Echinococcosis or Hydatid Disease Infection Causes Signs and Symptoms Diagnosis with Treatment

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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

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

· 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

· 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

· 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.

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.

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

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 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.