First human infection and management of Versteria rafei infection restricted to the liver with phylogenetic analysis in the context of known cases.

A recently described cestode genus, Versteria, has been implicated in disseminated human disease in North America. We report the first known case of infection with a recently reported species, Versteria rafei, localised to the liver with attempted surgical resection. Through review of other patients known to be infected with this parasite, we established that this is a rare zoonotic infection involving contact with minks and mustelids. Although Versteria belongs to the same family as Echinococcus, there are several important differences. Known Versteria infections in humans typically are symptomatic, quickly involve multiple organs without treatment, and occur in immunosuppressed hosts. Furthermore, albendazole appears to be at least parasitostatic, with a reduction but not a resolution of the lesions under treatment and development of calcifications analogous to changes seen with treatment for alveolar echinococcosis.