Infectious Disease Book

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EchinococcosisAka: Echinococcus granulosis, Echinococcus, Hydatid Disease

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  1. See Also
    1. Alveolar Hydatid Disease
  2. Epidemiology
    1. Endemic worldwide in sheep raising areas
      1. Mediterranean
      2. Prior Soviet Union block nations
      3. Australia
      4. South America
      5. Africa
    2. U.S. sources
      1. Immigrants to North America
      2. Western U.S. sheep farmers
      3. Southwestern Native Americans
      4. Native Inuits in Alaska and Canada (Caribou, wolves)
      5. Some cases along Mississippi
  3. Etiology
    1. Echinococcus granulosis
  4. Pathophysiology
    1. Infection with the Tapeworm Echinococcus larvae
      1. Produces expanding cysts (grow at 1-5 cm per year)
    2. Sites of involvement
      1. Liver (most common)
      2. Lung (second most common)
      3. Kidney
      4. Muscle
      5. Spleen
      6. Brain
      7. Bone
    3. Transmission
      1. Definitive Host: Dogs and other carnivores
      2. Intermediate host: Human, Sheep, Cattle
      3. Infections in Human by ingestion of ova
  5. Symptoms
    1. Asymptomatic in 60% of cases (for 10-20 years)
    2. Cough
    3. Abdominal mass
    4. Hemoptysis
    5. Chest Pain
  6. Complications
    1. Cyst rupture
      1. Anaphylactic reaction
      2. Pyopneumothorax
      3. Mediastinal Erosion
  7. Labs
    1. Complete Blood Count
      1. Eosinophilia may be present
    2. Skin test
      1. Casoni's Antigen
    3. Echinococcus serologic titer
      1. Test Sensitivity: 50% of lung infections
      2. EITB has highest sensitivity and Specificity
    4. Fine needle aspiration of cyst
      1. Tapeworm parts and Eosinophilic granules
  8. Radiology
    1. Abdominal ultrasound or CT: Liver or kidney cysts
    2. Chest XRay: Lung cysts
      1. Size: 1-10 cm in diameter
      2. Lower lobes and right side more commonly involved
      3. Consider CT Chest or MRI Chest
  9. Management
    1. Surgical excision of cysts
    2. Anti-Helminth agents (used concurrently with surgery)
      1. Albendazole (Albenza)
      2. Mebendazole (Vermox)
  10. Prevention: Education program in endemic areas
    1. Carefully wash fruits and vegetables before ingestion
    2. Avoid water potentially contaminated by dog feces
    3. Hand washing after soil exposure
    4. Treat dogs frequently with worming formulations
    5. Avoid feeding dogs the entrails of livestock
  11. Prognosis
    1. Mortality as high as 4-5% in untreated patients
  12. References
    1. Chrieki (2002) Am Fam Physician 66(5):817

Echinococcosis (C0013502)

Definition (MSH)An infection caused by the infestation of the larval form of tapeworms of the genus Echinococcus. The liver, lungs, and kidney are the most common areas of infestation.
ConceptsDisease or Syndrome (T047)
ICD9122
EnglishEchinococciasis, Echinococcoses, Echinococcosis, Echinococcus disease, Hydatid Cyst, Hydatid Cysts, Hydatid disease, Hydatidoses, Hydatidosis
Spanishenfermedad hidatídica, enfermedad hidatidica, equinococosis, hidatidosis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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