Differentiation of Cerebral Cystic Echinococcosis (CCE) from Coenurosis Using Morphometric and Molecular Methods

Fattaneh  Mikaeili; Sharif  Maraghi; Eshrat  Beigom Kia; Fatemeh Sadat  Sadjjadi; Mehdi  Karamian; Seyed Shahram  Shekarforoush; Majid Fasihi  Harandi; Seyed Mahmoud  Sadjjadi

doi:10.18502/ijpa.v20i2.19023

Fattaneh Mikaeili Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Sharif Maraghi Department of Parasitology and Mycology, School of Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
Eshrat Beigom Kia Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Sadat Sadjjadi Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
Mehdi Karamian Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Seyed Shahram Shekarforoush Department of Food Hygiene and Public Health, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
Majid Fasihi Harandi Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Seyed Mahmoud Sadjjadi Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

DOI: https://doi.org/10.18502/ijpa.v20i2.19023

Keywords: Cerebral cystic echinococcosis; Cerebral coenurosis; Morphometry; Molecular; NADH dehydrogenase 1 gene

Abstract

Background: Cerebral cystic echinococcosis (CCE) and coenurosis are zoonotic diseases caused by the larval stages of Echinococcus granulosus sensu lato (s.l.) and Taenia spp., respectively. Due to the similarity between the symptoms and clinical samples of CCE and cerebral coenurosis, especially in cases with no protoscoleces, the diagnostic methods for the differentiation of CCE from cerebral coenurosis are crucial, especially in countries where both diseases are endemic. To compare CCE and coenurosis, morphometric indices of protoscoleces and molecular methods were used in the present study.

Methods: In this regard, four isolates of human cerebral echinococcal cysts, three isolates of Coenurus cerebralis from sheep, and one non-cerebral Coenurus from sheep muscles were evaluated. The isolated specimens have been collected from Shiraz, Ahvaz, Tehran and Kerman from before 2000 to 2022. The molecular characterization was carried out using the partial NADH dehydrogenase1 (nad1) gene. Phylogenetic analysis was performed using the maximum likelihood method.

Results: In fertile cysts, the total size of the large and small hooks of Coenurus was larger than cerebral echinococcal cyst. These parameters demonstrated significant morphological differences between the C. cerebralis and the cerebral echinococcal cyst. Molecular methods identified the cerebral echinococcal cysts as E. canadensis (G6) genotype. One C. cerebralis and the non-cerebral Coenurus were identified as Taenia multiceps and T. multiceps gaigeri, respectively.

Conclusion: Morphometric indices are significantly different between protoscoleces of C. cerebralis and cerebral echinococcal cysts. Hence, they could be used for differential diagnosis of the fertile cysts of these cestodes. However, in cases with no protoscoleces, molecular methods are essential for the differentiation of CCE from cerebral coenurosis, especially in regions where both diseases are prevalent and endemic.