Medical history (history of illness) represents an important component in the diagnosis of echinococcosis. Family history What is the general health status of your relatives? Social history What is your profession? Do you work a lot with animals? Are you a hunter? Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? … Echinococcosis: Medical History
Differential diagnoses of alveolar echinococcosis Infectious and parasitic diseases (A00-B99). Abscesses – encapsulated collections of pus, unspecified. Alveolar echinococcosis Tuberculosis Neoplasms – tumor diseases (C00-D48) Hepatocellular carcinoma (hepatocellular carcinoma). Neoplasms, unspecified Differential diagnoses of cystic echinococcosis Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Dysontogenetic cysts – cyst (fluid-filled growth in body tissue) caused by an … Echinococcosis: Or something else? Differential Diagnosis
Consequential diseases or complications of alveolar echinococcosis (AE) In 99% of all cases, the liver is the primary target organ, where the six-hooked larva (oncosphere) undergoes metamorphosis to become a metacestode. Infectious and parasitic diseases (A00-B99). Secondary involvement of other organs, such as brain, lungs, peritoneum (peritoneal cavity) (metastasis outside the liver: affects approximately one-third … Echinococcosis: Complications
WHO-IWGE PNM classification for alveolar echinococcosis (AE). P Hepatic localization of parasitic structures. PX No evaluation possible P0 No evidence of hepatic involvement P1 Peripheral focus without involvement of proximal vessels or bile ducts P2 Central focus involving proximal vessels or bile ducts of a liver lobe P3 Central focus with involvement of hilar (“pulmonary … Echinococcosis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? … Echinococcosis: Examination
1st order laboratory parameters – obligatory laboratory tests. Antibody detection using: IHA (Indirect Hemagglutination). ELISA (Enzyme Linked Immunosorbent Assay) [sensitivity: CE1 + CE2: approximately 90%; CE4 + CE5: sensitivity: <50%] IFT (indirect immunofluorescence). Western blot (Western blot; transfer (English blotting) of proteins onto a carrier membrane, which can subsequently be detected via different reactions) [specificity: … Echinococcosis: Test and Diagnosis
Therapeutic target Cyst inactivation Therapy recommendation Alveolar echinococcosis (AE). If surgical resection is not possible: lifelong therapy with with the benzimidazoles albendazole or mebendazole (anthelmintics/drugs against worm diseases) Close follow-up; if necessary, later surgical curative resection (surgical removal aimed at curing the patient) if the response to drug therapy is good. Cystic Echinococcosis (CE). Primary … Echinococcosis: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of abdominal organs) – for basic diagnosis [sensitivity (percentage of diseased patients in whom the disease is detected by use of the procedure, i.e., a positive finding occurs): 90-98%; specificity (probability that actually healthy individuals who do not have the disease in question are also detected as … Echinococcosis: Diagnostic Tests
In addition to surgical resection (surgical removal), drug and percutaneous (“through the skin“) therapies are also available. Alveolar Echinococcosis (AE) Surgical resection is the only curative therapy (therapy that aims to cure the patient)! In alveolar echinococcosis, an attempt is made to radically remove the finding, i.e., complete surgical resection (R0; removal in healthy tissue) … Echinococcosis: Surgical Therapy
To prevent echinococcosis, care must be taken to reduce risk factors. Risk factors of alveolar echinococcosis Behavioral risk factors Direct contact with infected animals (fur). Smear infection Work with contaminated soil Infection through contaminated water and contaminated food is questionable Risk factors of cystic echinococcosis Behavioral risk factors Direct contact with infected animals (fur). Smear … Echinococcosis: Prevention
The following symptoms and complaints may indicate echinococcosis: Alveolar echinococcosis (AE) (fox tapeworm) A 5-15 year asymptomatic incubation period of AE is due to the slow growth of the larva.E. multilocularis grows infiltrative tumors. It can spread from the liver to adjacent structures and lead to distant metastases. This also explains the symptoms that follow. … Echinococcosis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Worms of the genus Echinococcus must undergo host switching. In this process, larvae develop in intermediate hosts (rodents, sheep, etc)/missing hosts. In the final hosts (carnivores, especially canines), the sexually mature worms parasitize.Alveolar echinococcosis (AE):In 99% of all cases, the liver is the primary target organ, where the six-hooked larva (oncosphere) … Echinococcosis: Causes
