Difference between revisions of "Echinococcosis"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
 
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==Clinical Features==
 
==Clinical Features==
 
*Asymptomatic for many years
 
*Asymptomatic for many years
*Abdominal cysts- pain, distension, nausea and vomiting
+
*Abdominal cysts- [[abdominal pain|pain]], distension, [[nausea/vomiting]]
*Alveolar abscess-chest pain, shortness of breath, chronic cough
+
*Alveolar abscess- [[chest pain]], [[shortness of breath]], chronic [[cough]]
*Musculoskeletal pain, blindness, headache, and stroke like symptoms if involving muscles, bones, eyes or brain
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*Musculoskeletal pain, [[vision loss|blindness]], [[headache]], and [[stroke]]-like symptoms if involving muscles, bones, eyes or brain
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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==Evaluation==
 
==Evaluation==
 
===Work-up===
 
===Work-up===
*Abdominal Ultrasound (most widely used)
+
*[[ultrasound: Abdomen|Abdominal ultrasound]] (most widely used)
 
*CT
 
*CT
 
*MRI
 
*MRI

Latest revision as of 00:47, 2 October 2019

Background

  • 2 most important forms are cystic and alveolar caused by E. granulosus and E. multilocularis
  • Humans are accidental immediate hosts by ingesting parasitic eggs from contaminated food, soil, water, or direct contact with definitive hosts
  • Usual intermediate hosts-sheep, goat, swine, cattle, rodents and camel
  • Definitive hosts-dogs, cats, fox, and wolves
  • Ingested eggs then hatch, penetrate intestinal mucosa, and spread hematogenously to final destination to form cysts

Clinical Features

Differential Diagnosis

Hepatic abscess

Evaluation

Work-up

  • Abdominal ultrasound (most widely used)
  • CT
  • MRI
  • ELISA-sensitivity inversely related to antigen sequestration in cysts
  • Percutaneous aspiration

Management

  • Tissue stage/hydatid disease: albendazole 400mg BID x 28 days, repeat as needed every 2 weeks x 3 cycles
  • Surgical removal
    • Do not aspirate cysts (risk of seeding disease or anaphylactoid reaction from spillage of hydatid sand which contains antigenic proteins)
    • PAIR (Percutaneous aspiration, injection, reaspiration)
      • Inject with 95% ethanol or hypertonic saline, leave in for 15 minutes, then reaspirate

Disposition

  • Discharge (if no significant clinical complications)

See Also

References