The echinococcosis is a zoonosis whose etiological agents are nematodes of the genus Echinococcus. There are five species of Echinococcus, two of them, E. oligarthrus (Diesing, 1863) and E. vogeli (Rausch & Bernstein, 1972) only occur in neotropical areas. The echinococcosis by E. vogeli causes multiple hydatid cysts, mainly in the liver of intermediate hosts, of which one is the human being. The lack of knowledge about the disease makes the diagnosis is delayed or even misleading. The lack of systematic information on treatment is also difficult to assess
the results and prognosis of patients with peritoneal and hepatic lesions caused by E. vogeli. Here we describe the clinical features of patients, we propose
a radiological classification protocol used in the classification of alveolar echinococcosis (E. multilocularis "PNM" Classification, Kern et al., 2006), which was also suitable for polycystic echinococcosis (E. vogeli) and describe a therapeutic option for the treatment of hydatid disease which previously had only been used for cases of cystic echinococcosis (E. granulosus, PAIR-Puncture, Aspiration, Injection, Reaspiration, Brunnetti et al., 2001). A prospective cohort study was initiated in 1999 and by 2009 included 60 patients. We describe the main symptoms and signs: pain in upper abdomen (65%) and hepatomegaly (60%) and patients were classified according to the "PNM" classification and submitted to three therapeutic modalities: (i) chemotherapy with albendazole at a dose of 10mg/kg/day, (ii) surgical removal of cysts or (iii) percutaneous puncture of the
cysts- PAIR. After exclusion of two cases, due to inadequacy of the research protocol, the groups were distributed as follows: treatment with albendazole: n = 28 (48.3%, 28/58), surgical therapy: n = 25 (52.1%; 25/58) and PAIR: n = 5 (8.1%, 5 / 58). The results were stratified according to outcome of therapy: "Cure", represented by the disappearance of lesions after clinical or surgical treatment, "clinical improvement", defined as asymptomatic patients without weight loss and physiological functions preserved, "No Improvement" included patients who remained
symptomatic, "Death" and "No Information", the monitoring did not allow a conclusion about the outcome. The three treatment groups together demonstrade lethality rate of 15.5% (9 / 58), "no improvement" 1.7% (1 / 58), "clinical improvement"
in 40.0% (23/58) and "cure "in 32.8% (19/58). Regarding the outcome "death", there was no difference between therapies with albendazole or surgical treatment with 4 (14.2%) and 3 (12%) deaths respectively, but in the first group, albendazole, the outcome "cure" was 4.3% (1 / 23) and "clinical improvement" 74.0% (17/23), whereas in the "surgery" to "cure" represented 71.0% (17/24) and "clinical improvement" 16.7 (4 / 24). Therapy "PAIR" was associated with a lethality
rate of 40% (2 / 5), cure in 20% (fifth) and clinical improvement in 40% (2 / 5). The "PNM" classification was useful to indicate such therapy in cases of polycystic hydatid disease. In conclusion, in the series studied surgical therapy has better results in the clinical therapy on the outcomes "cure" and "clinical improvement". The treatment for PAIR needs further studies.
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