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Infection

, Volume 45, Issue 3, pp 365–368 | Cite as

Hints for control of infection in unique extrahepatic vertebral alveolar echinococcosis

  • Jean-François FaucherEmail author
  • Cécile Descotes-Genon
  • Bruno Hoen
  • Joël Godard
  • Sophie Félix
  • Sébastien Aubry
  • Oleg Blagosklonov
  • Frédéric Grenouillet
  • Marie-Pascale Brientini
  • Carine Richou
  • Solange Bresson-Hadni
  • Catherine Chirouze
Case Report

Abstract

The prognosis of vertebral alveolar echinococcosis (AE) is poor. We report on the unique outcome of a patient with preexisting liver cirrhosis, in whom a diagnosis of vertebral AE was established on vertebral histopathology (D4 corporectomy in 2010 for paraplegia). Therapeutic drug monitoring of albendazole (ABZ) showed that a low dosage was appropriate. The patient recovered and ABZ withdrawal was decided in 2014, with no relapse 18 months later. In this patient, infection was purely or mainly localized in the dorsal spine, and this may have been favored by liver cirrhosis. A longer follow-up is, however, needed to confirm cure.

Keywords

Alveolar echinococcosis Vertebral Therapeutic drug monitoring Cure 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Keutgens A, Simoni P, Detrembleur N, Frippiat F, Giot JB, Spirlet F, Aghazarian S, Descy J, Meex C, Huynen P, Melin P, Müller N, Gottstein B, Carlier Y, Hayette MP. Fatal alveolar echinococcosis of the lumbar spine. J Clin Microbiol. 2013;51:688–91.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Nourrisson C, Mathieu S, Beytout J, Cambon M, Poirier P. Osteolytic bone lesion: vertebral alveolar echinococcosis in a patient with splenectomy. Rev Med Interne. 2014;35:399–402.CrossRefPubMedGoogle Scholar
  3. 3.
    Nell M, Burgkart RH, Gradl G, von Eisenhart-Rothe R, Schaeffeler C, Nell M, Burgkart RH, Gradl G, von Eisenhart-Rothe R, Schaeffeler C, Trappe D, da Costa CP, Gradinger R, Kirchhoff C. Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle. Ann Clin Microbiol Antimicrob. 2011;10:13.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Toussaint F, Pere P, Le Chaffotec L, Grandhaye P, Pourel J, Chary-Valckenaere I. Alveolar echinococcosis of the spine. J Clin Rheumatol. 2001;7:248–51.CrossRefPubMedGoogle Scholar
  5. 5.
    Georges S, Villard O, Filisetti D, Mathis A, Marcellin L, Hansmann Y, Candolfi E. Usefulness of PCR analysis for diagnosis of alveolar echinococcosis with unusual localizations: two case studies. J Clin Microbiol. 2004;42:5954–6.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Scheuring UJ, Seitz HM, Wellmann A, Hartlapp JH, Tappe D, Brehm K, Spengler U, Sauerbruch T, Rockstroh JK. Long-term benzimidazole treatment of alveolar echinococcosis with hematogenic subcutaneous and bone dissemination. Med Microbiol Immunol. 2003;192:193–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Merkle EM, Kramme E, Vogel J, Krämer S, Schulte M, Usadel S, Kern P, Brambs HJ. Bone and soft tissue manifestations of alveolar echinococcosis. Skeletal Radiol. 1997;26:289–92.CrossRefPubMedGoogle Scholar
  8. 8.
    Claudon M, Bracard S, Plenat F, Regent D, Bernadac P, Picard L. Spinal involvement in alveolar echinococcosis: assessment of two cases. Radiology. 1987;162:571–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Brunetti E, Kern P, Vuitton DA. Writing panel for the WHO-IWGE expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114:1–16.CrossRefPubMedGoogle Scholar
  10. 10.
    Reuter S, Seitz HM, Kern P, Junghanss T. Extrahepatic alveolar echinococcosis without liver involvement: a rare manifestation. Infection. 2000;28:187–92.CrossRefPubMedGoogle Scholar
  11. 11.
    Kern P, Bardonnet K, Renner E, Auer H, Pawlowski Z, Ammann RW, Vuitton DA, Kern P. European echinococcosis registry. European echinococcosis registry: human alveolar echinococcosis, Europe, 1982–2000. Emerg Infect Dis. 2003;9:343–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Crouzet J, Grenouillet F, Delabrousse E, Blagosklonov O, Thevenot T, Di Martino V, Piarroux R, Mantion GA, Bresson-Hadni S. Personalized management of patients with inoperable alveolar echinococcosis undergoing treatment with albendazole: usefulness of positron-emission-tomography combined with serological and computed tomography follow-up. Clin Microbiol Infect. 2010;16:788–91.CrossRefPubMedGoogle Scholar
  13. 13.
    Ammann RW, Stumpe KD, Grimm F, Deplazes P, Huber S, Bertogg K, Fischer DR, Müllhaupt B. Outcome after discontinuing long-term benzimidazole treatment in patients with non-resectable alveolar echinococcosis with negative FDG-PET/CT and anti-EmII/3-10 serology. PLoS Negl Trop Dis. 2015;9:e0003964.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Caoduro C, Porot C, Vuitton DA, Bresson-Hadni S, Grenouillet F, Richou C, Boulahdour H, Blagosklonov O. The role of delayed 18F-FDG PET imaging in the follow-up of patients with alveolar echinococcosis. J Nucl Med. 2013;54:358–63.CrossRefPubMedGoogle Scholar
  15. 15.
    Nagy J, Schipper HG, Koopmans RP, Butter JJ, Van Boxtel CJ, Kager PA. Effect of grapefruit juice or cimetidine coadministration on albendazole bioavailability. Am J Trop Med Hyg. 2002;66:260–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jean-François Faucher
    • 1
    Email author
  • Cécile Descotes-Genon
    • 1
  • Bruno Hoen
    • 1
  • Joël Godard
    • 2
  • Sophie Félix
    • 3
  • Sébastien Aubry
    • 4
  • Oleg Blagosklonov
    • 5
  • Frédéric Grenouillet
    • 6
    • 7
  • Marie-Pascale Brientini
    • 7
    • 8
  • Carine Richou
    • 7
    • 9
  • Solange Bresson-Hadni
    • 7
  • Catherine Chirouze
    • 1
  1. 1.Service des maladies infectieuses et TropicalesCentre Hospitalier UniversitaireBesançonFrance
  2. 2.Service de neurochirurgieCentre Hospitalier UniversitaireBesançonFrance
  3. 3.Laboratoire d’anatomie et cytologie pathologiqueCentre Hospitalier UniversitaireBesançonFrance
  4. 4.Service de radiologie ostéo-articulaireCentre Hospitalier UniversitaireBesançonFrance
  5. 5.Service de médecine nucléaireCentre Hospitalier UniversitaireBesançonFrance
  6. 6.Laboratoire de parasitologie-mycologieCentre Hospitalier UniversitaireBesançonFrance
  7. 7.WHO Collaborating Centre for Prevention and Treatment of Human EchinococcosisBesançonFrance
  8. 8.Laboratoire de pharmacologie clinique et toxicologieCentre Hospitalier UniversitaireBesançonFrance
  9. 9.Service d’hépatologieCentre Hospitalier UniversitaireBesançonFrance

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