Presentation
A patient with acute eosinophilic cholecystitis is presented. This was in association with hepatic hydatid disease and was the presenting feature of that disease. [ncbi.nlm.nih.gov]
Frank intrabiliary rupture was present in one case of our series. [doi.org]
Trop Parasitol 3:161–165 View Article Google Scholar Korwar V, Subhas G, Gaddikeri P, Shivaswamy BS (2011) Hydatid disease presenting as cutaneous fistula: review of a rare clinical presentation. [springerplus.springeropen.com]
Immune System
- Splenomegaly
Abdomen: non-tender, non-distended, no hepatomegaly or splenomegaly. Remainder of the exam was unremarkable. Laboratory Examination: Hb 10.5 mg/dL, Hct 36%, WBC 11.4 (0 band, 68 neutrophils, 1 eosinophils, 9 monos, 22 lymphs), platelets 647,000. [uab.edu]
Clinical features include LIVER CIRRHOSIS; LIVER FAILURE; SPLENOMEGALY; TREMOR; bradykinesia; DYSARTHRIA; CHOREA; MUSCLE RIGIDITY; Kayser-Fleischer rings (pigmented corneal lesions); ATAXIA; and intellectual deterioration. [healthdictionary.info]
The physical examination revealed hepatomegaly in ten patients, collateral venous circulation in seven, ascites in five, splenomegaly in three, and cutaneomucosal jaundice in two ( table I ). [em-consulte.com]
Clinical symptoms are caused by splenomegaly, secondary infections, or rupture of the cyst. The frequency of renal echinococcosis is 4% and is close to that of splenic disease [21, 39–41, 42•]. [slideheaven.com]
Entire Body System
- Collapse
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[…] the site and size of the cyst (hydatid) of the lungs, liver and subcutaneous tissues may be asymptomatic for many years, but pressure effects may develop; in sensitive areas, hydatids may cause blocking effects and mechanical compression leading to collapse [web.archive.org]
When the cyst wall is punctured and it collapses, the bile may then leak into the remnant cavity. [doi.org]
Ruptured cysts are collapsed and contain variable amounts of eosinophilic necrotic debris admixed with degenerate neutrophils, eosinophils, lymphocytes, plasma cells, foamy macrophages and multinucleated giant cells, which extend into the adjacent fibrous [askjpc.org]
We report a case with an unusual localization of diaphragmatic and serratus muscle anterior hydatidosis that occurred simultaneously. albenza reviews A young soldier was brought to the emergency of Combined Military Hospital (CMH), Multan in a collapsed [ortopediaruggiero.it]
- Hunting
Estonian Ministry of Environment, Hunting Department. 2016. Available: http://www.envir.ee/et/jahindus. 30. Sergeant ESG. Epitools epidemiological calculators. [doi.org]
In this study, metacestodes from a paca hunted in Mato Grosso do Sul state (Cerrado biome) were identified morphological and histopathological techniques and further confirmed by molecul... more [scinapse.io]
- Chills
With secondary infection, tender hepatomegaly, chills, and spiking temperatures occurs. Urticaria and erythema occur in cases of generalized anaphylactic reaction. [intechopen.com]
- Lymphadenopathy
No edema, no cyanosis, no lymphadenopathy. Lungs: breath sounds absent, diffuse crackles in the left lung. Heart: heart sounds regular, tachycardic, no murmurs or gallops, no jugular venous distension. [uab.edu]
Respiratoric
- Sputum
[…] surgical removal of large solitary liver cysts IMMUNIZATION: None available PROPHYLAXIS: Mebendazole and albendazole have been used successfully SECTION VI - LABORATORY HAZARDS LABORATORY-ACQUIRED INFECTIONS: None reported to date SOURCES/SPECIMENS: Sputum [web.archive.org]
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) Chest pain (lung cyst) Cough (lung [medlineplus.gov]
Parasitic cysts (echinococcosis) may also cause fever, bloody sputum, and severe skin itching. The type of echinococcosis caused by E. multilocularis (called alveolar echinococcosis) can cause symptoms similar to cirrhosis or liver cancer. [innerbody.com]
No sputum available. CXR [ Image A ] and a looping Video clip from an ultrasound of the right hemithorax are shown. Diagnosis: Echinococcus granulosus. Hydatid of the lung. [uab.edu]
SOURCES / SPECIMENS: Animal feces; human and animal tissues such as spleen, kidneys, heart, bone, and brain Footnote 2, sputum. PRIMARY HAZARD: Ingestion of the infectious eggs Footnote 1-3. [canada.ca]
Gastrointestinal
- Abdominal Mass
Physical examination was unremarkable; no abdominal mass was palpated. Routine blood count, biochemistry and urine analysis were within normal limits. Serologic testing for echinococcosis was not performed. [omicsonline.org]
On the other hand, if the patient has cysts in the liver and is symptomatic, they will suffer from abdominal pain, abnormal abdominal tenderness, hepatomegaly with an abdominal mass, jaundice, fever and/or anaphylactic reaction. [en.wikipedia.org]
The first reported case was a 54-year-old fisherman from Winnipeg, Manitoba, Canada who presented with an abdominal mass in 1928 [ 38 ]. The patient was operated on in 1928, but succumbed to his disease in 1935. [parasite-journal.org]
Patients may have a palpable abdominal mass, abdominal pain, hematuria, or albuminuria. Cerebral echinococcosis is seen in 2 to 3% of patients with cystic hydatidosis. [slideheaven.com]
- Loss of Appetite
History: 69-year-old male, with history of COPD for 20 years and hypertension, presented to the ER with a 6-week history of dry cough and exertional dyspnea, loss of appetite and unintentional weight loss of 5 kg during the past month. [uab.edu]
Cardiovascular
- Hypertension
Of these patients, 427 (39.1%) were cases with complications, including secondary infection, rupture, obstructive jaundice, anaphylactic shock, disseminated implantation with resultant multiple echinococcosis and portal hypertension. [ncbi.nlm.nih.gov]
Portal hypertension was noted in all seven patients with a US Doppler examination. [em-consulte.com]
In contrast, infection with E. multilocularis resembles a hepatic malignancy that invades and destroys the surrounding tissue, which can lead to complications such as portal hypertension, cholangitis, jaundice, and even cirrhosis. [amboss.com]
It may present as an invasive mass causing biliary obstruction or portal hypertension due to invasion of the biliary and vascular structure of the liver. [journals.lww.com]
Portal hypertension (pre-hepatic, hepatic, post-hepatic) is a very rare complication of hydatid cyst of liver.The compression of the hepatic veins can be responsible for Budd-Chiari syndrome and portal hypertension [ 19 - 20 ]. ( fig 14 -15) Vascular [intechopen.com]
Liver, Gall & Pancreas
- Hepatomegaly
Hepatomegaly and marked epigastric tenderness were consistently observed. Laboratory findings included obstructive liver function tests, leucocytosis, eosinophilia, and hyperamylasemia. [ncbi.nlm.nih.gov]
→ RUQ pain Malaise, nausea, vomiting Hepatic cyst Hepatomegaly → RUQ pain Malaise, weight loss, nausea, vomiting Cyst that invades and destroys the liver and surrounding tissue Portal hypertension, cholestatic jaundice, cholangitis Budd-Chiari syndrome [amboss.com]
Normal Normal Hepatomegaly Hemoglobin (g/dl) 12 13.2 14 14.1 RBCs (106/ml) 3.9 4.4 4.8 4.5 WBCs (103/ml) 8.4 12.7 6.6 19.2 Eosinophils (%) 8 18 4 17 Bilirubin (mg/dl) 1.7 2.2 0.9 1.2 ALT (U/ml) 58 34 22 41 AST (U/ml) 74 61 34 36 ALKP (U/L) 18 22 16 11 [casesjournal.biomedcentral.com]
- Liver Mass
Unlike CE, AE is still unfamiliar to our clinicians and the majority of Czech cases have been diagnosed histologically after surgery of liver mass process suspected from malignancy. [parasite-journal.org]
Musculoskeletal
- Fracture
Rare involvement of other organs include Eyes: ocular cysts, vision problems Bones: pathologic fractures Kidney: flank pain, hematuria Heart : pericardial tamponade and wall rupture Spinal cord : symptoms of cord compression Brain: seizures or signs of [amboss.com]
In the long bones it may cause fractures and deformity. Polycystic echinococcosis Polycystic echinococcosis is the rarest type of echinococcosis, and may be caused by E. vogeli and E. oligarthrus, which are confined to Latin America. [patient.info]
Hydatid disease of the femur with an Extraosseous extent due to a former biopsy complicated by a pathological fracture. Case Reports in Orthopedics. 2012;2012:1–4. doi:10.1155/2012/169545. 46. [slideheaven.com]
Radiographs revealed a pathological femoral shaft fracture of the left femur. A surgical biopsy was performed and hooks and protoscoleces were seen by the unstained microscopic examination of the removed tissues. [parasite-journal.org]
Psychiatrical
- Fear
Previously, percutaneous treatment of hepatic hydatid cyst has rarely been performed because of the fear of dissemination, peritoneal spillage, and anaphylactic shock, however, percutaneous drainage has been used successfully in recent years. 3 The experts [doi.org]
Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis-a systematic literature review. PLoS Negl Trop Dis. 2011 Jun. 5(6):e1154. [Medline]. [Full Text]. [emedicine.com]
Treatment
Conservative surgery in the treatment of hepatic hydatidosis. Eur J Surg 1995;161:415-20. [Figure 1], [Figure 2], [Figure 3], [Figure 4] [doi.org]
Advances in classification and treatment of echinococcosis prompted experts from different continents to review the current literature, discuss recent achievements and provide a consensus on diagnosis, treatment and follow-up. [ncbi.nlm.nih.gov]
The risk of treatment in pregnant women who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment. [web.archive.org]
Prognosis
Prognosis mainly depends on the type of infestation (ie, whether it is cystic [CE] or alveolar echinococcosis [AE]). In CE, the prognosis is generally good, and complete cure is possible with total surgical excision without spillage. [emedicine.medscape.com]
Early diagnosis is necessary to improve prognosis. [ncbi.nlm.nih.gov]
With Cystic Echinococcosis, prognosis is good with surgical excision without spillage In Alveolar Echinococcosis, 10-year mortality rates of 10% Hydatid Cyst of the Liver. [learningradiology.com]
Etiology
MORPHOLOGIC DIAGNOSIS: Liver: Hydatid cyst, multiloculated, with multifocal granulomatous and necrotizing cholangiohepatitis and fibrosis, etiology consistent with Echinococcus multilocularis, Barbary ape ( Macaca sylvana ), primate. [askjpc.org]
ECHINOCOCCOSIS OF BONE J Bone Joint Surg Am, 1945 Jul; 27 (3): 401 -411. http://dx.doi.org/ Abstract The development of our knowledge of echinococcus disease has been outlined, and its etiology and distribution have been described. [web.archive.org]
Kupferminc and Ido Nachmany, Major liver resection in pregnancy: three cases with different etiologies and review of the literature, The Journal of Maternal-Fetal & Neonatal Medicine, 10.1080/14767058.2017.1376315, 32, 2, (203-211), (2017). [doi.org]
[…] multilocularis (alveolar hydatid disease) or E. vogeli (polycystic hydatid disease) Humans become infected by eating food contaminated with tapeworm eggs, becoming intermediate hosts ( Wikipedia: Echinococcus [Accessed 5 January 2018] ) Pathophysiology / etiology [pathologyoutlines.com]
Etiology Pathogens : Echinococcus tapeworms Echinococcus granulosus causes CE Echinococcus multilocularis causes AE Other types (e.g., E. vogeli and oligarthus ) are mainly localized to the tropical climates of South America and may cause polycystic echinococcosis [amboss.com]
Epidemiology
Method Publications on alveolar echinococcosis throughout the world were systematically reviewed with special reference to ecology, epidemiology and countermeasures. [doi.org]
The epidemiological and parasitological aspects are reviewed, and the importance of the radiological signs and differential diagnosis are emphasized. [ncbi.nlm.nih.gov]
However, the increasing use of mass screenings with ultrasonography in endemic countries is generating important epidemiological data. [emedicine.com]
Epidemiology of human alveolar echinococcosis in China. Parasitol Int. 2006;55:S221–5. CrossRef PubMed Google Scholar 18. Kapel CMO, Torgerson PR, Thompson RCA, Deplazes P. [link.springer.com]
Pathophysiology
[…] commonly E. multilocularis (alveolar hydatid disease) or E. vogeli (polycystic hydatid disease) Humans become infected by eating food contaminated with tapeworm eggs, becoming intermediate hosts ( Wikipedia: Echinococcus [Accessed 5 January 2018] ) Pathophysiology [pathologyoutlines.com]
[…] may cause polycystic echinococcosis Transmission Hand-to-mouth From the fur of definitive hosts (e.g., petting a dog or cat ) Contaminated dirt (e.g., dog feces ) Fecal-contaminated food or water (e.g., wild berries, mushrooms) References: [1] [2] [3] Pathophysiology [amboss.com]
Pathophysiology There are four types of echinococcosis, of which the first two are the most common and therefore the most important, the third rare and the fourth extremely rare [ 2, 4, 5 ] : Cystic echinococcosis due to E. granulosus - this is also known [patient.info]
Pathophysiology In primary echinococcosis, metacestodes develop from oncospheres after peroral infection with E granulosus eggs. In secondary echinococcosis, larval tissue proliferates after being spread from the primary site of the metacestode. [emedicine.com]
Prevention
Prevent dogs from soiling the immediate environment. Prevent dogs from roaming or having access to raw sheep meat or viscera. All sheep carcasses should be disposed of correctly and immediately. [patient.info]
Prevention and control Cystic echinococcosis is a preventable disease as it involves domestic animal species as definitive and intermediate hosts. [web.archive.org]
抄録 Purpose This article focuses on understanding epidemiological features of alveolar echinococcosis and discussing its prevention and control, especially from a viewpoint of the ecosystem and risk management. [doi.org]