Echinococcosis
What is it?
Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinocococcus. The two most important forms in humans are cystic echinococcosis (hydatidosis) and alveolar echinococcosis. Humans are infected through ingestion of parasite eggs in contaminated food, water or soil, or after direct contact with animal hosts.
Additional names
This group contains additional names:
- Hepatic Alveolar Echinococcosis
Signs & symptoms
Persons with cystic echinococcosis often remain asymptomatic until the cysts grow large enough to cause discomfort, pain, nausea, and vomiting. The cysts grow over the course of several years before reaching maturity and the rate at which symptoms appear typically depends on the location of the cyst. The cysts are mainly found in the liver and lungs but can also appear in the spleen, kidneys, heart, bone, and central nervous system, including the brain and eyes. Cyst rupture is most frequently caused by trauma and may cause mild to severe allergic reaction as a result of the release of cystic fluid.
Alveolar echinococcosis (AE) is characterized by parasitic tumors in the liver and may spread to other organs including the lungs and brain. This is not a cyst but it can cause vesicles that invade and destroy surrounding tissues and cause discomfort or pain, weight loss, and malaise.
Diagnosis
Ultrasonography imaging is the technique of choice for the diagnosis of both cystic echinococcosis and alveolar echinococcosis in humans. This technique is usually validated by computed tomography (CT) and/or magnetic resonance imaging (MRI) scans. After a cyst has been detected, serologic tests may be used to confirm the diagnosis. Indirect hemagglutination test and enzyme-linked immunosorbent assay are the most widely used methods for detection of anti-Echinococcus antibodies (immunoglobulin G - IgG).
Treatment
Both cystic echinococcosis and alveolar echinococcosis are complicated to treat, and sometimes require extensive surgery and/or prolonged drug therapy. There are 4 options for the treatment of cystic echinococcosis:
- Percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique
- Surgery
- Anti-infective drug treatment - Albendazole/Praziquantel
- Watch and wait.
The choice must primarily be based on the ultrasound images of the cyst, following a stage-specific approach. For alveolar echinococcosis, early diagnosis and radical (tumour-like) surgery followed by anti-infective prophylaxis with albendazole remain the key elements.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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