Post-Chikungunya Rheumatoid Arthritis, Saint Martin

ies against Em2G11 have shown excellent properties for distinguishing between cystic and alveolar echinococcosis. Although reported to not cross-react with purified laminated layer fractions from in vitro–kept E. vogeli (10), antibodies against Em2G11 exhibited an unusual and possibly discriminatory staining pattern when applied to the E. vogeli lesion from the patient reported here. Antibodies against EM10, which has not before been used for species discrimination on tissue sections, have also shown different staining properties. Our findings suggest that there may be more undiagnosed cases of polycystic neotropical echinococcoses in immigrants from South America. In retrospect, the treatment (although aimed at E. granulosus) was successful despite the polycystic and proliferative nature of E. vogeli lesions, as indicated by an uneventful prolonged follow-up period for this patient with a well-circumscribed liver lesion. If neotropical echinococcosis had been considered before surgery (on the basis of radiologic features and the patient’s origin), the management would also have included a preoperative and prolonged course of albendazole therapy.