2. ECHINOCOCCOSIS
Is a parasitic disease caused by tapeworms of the
genus Echinococcus
Cystic hydatid disease → Echinococcus granulosus
Alveolar hydatid disease → Echinococcus multilocularis
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3. Transmission
Humans are infected through ingestion of parasite eggs in
contaminated food, water or soil, or through direct contact
with animal hosts.
The larvae hatch, penetrate the gut, and are carried by the
vascular or lymphatic systems to the liver, lungs, and less
commonly bones, brain, or heart.
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5. CLINICAL MANIFESTATIONS
Asymptomatic, or regress spontaneously
Symptoms (non specific)
Abdomen → abdominal pain , vomiting, a palpable mass,
increased abdominal girth.
Liver→ hepatomegaly, obstructive jaundice and hepatic
failure.
Lung → chest pain, cough, or hemoptysis.
Mass effects can be noted in the brain and bone.
Anaphylaxis can occur with cyst rupture from trauma or
intraoperatively
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6. DIAGNOSIS
Symptoms and signs are usually nonspecific
Ultrasonography
Chest radiograph
CT or MRI
Serologic studies
Biopsy
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8. TREATMENT
For CE1 and CE3 small cystic lesions that are <5 cm in
diameter, albendazole chemotherapy alone (15 mg/kg/day
divided bid PO for 1-6 mo; maximum: 800 mg/day) may result
in a high rate of cure.
For larger CE1 and CE3 lesions, ultrasound- or CT-guided
PAIR (percutaneous aspiration, instillation, and reaspiration)
along with prophylactic chemotherapy.
CE2 management is with surgery.
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Open Types
9. TREATMENT cont’d.
CE4 and CE5 cysts are in the process of degeneration and
usually do not require specific therapy. They can be
managed with serial imaging studies to document resolution
(watch and wait).
Small thoracic cysts may resolve with chemotherapy, but
most cysts require operative removal.
Surgery is the treatment of choice for complicated cysts,
including ruptured cysts, cysts communicating with the biliary
tract, large pulmonary cysts, or cysts of the central nervous
system or bones.
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10. TREATMENT cont’d.
Alveolar hydatidosis frequently requires radical surgery,
including partial hepatectomy, lobectomy, or liver
transplantation. Medical therapy with albendazole should be
continued for 2 yr after presumably curative surgery. In
patients who are not operative candidates or whose lesions
are not amenable to surgical cure, albendazole long-term
suppressive therapy should be used to slow the progression,
but the infection generally recurs if albendazole is stopped.
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11. LARGEST DISCOVERY!!
The Largest hydatid cyst contained 37 litres of fluid!! and
was removed from 80 year old Abdullah Bakhet Al Hagawe by
Dr. Abdul Rahman Arishi and Dr. Mohammad Shahid Hussain
Khan, at the King Fahd Central Hospital in Jizan, Saudi Arabia,
on 12 January 2005. The main cysts had multiple daughter
cysts attached and was found in his abdomen.
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12. REFERENCES
Nelson textbook of pediatrics, 20th edition, 1753ff, Chapter
304, 2016.
http://emedicine.medscape.com/article/178648-overview
http://www.who.int/mediacentre/factsheets/fs377/en/
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