# Alveolar Echinococcosis in the Early 2020s: A Systematic Review

## TL;DR

This review summarizes recent findings on alveolar echinococcosis, a hard-to-diagnose parasitic disease, highlighting challenges in detection and treatment.

## Contribution

The paper provides a comprehensive overview of AE research from 2020 to 2025, emphasizing gaps in diagnosis and treatment.

## Key findings

- AE is associated with atypical infection sites and complications.
- Epidemiological data varies significantly between endemic and non-endemic regions.
- Current diagnostic and treatment options remain limited and face challenges like delayed diagnosis.

## Abstract

Background: Alveolar echinococcosis (AE) is a neglected parasitic disease caused by Echinococcus multilocularis that is difficult to diagnose and treat. Methods: This systematic review has gathered articles presenting original data from the past 5 years, from January 2020 to December 2025, with epidemiological data (incidence, prevalence), treatment options, case reports, and other findings relevant to the prevention and control of this disease, representing the inclusion criteria of this study. Three medical databases were searched for the study: PubMed, Web of Science, and ScienceDirect. To improve our understanding of the available data, no spatial or temporal restrictions were imposed on the study’s duration or follow-up period. Results: A total of 248 articles are included in this review, which describe atypical sites and complications owing to Echinococcus multilocularis infection, the heterogeneity of epidemiological studies in different endemic and non-endemic regions, diagnosis techniques based on imaging, histopathology, and molecular techniques, as well as surgical and non-surgical treatment options (and lack thereof regarding the latter). Conclusions: Although advances have been made in the diagnosis, management, and treatment of AE, challenges remain, particularly with regard to misdiagnosis, delayed diagnosis, and limited antiparasitic therapy.