There are 4 options for the treatment of cystic echinococcosis:
- percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique;
- surgery
- anti-infective drug treatment
- “watch and wait”.
What is the best treatment for echinococcosis?
Treatment. Chemotherapy, cyst puncture, and PAIR (percutaneous aspiration, injection of chemicals and reaspiration) have been used to replace surgery as effective treatments for cystic echinococcosis. However, surgery remains the most effective treatment to remove the cyst and can lead to a complete cure.
How are patients with echinococcosis diagnosed?
patients with echinococcosis is the diagnosis of the infection by imaging or by other methods of direct parasite identification. Alternatively, they are classified as false positive (FP) or false negative (FN). Chapter 2 Echinococcosis in humans: clinical aspects, diagnosis and treatment WHO/OIE Manual on echinococcosis in humans and animals 69
What is the epidemiology of echinococcosis in humans and animals?
74 WHO/OIE Manual on echinococcosis in humans and animals infections of livestock (horses and pigs) do not play a role in epidemiology, as the parasite normally does not produce protoscoleces. However, such infections are indicators for environmental contamination with E. multiloculariseggs and the potential infection risk for humans.
What is the who manual on echinococcosis in humans and animals?
84 WHO/OIE Manual on echinococcosis in humans and animals Predictive values Examples of predictive values of a coproantigen ELISA for detectingE. multiloculariswith different prevalences in fox and dog populations are presented in Table 3.5. For epidemiological investigations,
What is the drug of choice for echinococcosis?
Medication Summary Albendazole and mebendazole are the only anthelmintics effective against cystic echinococcosis. Albendazole is the drug of choice against this disease because its degree of systemic absorption and penetration into hydatid cysts is superior to that of mebendazole.
What is the best treatment for hydatid disease?
Percutaneous drainage with albendazole therapy is a safe and effective alternative treatment for hydatid cysts of the liver. Radical surgery with pre- and post-operative administration of albendazole is the best treatment option for liver hydatid cysts due to low recurrence and complication rates.
What is the only treatment for hydatid cysts in humans?
Medical Care Two benzimidazolic drugs, mebendazole and albendazole, are the only anthelmintics effective against cystic echinococcosis. Albendazole and mebendazole are well tolerated but show different efficacy. Albendazole is significantly more effective than mebendazole in the treatment of liver cysts.
Can hydatid disease be treated?
Treatment for hydatid disease Surgical removal of the cysts is the most common treatment, often in combination with specific anti-parasitic drug therapy.
Which anti parasitic drug is used for hydatid cyst?
Drug therapy for echinococcosis is limited. The anthelmintic benzimidazoles, namely albendazole and mebendazole, are used for treatment and prophylaxis. Praziquantel, an isoquinoline derivative, is used as an adjunct for therapy.
Can liver cyst be cured with medication?
Liver cysts are fluid-filled sacs that appear on your liver. Nearly all liver cysts are benign (noncancerous) and don't grow large enough to cause symptoms. Healthcare providers may treat liver cysts by monitoring the cysts. They may also treat the cysts with surgery or medication.
How do you test for Echinococcus?
granulosus is endemic suggests a diagnosis of cystic echinococcosis. Imaging techniques, such as CT scans, ultrasonography, and MRIs, are used to detect cysts. After a cyst has been detected, serologic tests may be used to confirm the diagnosis. Alveolar echinococcosis is typically found in older people.
What is Scolicidal agent?
To date, many scolicidal agents including some plant extracts, mannitol, ABZ, chlorhexidine gluconate (Chx-Glu), honey, hypertonic saline, silver nitrate, cetrimide, ethyl alcohol, H2O2, and povidone-iodine have been used for inactivation of the hydatid cyst content.
How do liver cysts dissolve?
The most effective treatment for liver cysts is surgical removal. Surgeons can usually remove the cyst using a laparoscopic approach, which involves making only 2 or 3 small incisions into the abdomen. After removal, cysts are unlikely to return.
What is cysticercosis How is it treated?
Cysticercosis located outside of the nervous system usually does not require specific treatment. The treatment for cysticercosis located within the nervous system (neurocysticercosis) consists of antiparasitic therapy, corticosteroids, antiepileptic drugs, and/or surgery.
What parasite causes liver cysts?
Parasites - Echinococcosis Although most infections in humans are asymptomatic, CE causes harmful, slowly enlarging cysts in the liver, lungs, and other organs that often grow unnoticed and neglected for years.
How can you prevent echinococcosis?
Alveolar echinococcosis can be prevented by avoiding contact with wild animals such as foxes, coyotes, and dogs and their fecal matter and by limiting the interactions between dogs and rodent populations. Do not allow dogs to feed on rodents and other wild animals.
What is echinococcus caused by?
What is echinococcus? Echinococcus is an infection caused by a parasitic tapeworm from the Echinococcus genus. A few different types of tapeworms can cause echinococcus in humans, including: E. granulosus, E. multilocularis, and E. vogeli. In some cases, the organs affected depend on which type of tapeworm has caused your infection.
How to avoid tapeworms?
This includes enforcing meat inspection procedures. Avoiding undercooked or raw beef, pork, and fish can also help you avoid echinococcus.
What to do if you have cysts in your brain?
If the infection has affected your brain and fluid has accumulated there, your doctor may also recommend surgery to install a shunt. This device is used to drain fluid from your brain.
Can a chest X-ray show echinococcus?
For example, they may use a chest X-ray to rule out other types of infection. Your doctor may also use an abdominal MRI or CT scan to make their diagnosis. Because the incubation period can be long, echinococcus parasites may be discovered while your doctor is performing medical tests for other reasons.
What is the best treatment for cystic echinococcosis?
Chemotherapy, cyst puncture, and PAIR (percutaneous aspiration, injection of chemicals and reaspiration) have been used to replace surgery as effective treatments for cystic echinococcosis and, for some cases, no treatment but a conservative “watch and wait” approach is best.
How long does echinococcosis last?
Effective treatment involves benzimidazoles administered continuously for at least 2 years and patient monitoring for 10 years or more since recurrence is possible.
What is alveolar echinococcosis?
Alveolar echinococcosis closely mimics hepatic carcinoma or cirrhosis and is more commonly diagnosed in people of an advanced age. Plain radiographs show hepatomegaly and characteristic scattered areas of radiolucency outlined by calcific rings 2 to 4 mm in diameter. The usual CT image of E. multilocularis infection is that of indistinct solid tumors with central necrotic areas and perinecrotic plaque-like calcifications. Serologic test results are usually positive at high titers. Comparing a patient’s titers with both purified-specific and shared antigens permits the serologic discrimination between patients infected with E. multilocularis and those infected with E. granulosus.
How to treat a cyst in the liver?
Many abdominal cysts can be treated by injection of protoscolicidal chemical solutions into the cyst, followed by evacuation, prior to further manipulations and extirpation of cysts.
How many patients have been cured of benzimidazole?
Approximately one third of patients treated with chemotherapy with benzimidazole drugs have been cured of the disease and even higher proportions, between 30-50%, have responded with significant regression of the cyst size and alleviation of symptoms.
Does albendazole help cysts?
Albendazole has been administered to patients prior to surgery for the intended purpose of facilitating the safe surgical manipulation of the cysts by inactivating protoscolices, altering the integrity of the cysts membranes, and reducing the turgidity of the cysts.
Transmission
Signs and Symptoms
- Cystic echinococcosis / hydatid disease
Human infection with E. granulosusleads to the development of one or more hydatid cysts located most often in the liver and lungs, and less frequently in the bones, kidneys, spleen, muscles and central nervous system. The asymptomatic incubation period of the disease can last many year… - Alveolar echinococcosis
Alveolar echinococcosis is characterized by an asymptomatic incubation period of 5–15 years and the slow development of a primary tumour-like lesion which is usually located in the liver. Clinical signs include weight loss, abdominal pain, generalmalaise and signs of hepatic failure. L…
Distribution
- Cystic echinococcosis is globally distributed and found in every continent except Antarctica. Alveolar echinococcosis is confined to the northern hemisphere, in particular to regions of China, the Russian Federation and countries in continental Europeand North America. In endemic regions, human incidence rates for cystic echinococcosis can reach more than 50 per 100 000 p…
Diagnosis
- Ultrasonography imaging is the technique of choice for the diagnosis of both cystic echinococcosis and alveolar echinococcosis in humans. This technique is usually complemented or validated by computed tomography (CT) and/or magnetic resonance imaging(MRI) scans. Cysts can be incidentally discovered by radiography. Specific antibodies are detected by differe…
Health and Economic Burden
- Both cystic echinococcosis and alveolar echinococcosis represent a substantial disease burden. Worldwide, there may be in excess of 1 million people living with these diseases at any one time. Many of these people will be experiencing severe clinicalsyndromes which are life-threatening if left untreated. Even with treatment, people often face reduced quality of life. For cystic echinoco…
Surveillance, Prevention and Control
- Robust surveillance data is fundamental in order to show burden of disease and to evaluate progress and success of control programmes. However, as for other neglected diseases which are focused in underserved populations and remote areas, data is especiallyscarce and will need more attention if control programmes are to be implemented and measured.
Who and Country Response
- Strengthening echinococcosis prevention and control
Informal Working Groups on Echinococcosis were founded in 1985 under the auspices of the WHO. For 10 years, under the leadership of Professor J. Eckert (University of Zurich, Switzerland), the groups organised meetings of specialists and promoted internationalscientific exchange an… - Building capacity to enhance early diagnosis and clinical management of CE
WHO has been asked by the endemic countries to provide support on early diagnosis and clinical management of cystic echinococcosis. WHO supports capacity building through training courses targeting medical and paramedical personnel, focused on theclinical management of cystic echi…