echinococcosis (hydatid disease)
Jump to navigation
Jump to search
Etiology
Epidemiology
- distribution is species dependent
- definitive hosts are dogs that pass eggs in their feces
- humans are intermediate hosts
- infection acquired after ingestion of eggs
- when dog ingests beef, lamb, rodent etc containing cysts, the life cycle is complete
Pathology
- larvae produces expanding cysts, esp. liver &/or lungs
- cysts (hydatid cysts) may involve any organ
- bone (invasion of medulla; pathologic fractures)
- central nervous system (space-occupying lesions)
- heart (conduction defects; pericarditis)
- liver
Clinical manifestations
- depends upon size & location of cysts & amount of tissue destruction
- often 5-20 years elapses before cysts are of sufficient size to cause symptoms
- anaphylaxis may result from rupture of cyst fluid into pleural or peritoneal cavities
- compression of a bile duct or leakage of cysts fluid into the biliary tree may mimic recurrent cholelithiasis
- abdominal pain or right upper quadrant palpable mass may occur with hepatic echinococcosis
- fever, pruritus or urticaria may occur with leakage or rupture of cysts
Laboratory
- eosinophilia is infrequent
- skin testing (Casoni antigen)
- serology: serum Echinococcus antibody
- fine-needle aspiration of cyst fluid
- presence of scoliceal hooklets
- NOT routinely recommended; risk of fluid leakage
- dissemination of infection
- anaphlaxis
- see ARUP consult[3]
Radiology
- demonstration of cysts
Management
- surgical excision, when feasible
- definitive treatment
- risks of dissemination of infection &/or anaphlaxis
- minimize risk with hypertonic saline or ethanol
- albendazole
- in conjunction with surgery
- as medical management
- 400 mg BID for 28 days, repeated up to 8 times, separated by drug-free intervals of 2-3 weeks
- prophylaxis
- praziquantel treatment of infected dogs
- denying dogs access to butchering sites or scraps from infected animals
More general terms
Additional terms
- Echinococcus antibody in serum
- Echinococcus granulosus
- Echinococcus multilocularis
- Echinococcus vogeli
- hydatid cyst; echinococcal cyst
References
- ↑ DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 932
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 932
- ↑ 3.0 3.1 ARUP Consult: Echinococcus Species - Echinococcus The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/echinococcus-species
- ↑ Murali MR, Uyeda JW, Tingpej B. Case records of the Massachusetts General Hospital. Case 2-2015. A 25-year-old man with abdominal pain, syncope, and hypotension. N Engl J Med. 2015 Jan 15;372(3):265-73 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25587951 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1410939