Echinococcus: Difference between revisions
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Echinococcus
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| + | ==Background== |
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| + | * [[Cestode]] |
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| − | == Definition == |
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| + | === Microbiology === |
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| − | * Parasitic disease caused by infection with the echinococcus tapeworm |
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| + | *[[Echinococcus granulosus]] ''sensu stricto'' (G1 to G3), the major cause of [[cystic echinococcosis]] |
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| + | * [[Echinococcus vogeli]], causes polycystic echinococcosis |
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| + | * [[Echinococcus oligarthrus]], extremely rare cause of human echinococcosis |
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| + | * ''Echinococcus felidis'' |
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| + | * ''Echinococcus shiquicus'' |
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| + | === Epidemiology === |
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| + | {| class="wikitable" |
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| + | !Intermediate Hosts |
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| + | !Definitive Hosts |
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| + | !Distribution |
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| + | !Risk Factors |
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| + | |- |
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| + | |[[Echinococcus granulosus]] |
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| + | |sheep, cattle, pigs, camels, and goats |
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| + | |dogs and other canids |
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| + | |worldwide, with highest prevalence in Mediterranean, Russia, China, central Asia, north and east Africa, Australia, and South America |
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| + | |shepherds, exposure to feral dogs, slaughterhouse, unsanitary living conditions |
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| + | |- |
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| + | |[[Echinococcus multilocularis]] |
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| + | |rodents, domestic pigs, wild boars, dogs, monkeys |
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| + | |foxes, dogs, cars |
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| + | |mostly described in Europe and Asia, rare in North America |
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| + | | |
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| + | |- |
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| + | |[[Echinococcus vogeli]] |
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| + | |rodents |
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| + | |bush dogs |
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| + | |Central and South America |
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| + | | |
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| + | |- |
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| + | |[[Echinococcus oligarthus]] |
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| + | | |
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| + | | |
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| + | |Central and South America |
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| + | |} |
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| − | == |
+ | == Clinical Manifestations == |
| + | * Any many present asymptomatically |
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| − | * Exposure to sheep |
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| + | * Rarely present with [[anaphylaxis]] from cyst rupture |
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| − | * Exposure to dogs fed home-slaughtered animals |
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| − | == |
+ | === Cystic Echinococcus === |
| + | * Liver is the most common site (60%), followed by lung (20-30%) |
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| − | * Hydatid cysts with surrounding daughter cysts |
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| + | * Can infect other sites including brain (10%) |
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| − | ** Liver most common |
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| + | * Can cause anaphylaxis when ruptures |
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| − | ** Lung second-most common |
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| + | * Can cause cholangitis |
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| − | === Alveolar |
+ | === Alveolar Echinococcus === |
| − | * Presents as |
+ | * Presents as liver cancer or metastases of unknown primary |
| + | *Liver involvement is present in 95% of cases |
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| − | * May also mimic hepatic carcinoma, cirrhosis, and tuberculosis |
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| − | * Main treatment is surgical resection followed by at least 2 years of antihelminthic therapy |
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| + | == Diagnosis == |
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| − | * Poor prognosis, with 90% 10-year mortality if untreated |
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| + | |||
| + | * Generally made with ultrasound, possibly with MRI |
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| + | * Serology can be helpful, but not necessarily that sensitive or specific |
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| + | * Aspiration may be considered, but there is a risk of allergic reaction and a risk of secondary recurrence from leakages of hydatid fluid or protoscolices |
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| + | {{DISPLAYTITLE:''Echinococcus''}} |
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| + | [[Category:Cestodes]] |
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Latest revision as of 12:20, 4 May 2022
Background
Microbiology
- Echinococcus granulosus sensu stricto (G1 to G3), the major cause of cystic echinococcosis
- Echinococcus equinus (G4)
- Echinococcus ortleppi (G5)
- Echinococcus canadensis (G6 to G10)
- Echinococcus multilocularis, the major cause of alveolar echinococcosis
- Echinococcus vogeli, causes polycystic echinococcosis
- Echinococcus oligarthrus, extremely rare cause of human echinococcosis
- Echinococcus felidis
- Echinococcus shiquicus
Epidemiology
| Species | Intermediate Hosts | Definitive Hosts | Distribution | Risk Factors |
|---|---|---|---|---|
| Echinococcus granulosus | sheep, cattle, pigs, camels, and goats | dogs and other canids | worldwide, with highest prevalence in Mediterranean, Russia, China, central Asia, north and east Africa, Australia, and South America | shepherds, exposure to feral dogs, slaughterhouse, unsanitary living conditions |
| Echinococcus multilocularis | rodents, domestic pigs, wild boars, dogs, monkeys | foxes, dogs, cars | mostly described in Europe and Asia, rare in North America | |
| Echinococcus vogeli | rodents | bush dogs | Central and South America | |
| Echinococcus oligarthus | Central and South America |
Clinical Manifestations
- Any many present asymptomatically
- Rarely present with anaphylaxis from cyst rupture
Cystic Echinococcus
- Liver is the most common site (60%), followed by lung (20-30%)
- Can infect other sites including brain (10%)
- Can cause anaphylaxis when ruptures
- Can cause cholangitis
Alveolar Echinococcus
- Presents as liver cancer or metastases of unknown primary
- Liver involvement is present in 95% of cases
Diagnosis
- Generally made with ultrasound, possibly with MRI
- Serology can be helpful, but not necessarily that sensitive or specific
- Aspiration may be considered, but there is a risk of allergic reaction and a risk of secondary recurrence from leakages of hydatid fluid or protoscolices
