Echinococcosis

Echinococcosis is a parasitic disease caused by infection with the larval stage of the Echinococcus tapeworm, most commonly Echinococcus granulosus or Echinococcus multilocularis. The disease is characterized by the formation of hydatid cysts in various organs, primarily the liver and lungs, which can lead to severe complications and may require surgical intervention.

Echinococcosis has a global distribution but is more common in regions where livestock farming is prevalent, and sanitary conditions are poor. Countries in the Mediterranean, the Middle East, South America, and Eastern Europe have higher incidence rates. Humans typically become infected by contact with dogs carrying the parasite’s eggs in their feces or by consuming contaminated food and water.

The pathophysiology of echinococcosis involves human ingestion of Echinococcus eggs. The eggs hatch in the intestine, and the larvae migrate through the bloodstream to various organs, developing into hydatid cysts. These cysts contain many larvae and can grow significantly over time, causing pressure on adjacent organs and tissues.

The causes of echinococcosis include ingestion of Echinococcus eggs from contaminated food or water or contact with infected animals, usually dogs. Poor hygiene conditions and lack of education about hygiene practices are major risk factors.

The symptoms of echinococcosis depend on the location and size of the cysts. In the liver, patients may experience abdominal pain, hepatomegaly, and jaundice. Alveolar echinococcosis symptoms can include cough, shortness of breath, and chest pain. In advanced cases, cysts can rupture, leading to allergic reactions, anaphylaxis, or bacterial superinfection.

The differential diagnosis of echinococcosis includes other diseases that can cause organ cysts or tumors, such as hepatic amoebiasis, parasitic infections, and neoplasms. Diagnosis is based on clinical presentation, imaging studies, and laboratory tests.

Complications of echinococcosis include cyst rupture, which can cause anaphylactic shock, bacterial superinfection, and fistula formation. Large cysts can also cause functional impairments in the affected organs.

Treatment of echinococcosis includes surgical removal of the cysts when feasible and pharmacological treatment with anthelmintic drugs such as albendazole. Surgery is preferred when cysts are accessible, and the patient's condition permits it. When surgical removal is not possible, medication is used to reduce cyst size and control symptoms.

Laboratory tests are crucial for diagnosing and monitoring echinococcosis. Diagnosis typically involves detecting antibodies against Echinococcus in the blood. Tests include enzyme-linked immunosorbent assay (ELISA) and indirect hemagglutination assay (IHA), which are sensitive and specific for detecting infection. Imaging studies, such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), are also crucial for locating and assessing cysts.

• Echinococcus sp., Antibodies IgG
• Echinococcus, Serological Testing (E. granulosus & E. multilocularis)
• Echinococcus, Confirmatory Antibodies by Western Blot
• Echinococcus granulosous, Molecular Testing

Monitoring treatment involves periodic evaluation with imaging studies to assess the progress of cysts and the response to pharmacological therapy. Monitoring antibody levels can also evaluate treatment response and detect any recurrence.

This article belongs to a new series on our blog that covers all fields of health! We present information on the most frequent pathological conditions in a comprehensive, clear, understandable, but always scientifically documented way so you can know and protect the most crucial good: your health!

Ioannis Sideris, Medical Doctor