A ten-year evaluation of central nervous system cystic echinococcosis in a highly endemic area of Iran: Molecular epidemiology and clinicopathological characteristics

IF 2 Q3 INFECTIOUS DISEASES

Parasite Epidemiology and Control Pub Date : 2025-02-01 DOI:10.1016/j.parepi.2025.e00414

Mohsen Najjari , Ali Dehesht Manesh , Shahab Rezaeian , Bibi Razieh Hosseini Farrash , Mohammad Ali Mohammadi , Mohammad Ebrahimipour

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Abstract

Cystic echinococcosis can involve various organs in humans with the brain and spine being particularly vulnerable. This research aimed to study clinicopathological features and molecular analysis of the central nervous system (CNS) echinococcosis cases in a central hospital for hydatid cyst surgery in northeastern Iran. CNS echinococcosis cases from surgically managed human CE cases at Ghaem hospital in northeastern Iran were analyzed from 2012 to 2022. Demographic and clinicopathological data were collected for CNS echinococcosis cases and formalin-fixed paraffin-embedded (FFPE) blocks were used for molecular analysis. The total prevalence of CNS echinococcosis cases was 1. 8 %. Most of the CE cases were reported in women (64. 7 %) and from rural areas (58. 8 %). The highest number of cases (41. 2 %) were aged ≤18 years, with majority being ranchers (47. 1 %). Thirteen cases (76.5 %) were found to have cysts in their brain, particularly in the supratentorial site. Headache was the most commonly reported sign in cases (9/13, 69.2 %). Infiltration of eosinophils, polymorphic inflammatory cells, and giant cells, gliosis, and foreign body granulomatous reaction, along with mild infiltration of mononuclear cells showing degeneration and necrotic foci in the brain infections. Spine infections included bone cartilage, ligaments, and hydatid cyst wall fragments. PCR analysis conducted on 17 samples revealed the presence of 13 isolates of E. granulosus sensu lato. Among these, 11 were classified within the E. granulosus sensu stricto (G1 and/or G3) complex, while 2 isolates were identified as belonging to the E. canadensis G6/G7. Cerebrospinal infection is a significant aspect of CE cases in northcentral Iran, with a higher prevalence among women and in rural areas. Children were the most affected age group, with the E. granulosus s.s. genotypes being the most common.

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伊朗高流行区中枢神经系统囊性包虫病的十年评价：分子流行病学和临床病理特征

囊性棘球蚴病可累及人体多个器官，其中大脑和脊柱尤为脆弱。本研究旨在研究伊朗东北部一家中心医院包虫病手术的中枢神经系统（CNS）包虫病病例的临床病理特征和分子分析。分析了2012 - 2022年伊朗东北部Ghaem医院手术处理的人类CE病例的中枢神经系统棘球蚴病病例。收集中枢神经系统棘球蚴病病例的人口统计学和临床病理资料，采用福尔马林固定石蜡包埋（FFPE）块进行分子分析。中枢神经系统棘球蚴病总患病率为1。8%。大多数CE病例为女性（64例）。7%)和农村地区（58%）。8%)。病例数最高（41例）。（2%）年龄≤18岁，大多数是牧场主(47。1%)。13例（76.5%）发现脑内有囊肿，特别是在幕上部位。头痛是病例中最常见的症状（9/13,69.2%）。嗜酸性粒细胞浸润、多形性炎性细胞、巨细胞浸润、胶质瘤、异物肉芽肿反应，伴单核细胞轻度浸润，表现为脑感染的变性和坏死灶。脊柱感染包括骨软骨、韧带和包虫囊壁碎片。对17份样本进行PCR分析，共分离出13株感细粒绦虫。其中11株属于严格感细粒棘球绦虫（G1和/或G3）复合体，2株属于加拿大棘球绦虫G6/G7复合体。在伊朗中北部，脑脊液感染是CE病例的一个重要方面，在妇女和农村地区的患病率较高。儿童是最受影响的年龄组，其中颗粒棘球蚴基因型最常见。

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.