ECHINOCOCCOSIS OR HYDATID DISEASE

Infection in humans is caused by larva of Echinococ­cus granulosus. The definitive hosts are dogs.

ECHINOCOCCOSIS OR HYDATID DISEASE Infection in humans

• Eggs’are passed in the faeces of dogs.
• Cysts develop in man after ingestion of eggs.

HYDATID DISEASE Infection in humans is caused by larva of Echinococ­cus granulosus

Etiology OF ECHINOCOCCOSIS OR HYDATID DISEASE:

• · After man eats the eggs, the embryos / larva penetrate the intestine, enter the portal circula­tion and go to the liver and lungs. The larvas develop into hydatid cysts.
• · Daughter cysts develop inside the hydatid cysts.
• New larvas also develop in brood capsules which are cystic structures inside the hydatid cysts.
• · The cysts increase in size and may even rup­ture.

Echinococcosis or Hydatid Disease LIFE CYCLE

Clinical features OF ECHINOCOCCOSIS OR HYDATID DISEASE:

• · Echinococcal cysts enlarge and give rise to symp­toms in the involved organ.
• · The liver and lungs are commonly involved.
• · Cysts may be accidentally detected on x-ray or ultrasound.
• · There is abdominal pain or palpable mass in the region of liver.
• · There may be compression of bile duct, biliary obstruction, jaundice.
• · Rupture or leak of cyst produces fever, itching, urticaria, eosinophilia and even anaphylaxis.
• · Pulmonary hydatid cysts may rupture into bron­chial tree or peritoneal cavity.
• · There may be cough, chest pain, hemoptysis.
• · Cysts may also be present in bone, CNS, heart, pelvis.
• · The cysts may metastasize to spleen, lungs and brain.

Echinococcosis or Hydatid Disease CYSTS

Diagnosis OF ECHINOCOCCOSIS OR HYDATID DISEASE:

• · Cysts may be seen in X-ray, ultrasound, MRI, CT scans.
• · Well-defined cysts with thick and thin walls like egg shell or thick lines may be seen on CT or uItrasou nd.
• · Aspirated fluid from cysts may show scolices and hooklets.
• · Serodiagnostic assay – Specific echinococcal antigens by immunoblot is a highly specific test.

Treatment OF ECHINOCOCCOSIS OR HYDATID DISEASE:

• potential treatment modalities, including, laparoscopic techniques, the PAIR (Percutaneous Aspiration, Introduction of a protoscolicidal agent and Reaspiration) procedure,
•  and chemotherapy, which in certain cases, renders open techniques unnecessary
• Surgery should be done with care as the rupture of cysts can cause anaphylaxis.
• PAIR treatment (Percutaneous Aspiration, Infu­sion of drugs – scolicidal agents, Reaspiration) for cysts with multiple septa and cysts in the biliary tree.
• Albendazole 15 mg/kg/day in two divided doses 4 days before and 4 days after PAIR.
• Praziquantel – 50 mg/kg/day for 2 weeks. Albendazole for 3-6 months with or without PAIR.

Prevention ECHINOCOCCOSIS OR HYDATID DISEASE :

• · Proper hygiene
• · Praziquantel to dogs to reduce infection.

HYMENOLEPIASIS NANA

HYMENOLEPIASIS NANA

HYMENOLEPIASIS NANA LIFE CYCLE

• It is due to a tapeworm, common in children. It does not require an intermediate host. Usually asymptomatic.
• Anorexia, pain in abdomen and diarrhea occurs.

Treatment OF HYMENOLEPIASIS NANA:

• Praziquantel – 25 mg/kg single dose.