Echinococcus multilocularis
From IDWiki
Background
Microbiology
- Cestode in the Echinococcus family
- Disease is caused by the larval form
Life Cycle
- Definitive hosts are canid carnivorous animals
- Eggs contaminate the environment, including produce
- They are infective after a few days, and are viable for up to 16 months at 4ºC
- Intermediate hosts (metacestode) are rodents, possibly pigs, and and incidentally humans
- Intermediate host is eaten by the definitive host, completing the life cycle
Clinical Manifestations
- Causes alveolar echinococcosis
- Incubation period 5 to 15 years
- Vague abdominal pain may precede diagnosis by years
- Presents as a metastatic malignancy of unknown primary, mot commonly with malaise, weight loss, and right upper quadrant discomfort
- May also mimic hepatocellular carcinoma, cirrhosis, and tuberculosis
- Causes continuously-growing tumour-like polycystic mass, made up of multiple vesicles that are lined by laminated germinal layer
- Can cause cholestatic jaundrice, cholangitis, portal hypertension, and Budd-Chiari syndrome
Diagnosis
- Combination of radiologic and serologic investigations
- May be confirmed by biopsy
Management
- Main treatment is surgical resection followed by at least 2 years of antihelminthic therapy (e.g. albendazole)
- Poor prognosis, with 90% 10-year mortality if untreated
