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Echinococcus ( granulosus and multilocularis ) . Abdi Rahman Gulaid. Introduction . Echinococcosis : Echinococcosis commomly known as Hydatid Disease or Hydatidosis , is caused by a parasitic cestodes (tapeworms) of the genus Echinococcus . .
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Echinococcus(granulosusand multilocularis) AbdiRahmanGulaid
Introduction Echinococcosis: • Echinococcosiscommomly known as Hydatid Disease or Hydatidosis, is caused by a parasitic cestodes (tapeworms) of the genus Echinococcus.
Four species of Echinococcus cause infection in humans are: • E. granulosuscauses cystic echinococcosis • E. multilocularis causes alveolar echinococcosis • E. vogelicauses polycystic echinococcosis • E. oligarthrusis an extremely rare cause of human echinococcosis.
The geographic distribution • Echinococcusgranulosusis widely distributed across Canada and more frequent in rural, grazing areas. • Echinococcusmultilocularisoccurs in the northern hemisphere, including central Europe and the northern parts of Europe, Asia, and North America. • E. vogeli and E. oligarthrusoccur in Central and South America.
Transmission and Life Cycle of Echinococcus The Hydatid Tapeworm Life Cycle Diagram • Adult worm present in intestine of definitive host • Eggs passed in feces, ingested by humans or intermediate host • Onchosphere penetrates intestinal wall, carried via blood vessels to lodge in organs • hydatid cysts develop in liver, lungs, brain, heart • After ingestion, the protoscolices attach to the intestine. • Ingested protoscolices attach to small intestine and develops into adult worm and the cycle starts all over again.
Symptoms • E. granulosus • Can remain silent for years • It is the enlarging cysts that cause symptoms in organs • Hepatic involvement (75%) (abdominal pain, mass in the hepatic area, biliary duct obstruction) • Pulmonary involvement (chest pain, Cough, hemoptysis) • Brain, bone, and heart (10-20%) • Rupture of cyst (fever, hives, pus, anaphylactic shock, and the cyst spreads throughout body cavity) • E. multilocularis • Affects the liver as a slow growing destructive tumor • Abdominal pain, biliary obstruction, and sometimes metastatic lesions in lungs and brain are common symptoms
A section of human lung shows multiple protoscoleces liberated from a ruptured hydatid cyst
E. multilocularisSigns and Symptoms of Alveolar Hydatid Disease • No early symptoms • Cysts in multiple body organs • Symptoms of liver infestation: upper abdominal pain , weakness , weight loss , chest pain , cough, coughing blood , jaundice • Symptoms of brain infestation: • Blindness • Epilepsy • Symptoms of ruptured cysts: • Allergic rash • Fever
Diagnosis • Imaging (CT, MRI, and ultrasound) • Serologic testing (enzyme immunoassay, immunofluorescent assay) • Examination of cyst fluid Protoscoleces in a hydatid cyst removed from lung tissue
Treatment • Surgical removal via laparoscopy, can be curative for the treatment of echinococcosis • Medication is sometimes effective to keep the cyst from growing back • Praziquantel for definitive host (dog) • Albendazole, mebendazole intermediate host (sheep, other host)
Control Method • interrupt lifecycle by an possible means. • Destroy stray dogs • General education program • Sheep herders should not live closely with their dogs
-Center of Disease Control. http://www.dpd.cdc.gov/dpdx/html/Echinococcosis.htm • - journals.cambridge.org/production/action/cjoGetFulltext?fulltextd... by JD SMYTH - 1964 - Cited by 64 - Related articles • - www.sciencedirect.com/science/article/pii/0166685185900167 by DP McManus - 1985 - Cited by 42 - Related articles • - www.springerlink.com/index/MD4LQW968V6TUBPE.pdf by CP Nunes - 2004 - Cited by 12 - Related articles • http://www.fao.org/docrep/t1300t/t1300T0m.htm by A. Permin and J.W. Hansen Sources