//fpnotebook.com/
Echinococcosis
Aka: Echinococcosis, Echinococcus granulosis, Echinococcus, Hydatid Disease
- See Also
- Alveolar Hydatid Disease
- Epidemiology
- Endemic worldwide in sheep raising areas
- Mediterranean
- Prior Soviet Union block nations
- Australia
- South America
- Africa
- U.S. sources
- Immigrants to North America
- Western U.S. sheep farmers
- Southwestern Native Americans
- Native Inuits in Alaska and Canada (Caribou, wolves)
- Some cases along Mississippi
- Etiology
- Echinococcus granulosis
- Pathophysiology
- Infection with the tapeworm Echinococcus larvae
- Produces expanding cysts (grow at 1-5 cm per year)
- Sites of involvement
- Liver (most common)
- Lung (second most common)
- Kidney
- Muscle
- Spleen
- Brain
- Bone
- Transmission
- Definitive Host: Dogs and other carnivores
- Intermediate host: Human, Sheep, Cattle
- Infections in Human by ingestion of ova
- Symptoms
- Asymptomatic in 60% of cases (for 10-20 years)
- Cough
- Abdominal mass
- Hemoptysis
- Chest Pain
- Complications
- Cyst rupture
- Anaphylactic reaction
- Pyopneumothorax
- Mediastinal erosion
- Labs
- Complete Blood Count
- Eosinophilia may be present
- Skin test
- Casoni's Antigen
- Echinococcus serologic titer
- Test Sensitivity: 50% of lung infections
- EITB has highest sensitivity and Specificity
- Fine needle aspiration of cyst
- Tapeworm parts and Eosinophilic granules
- Radiology
- Abdominal Ultrasound or CT: Liver or Kidney Cysts
- Chest XRay: Lung cysts
- Size: 1-10 cm in diameter
- Lower lobes and right side more commonly involved
- Consider CT Chest or MRI Chest
- Management
- Surgical excision of cysts
- Anti-Helminth agents (used concurrently with surgery)
- Albendazole (Albenza)
- Mebendazole (Vermox)
- Not available as of 2012
- Prevention: Education program in endemic areas
- Carefully wash fruits and vegetables before ingestion
- Avoid water potentially contaminated by dog feces
- Hand Washing after soil exposure
- Treat dogs frequently with worming formulations
- Avoid feeding dogs the entrails of livestock
- Prognosis
- Mortality as high as 4-5% in untreated patients
- References
- Chrieki (2002) Am Fam Physician 66(5):817-20 [PubMed]