title: [Epidemiological and clinical characteristics of patients with echinococcosis - management in an infectiological service in Germany].
abstract: OBJECTIVE
  Cystic echinococcosis (CE) is a widespread zoonosis. Difficulties in patient care were investigated in order to improve the clinical management of CE patients.
  
  
  METHODS
  65 patients with CE attending our service between 1999 and 2011 were interviewed for their history. Previous diagnostic findings were taken into account. Diagnosis, staging and therapy relied on laboratory and imaging findings.
  
  
  RESULTS
  56 patients were immigrants and nine of German origin. 55 of 59 evaluable patients had been living in rural areas for many years. 34 of 35 patients recalled dog contacts. Symptoms had indicated CE in 21 of 59 (36 %) cases only, whereas CE was mostly detected accidentally. Diagnosis was hampered by false negative serological results (IHA false negative in 11 of 60 cases [18 %], EIA in 8 of 53 [15 %]), the low frequency of eosinophilia (15/61 [25 %]) and of IgE increase (27/57 [47 %]). Percutaneous treatment or surgery was performed in active CE of the liver; disseminated CE was treated non-surgically. Inactive CE cases were monitored without any intervention. Relapses occurred in 7 of 51 (14 %) patients with follow-up: one after surgery, six after conservative treatment.
  
  
  CONCLUSIONS
  The diagnosis of CE is delayed by the paucity of characteristic symptoms and the inconsistency of serologic results. Assessment of cyst morphology and localisation are particularly important for diagnosis, staging and follow-up. CE requires an interdisciplinary management which should be coordinated by specialized infectious diseases centres.
authors.affiliation: Tropenmedizinische Ambulanz, Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Orhun
authors.forename: I
authors.initials: I
authors.lastname: Müller-Stöver
authors.forename: M C
authors.initials: MC
authors.lastname: Holtfreter
authors.forename: H
authors.initials: H
authors.lastname: Dedelen
authors.forename: D
authors.initials: D
authors.lastname: Häussinger
authors.forename: J
authors.initials: J
authors.lastname: Richter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data*; D004443:Echinococcosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D055815:Young Adult