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Echinococcosis
Hydatidosis; Hydatid disease, Hydatid cyst disease; Alveolar cyst disease
Echinococcosis is an infection caused by either the Echinococcus granulosus or Echinococcus multilocularis tapeworm. The infection is also called hydatid disease.
Causes
Humans become infected when they swallow the tapeworm eggs in contaminated food. The eggs then form cysts inside the body. A cyst is a closed pocket or pouch. The cysts keep growing, which leads to symptoms.
E granulosus is an infection caused by tapeworms found in dogs, and livestock such as sheep, pigs, goats, and cattle. These tapeworms are around 2 to 7 mm long. The infection is called cystic echinococcosis (CE). It leads to growth of cysts mainly in the lungs and liver. Cysts can also be found in the heart, bones, and brain.
E multilocularis is the infection caused by tapeworms found in dogs, cats, rodents, and foxes. These tapeworms are around 1 to 4 mm long. The infection is called alveolar echinococcosis (AE). It is a life-threatening condition because tumor-like growths form in the liver. Other organs, such as the lungs and brain can be affected.
Children or young adults are more prone to get the infection.
Echinococcosis is common in:
- Africa
- Central Asia
- Southern South America
- The Mediterranean
- The Middle East
In rare cases, the infection is seen in the United States. It has been reported in California, Arizona, New Mexico, and Utah.
Risk factors include being exposed to:
- Cattle
- Deer
- Feces of dogs, foxes, wolves, or coyotes
- Pigs
- Sheep
- Camels
Symptoms
Cysts may produce no symptoms for 10 years or more.
As the disease advances and the cysts get larger, symptoms may include:
- Pain in the upper right part of the abdomen (liver cyst)
- Increase in size of the abdomen due to swelling (liver cyst)
-
Bloody sputum
(lung cyst)
Bloody sputum
Coughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract). Hemoptysis is the medical term for cough...
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Chest pain
(lung cyst)
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
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Cough
(lung cyst)
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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Severe allergic reaction (
anaphylaxis
) when cysts break open
Anaphylaxis
Anaphylaxis is a life-threatening type of allergic reaction.
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Exams and Tests
The health care provider will perform a physical exam and ask about the symptoms.
Physical exam
During a physical examination, a health care provider studies your body to determine if you do or do not have a physical problem. A physical examinat...
If the provider suspects CE or AE, tests that may be done to find the cysts include:
- X-ray, CT scan, or ultrasound to view the cysts
-
Blood tests, such as enzyme-linked immunoassay (
ELISA
),
liver function tests
ELISA
ELISA stands for enzyme-linked immunoassay. It is a commonly used laboratory test to detect antibodies in the blood. An antibody is a protein produ...
ImageRead Article Now Book Mark ArticleLiver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsin Alkaline phosph...
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Most often, echinococcosis cysts are found when an imaging test is done for another reason.
Treatment
Many people can be treated with anti-worm medicines.
A procedure that involves inserting a needle through the skin into the cyst may be tried. The contents of the cyst is removed ( aspirated ) through the needle. Then medicine is sent through the needle to kill the tapeworm.
Aspirated
Aspiration means to draw in or out using a sucking motion. It has two meanings:Breathing in a foreign object (sucking food into the airway). A medic...
The cysts may be removed with surgery, if possible. But this can be a complicated surgery.
Outlook (Prognosis)
If the cysts respond to oral medicines, the likely outcome is good.
When to Contact a Medical Professional
Call your provider if you develop symptoms of this disorder.
Prevention
Measures to prevent CE and AE include:
- Staying away from wild animals including foxes, wolves, and coyotes
- Avoiding contact with stray dogs
- Washing hands well after touching pet dogs or cats, and before handling food
References
Fischer PR, Cabada MM, White AC. Echinococcosis ( Echinococcus granulosus and Echinococcus multilocularis ). In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 304.
King CH, Fairley JK. Tapeworms (Cestodes). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 291.
Parasites-echinococcosis. Centers of Disease Control and Prevention Web site. Updated December 12, 2012. www.cdc.gov/parasites/echinococcosis/treatment.html . Accessed October 06, 2016.
White AC, Fischer PR, Legua P. Cestodes. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 226.
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Liver echinococcus - CT scan - illustration
This upper abdominal CT scan shows multiple cysts in the liver, caused by dog tapeworm (echinococcus). Note the large circular cyst (seen on the left side of the screen) and multiple smaller cysts throughout the liver.
Liver echinococcus - CT scan
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Liver echinococcus - CT scan - illustration
This upper abdominal CT scan shows multiple cysts in the liver, caused by dog tapeworm (echinococcus). Note the large circular cyst (seen on the left side of the screen) and multiple smaller cysts throughout the liver.
Liver echinococcus - CT scan
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 8/31/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
