of osseous echinococcosis, with an emphasis on the recurrence risk.
Literature review 1930-2012.
We retrieved 200 publications based upon single case reports or case series, mostly from resource-poor settings. Among the 721 rural patients (22% females; median age 37 years), 60% of all reported cases were from the Mediterranean region and almost all patients were immune competent. Echinococcus granulosus was identified as the most frequent species. Most infections involved a single bone (602/721; 83%) and often the spine (321 cases; 45%). In eight cases (8/702; 1%), a secondary bacterial surgical site infection was reported. Surgical intervention was performed in 702 cases (97%), with single intervention in 687 episodes (95%). Complete excision of the lesion was possible in only 117 episodes (16%). Albendazole was by far the most frequently used agent in monotherapy with various dosages, while mebendazole in monotherapy was less frequent (32 cases). The median duration of antihelminthic therapy was 6 months (range 0.7-144 months). There were 124 recurrences (17%) after a median delay of 2 years (range 0.4-17 years). In multivariate analysis, the presence of visceral organ involvement increased the odds of recurrence by 5.4 (95% CI 3.1-9.4), whereas the number of surgical interventions, the duration of antihelminthic therapy or the use of hypertonic saline did not influence recurrence.
Bone echinococcosis is a rare parasitic disease. While treatment modalities vary considerably, combined surgical and medical approaches are the standard of care with a 17% risk of recurrence.
Mots-clé
Albendazole/therapeutic use, Animals, Anthelmintics/therapeutic use, Bone Diseases/drug therapy, Bone Diseases/epidemiology, Bone Diseases/parasitology, Bone Diseases/surgery, Debridement, Echinococcosis/drug therapy, Echinococcosis/epidemiology, Echinococcosis/parasitology, Echinococcosis/surgery, Echinococcus granulosus/isolation & purification, Humans, Mebendazole/therapeutic use, Recurrence, Time Factors, Treatment Outcome, benzimidazoles, epidemiology, orthopaedic surgery, recurrence
Pubmed
Web of science
Création de la notice
14/03/2019 10:16
Dernière modification de la notice
05/12/2020 7:26
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