ECHINOCOCCOSIS OR HYDATID DISEASE

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

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ECHINOCOCCOSIS OR HYDATID DISEASE Infection in humans
  • Eggs’are passed in the faeces of dogs.
  • Cysts develop in man after ingestion of eggs.
ECHINOCOCCOSIS OR HYDATID DISEASE jvg
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.
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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 j
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.
Contraindications —
  • Patients at the extremes of age
  • Pregnant women
  • According to the World Health Organization (WHO) recommendations, surgery is contraindicated in:
  • Patients whose general condition is very poor
  • Patients with multiple cysts or cysts that are difficult to access Patients with dead or totally calcified cysts
Prevention ECHINOCOCCOSIS OR HYDATID DISEASE :
  • · Proper hygiene
  • · Praziquantel to dogs to reduce infection.

WHO recommendations state that medical therapy should be used for :

  • Multiple small liver cysts or cysts deep in liver parenchyma
  • Peritoneal cysts Patients following incomplete surgery or relapse
  • Patients with inoperable disease or those unfit for surgery
  • Patients with multiple cysts in two or more organs
  • Prevention of secondary spread of echinococcal infection following spontaneous rupture or aspiration of cysts

 

HYMENOLEPIASIS NANA

 

HYMENOLEPIASIS NANA hg
HYMENOLEPIASIS NANA
HYMENOLEPIASIS NANA u
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.

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