Laboratory Findings of Patients with Hydatidosis of the Central Nervous System



Clinical assessment of laboratory information is complex and is based on laboratory results and parasitological, histological, and immunological tests. The aim of hematologic tests is to look for eosinophilia, leucocytosis, elevation of the erythrocyte sedimentation rate, and possible anemia. The presence of eosinophilic cells in the sediment of the liquor and the presence of protoscoleces and hooklets is important for the diagnosis of hydatidosis of the central nervous system (CNS). The parasitological tests used involve macroscopic views of the surgically removed specimens as well as microscopic examination of centrifuged hydatid fluid looking for protoscoleces and hooklets. Histological examination of the affected tissue and membrane of the cysts is necessary. Immunological methods are an important part of the diagnostic procedures: indirect hemagglutination assays, immunofluorescent tests, enzyme linked immunosorbent assays, and enzyme linked immunoelectrotransfer blots. Polymerase chain reaction is a biomolecular method suitable for differentiation between Echinococcus granulosus and E. multilocularis. Clinical experience shows the need for combining two sensitive serological tests to achieve a more precise diagnosis of hydatidosis of the CNS .


Hydatid Cyst Cystic Echinococcosis Recombinant Antigen Alveolar Echinococcosis Immunological Method 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Thanks are due to Mr. Georgy Kerelov and Dr. Irina Marinova for operative collaboration in preparing the text and references. I would especially like to send my sincerest thanks to Fuad Sami Haddad for his critical comments and English language revision of the text.


  1. Abbassioun K, Amirjamshidi A. Diagnosis and management of hydatid cyst of the central nervous system: part 1: general consideration and hydatid disease of the brain. Neurosurg Q. 2001a;11:1–9.CrossRefGoogle Scholar
  2. Abbassioun K, Amirjamshidi A. Diagnosis and management of hydatid cyst of the central nervous system: part 2: hydatid cyst of the skull, orbit and spine. Neurosurg Q. 2001b;11:10–6.CrossRefGoogle Scholar
  3. Biffin A, Jones M, Palmer S. Human hydatid disease: evaluation of an ELISA for diagnosis, population screening and monitoring of control programmes. J Med Microbiol. 1993;39:48–52.PubMedCrossRefGoogle Scholar
  4. Craig P. Echinococcus multilocularis. Curr Opin Infect Dis. 2003;16:437–44.PubMedCrossRefGoogle Scholar
  5. Craig P, Larrien E. Control of cystic echinococcosis/hydatidosis: 1863–2002. Adv Parasitol. 2006;61:443–508.PubMedCrossRefGoogle Scholar
  6. Doiz O, Benito R, Sbihi Y, Osuna A, Clavel A, Gomez-Lus R. Western blot applied to the diagnosis and post-treatment monitoring of human hydatidosis. Diagn Microbiol Infect Dis. 2001;41:139–42.PubMedCrossRefGoogle Scholar
  7. Doiz O, Benito R, Gil J, Rojas A, Rubio MC, Osuna A. Pre- and postsurgical detection of IgG, IgM and IgA specific to hydatidosis by ELISA with purified antigen enriched with the 5/B antigen complex. J Clin Lab Anal. 2002;16:295–8.PubMedCrossRefGoogle Scholar
  8. Donovan SM, Mickiewicz N, Meyer RD, Panosian CB. Imported echinococcosis in southern California. Am J Trop Med Hyg. 1995;53:668–71.PubMedGoogle Scholar
  9. Eckert J, Dephazes P. Biological, epidemiological and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev. 2004;17:107–35.PubMedCentralPubMedCrossRefGoogle Scholar
  10. Force L, Torres J, Carrillo A, Busca J. Evaluation of eight serological tests in the diagnosis of human echinococcosis and follow-up. Clin Infect Dis. 1992;15:473–80.PubMedCrossRefGoogle Scholar
  11. Gadea I, Ayala G, Diago M, Cunat A, de Lomas JG. Immunological diagnosis of human cystic echinococcosis: utility of discriminant analyses applied to the enzyme linked immunoelectrotransfer blot. Clin Diagn Lab Immunol. 1999;6:504–8.PubMedCentralPubMedGoogle Scholar
  12. Gihan M, Hala S, Nabil S, Lalla E, Hala ST, Rania M, Samar K, Wagida A. Genetic variability of Antigen B among Echinococcus granulosus Egyptian isolates. Korean J Parasitol. 2009;4:250–64.Google Scholar
  13. Gonzalez Sapienza G, Lorenzo C, Nieto A. Imported immunodiagnosis of cystic hydatid disease by using a synthetic peptide with higher diagnostic value than that of its parent protein, Echinococcus granulosus antigen B. J Clin Microbiol. 2000;38:3979–83.PubMedCentralPubMedGoogle Scholar
  14. Haddad FS, Haddad G. Hydatid disease of the central nervous system. Personal experience: its appearance, management, and outcome in the brain and the spine. Neurosurg Q. 2005;15:33–40.CrossRefGoogle Scholar
  15. Herrera A, Martinez A, Rodrigues J. Spinal hydatidosis. Spine (Phila Pa 1976). 2005;30:2439–44.CrossRefGoogle Scholar
  16. Kagan IG. A review of serological tests for diagnosis of hydatid disease. Bull World Health Organ. 1968;39:25–37.PubMedCentralPubMedGoogle Scholar
  17. Kars Z, Kansu T, Ozcan OE, Erbengi A. Orbital echinococcosis. Report of two cases studied by computerized tomography. J Clin Neuroophthalmol. 1982;2:197–9.PubMedGoogle Scholar
  18. Makni F, Hachicha L, Mseddi F, Hammami H, Cheikhrouhou F, Sellami H, Mzali R, Boujelbene S, Rebai R, Beyrouti I, Ayadi A. Contribution of Western blotting to the diagnosis of hydatidosis. Bull Soc Pathol Exot. 2007;100:171–3.PubMedGoogle Scholar
  19. Ortona E, Rigano R, Margutti P. Native and recombinant antigens in the immunodiagnosis of human cystic echinococcosis. Parasite Immunol. 2000;22:553–9.PubMedCrossRefGoogle Scholar
  20. Ortona E, Rigano R, Buttari B, Delunardo F, Ioppolo S, Margutti P, Profumo E, Teggi A, Vaccari S, Siracusano A. An update on immunodiagnosis of cystic echinococcosis. Acta Trop. 2003;85:165–71.PubMedCrossRefGoogle Scholar
  21. Özek MM, Pamir MN, Sav A. Spontaneous rupture of an intraorbital hydatid cyst. J Clin Neuroophthalmol. 1993;13:135–7.PubMedCrossRefGoogle Scholar
  22. Porreti D, Felleisen E, Grimm F, Pfister M, Teuscher F, Zuercher C, Reichen J, Gottstein B. Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies. Am J Trop Med Hyg. 1999;60:193–8.Google Scholar
  23. Ramzy R, Helmi H, Zayyat E, Rifaat M, Hameed D, Abdel-Baki M. An enzyme-linked immunosorbent assay for detection of IgG1 antibodies specific to human cystic echinococcosis in Egypt. Trop Med Int Health. 1999;4:616–20.PubMedCrossRefGoogle Scholar
  24. Reittner P, Szolar D, Schmid M. Case report. Systemic manifestation of Echinococcus alveolaris infection. J Comput Assist Tomogr. 1996;20:1030–2.PubMedCrossRefGoogle Scholar
  25. Rosenvit M, Camicia F, Kamenetzky L, Musulin P, Gutierrez A. Identification and intra-specific variability analysis of secreted and membrane-bound proteins from Echinococcus granulosus. Parasitol Int. 2006;55:63–7.CrossRefGoogle Scholar
  26. Siles-Lucas M, Gottstein B. Review: molecular tools for the diagnosis of cystic and alveolar echinococcosis. Trop Med Int Health. 2001;6:463–75.PubMedCrossRefGoogle Scholar
  27. Taghipour M, Zamanizadeh B, Haghnegahdar A, Zare Z. Vertebral hydatidosis. Neurosurg Q. 2008;18(3):163–71.CrossRefGoogle Scholar
  28. Tappe D, Weise D, Ziegler U, Muller A, Mullges W, Stichr A. Brain and lung metastasis of alveoral echinococcosus in a refugee from a hyperendemic area. J Med Microbiol. 2008;57:1420–3.PubMedCrossRefGoogle Scholar
  29. Taratuto AL, Venturiello S. Echinococcosis. Brain Pathol. 1997;7:673–9.PubMedCrossRefGoogle Scholar
  30. Toussaint F, Pere P, Chaffotec L, Grandhaye P, Pourel J. Alveolar Echinococcosis of the spine. J Clin Rheumatol. 2001;7:448–51.CrossRefGoogle Scholar
  31. Turgut M. Hydatidosis of central nervous system and its coverings in the pediatric and adolescent age groups in Turkey during the last century: a critical review of 137 cases. Childs Nerv Syst. 2002;18:670–83.PubMedCrossRefGoogle Scholar
  32. Turgut M, Benli K, Eryilmaz M. Secondary multiple intracranial hydatid cysts caused by intracerebral embolism of cardiac echinococcosis: an exceptional case of hydatidosis. J Neurosurg. 1997;86:714–8.PubMedCrossRefGoogle Scholar
  33. Verastegui M, Moro P, Guevara A, Rodrigues T, Miranda E, Gilman R. Enzyme-linked immunoelectrotransfer blot test for diagnosis of human hydatid disease. J Clin Microbiol. 1992;30:1557–61.PubMedCentralPubMedGoogle Scholar
  34. Vogel H. How does the alveolar echinococcus grow (in German). Tropenmed Parasitol. 1978;29:1–11.PubMedGoogle Scholar
  35. Weiss JB. DNA probes and PCR for diagnosis of parasitic infection. Clin Microbiol Rev. 1995;8:113–30.PubMedCentralPubMedGoogle Scholar
  36. Yang Y, Sun T, McManus D. Molecular confirmation of a case of multiorgan cystic echinococcosis. J Parasitol. 2006;92:206–8.PubMedCrossRefGoogle Scholar
  37. Yang Y, Vuitton D, Jones M, Craig P, McManus D. Brain metastasis of alveolar echinococcosis in hyperendemic focus of Echinococcus multilocularis infection. Trans R Soc Trop Med Hyg. 2005;99:937–41.PubMedCrossRefGoogle Scholar
  38. Zhang W, McManus D. Recent advances in the immunology and diagnosis of echinococcosis. Immunol Med Microbiol. 2006;47:24–41.CrossRefGoogle Scholar
  39. Zhang W, Li J, McManus D. Concepts in immunology and diagnosis of hydatid disease. Clin Microbiol Rev. 2003;16:18–36.PubMedCentralPubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Clinical Parasitology and Tropical MedicineMedical University of PlovdivPlovdivBulgaria
  2. 2.Department of Infectious Diseases, Parasitology and Tropical MedicineSt. George University HospitalPlovdivBulgaria

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