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Echinococcosis: symptoms and treatment, complications, prevention

What it is? Echinococcosis is an infectious disease that occurs when parasitizing the larvae of echinococcus tapeworm in the human body.

The helminth itself lives and breeds in the body of carnivorous animals. Most often they are infected with dogs and wild canines - wolves, jackals, foxes. Rarely sick cats. Therefore, pet owners should be very careful to avoid infection.

When eggs mature, they are excreted with feces out. At the same time, they can get on the animal's hair, in the ground, water, and plants.

Human infection occurs when a mature egg is introduced into the mouth through hands that have been contaminated after “communication” with the animal. Also, the probability of invasion is preserved due to ingestion of "infected" herbs, wild berries, and water (if these factors listed are used for human consumption).

Echinococcosis

Echinococcosis in the liver

In addition to humans, sheep, cows and goats can be infected through grass on pasture. This path is more rare, but you should not forget about it.

Man and herbivores are intermediate hosts in which the larvae develops. The further chain of infection is built up only when the intermediate host dies and eats its remains infected with larvae. This is done by dogs or wild animals.

Thus, a person becomes a dead end for the further development of echinococcus. However, this leads to serious complications that develop in the body.

Professions that are dangerous in terms of echinococcus infection are associated with animal husbandry and hunting. Thus, the high risk of echinococcosis with shepherds, hunters, slaughterhouse workers, tanners, as well as their family members. Therefore, vaccination is widespread among these population groups. Its effectiveness has been proven in a series of clinical studies that were originally conducted on sheep.

Content

Symptoms of echinococcosis

Symptoms of echinococcosis

After entering the digestive tract, the eggs enter the blood through enterocytes (intestinal cells). With blood flow, they can be carried to any organ, but in 75% of cases, echinococcus oncospheres enter the liver. It is the hepatic localization that determines the specificity of the clinical picture in a given disease.

The second organ for the frequency of invasion is the lungs - in 20% of cases. Rarely contamination of the brain, spleen, bones, heart, pancreas, in about 1-3% of cases.

The minimum frequency of parasitism of echinococcus in these organs is associated with a high frequency of diagnostic errors. To reduce it to zero, it is very important to clarify a person’s contacts with potential sources of infection.

Over time, a specific echinococcal cyst is formed and grows inside the affected organ, initially not having a strong effect on the body. As it grows, a squeezing effect on the affected organ appears, and if the walls are damaged and fluid is released, an allergic reaction occurs.

Thus, the symptoms of echinococcosis, on the one hand, consist of signs of mechanical compression and the associated atrophy, and on the other hand, the allergy-causing action of the parasite.

With echinococcosis, a person’s symptoms may appear several years after infection, as the cyst grows slowly. This is also due to the fact that the parasite uses adaptive mechanisms in order not to be detected by the immune system.

Thus, the larva produces a number of substances that depress the work of human immunity, and is protected by embedding host protein structures into its envelope, with the result that immune cells perceive it as their own and do not attack. This causes a long persistence of echinococcus in the body.

In liver echinococcosis, signs are common, non-specific. Patients noted weakness, the appearance of fatigue, dyspepsia, that is, nausea, indigestion, belching, heaviness in the right hypochondrium.

There may be headaches, as well as an allergic rash and itching of the skin. A growing cyst slowly begins to squeeze the liver tissue, which leads to a gradual disruption of its normal structure and functioning: first there is a dystrophy of the cells, that is, a disturbance of the normal metabolism in them, and then atrophy - complete death.

Atrophy of a part of the liver tissue adversely affects the overall functionality of the entire organ, which is especially noticeable with an increase in the load on the liver, for example, in case of poisoning, intake of large amounts of alcohol. This is how chronic liver failure is formed.

Squeezing the bile duct leads to pain in the right hypochondrium by type of colic, nausea, discolored stool . All these symptoms are combined into the concept of intrahepatic cholestasis. One of its bright signs is intense and painful itching of the skin.

It is caused by the accumulation of bile acids in the dermis, which are a strong irritant for sensitive nerve endings.

Echinococcosis of the lungs is manifested depending on the location of the cyst, its size and growth rate. If the cyst is located closer to the ribs, then even in the case of its small size, it will manifest itself quite early, as it will constantly press on the lining of the lungs - the pleura, and lead to painful sensations.

When the parasite is located closer to the bronchi, a person will experience persistent dry cough, shortness of breath, pain when breathing, and blood may appear in the sputum. With the compression of the lung tissue gradually increases chronic respiratory failure. Clinically, this is manifested by the following symptoms:

  • Increased respiratory rate;
  • Feeling short of breath;
  • Cyanosis of the nose, nasolabial triangle, finger tips, etc. (acrocyanosis);
  • Increased fatigue during normal exercise;
  • The participation of auxiliary muscles in the act of breathing, etc.

Echinococcosis of the brain also manifests itself as the cyst grows. At the beginning of the symptoms may not be, but with the development of a squeezing effect on the brain tissue, the symptoms may resemble manifestations of volumetric processes - tumors.

A persistent headache appears that is difficult or impossible to eliminate with conventional painkillers. There is an increase in intracranial pressure, may develop dizziness, epileptic seizures.

When a cyst damages the parts of the brain responsible for movement, motor disturbances occur in the limbs, on the side opposite to the location of the parasite .

However, unlike tumors and stroke with cerebral echinococcosis, serological tests to identify this pathogen are positive. In addition, conservative antiparasitic treatment is effective and leads to regression of clinical symptoms.

Diagnostics

Diagnostic search for suspected echinococcosis has several goals:

  • Identification of indirect signs of the presence of parasites in the body;
  • Direct identification of the pathogen;
  • Determination of the degree of target organ damage, i.e. the degree of their failure.

Therefore, all patients in whom it is assumed echinococcosis, prescribe the following studies that reveal characteristic abnormalities:

  • A blood test reveals a high level of eosinophils;
  • Immunological methods are to identify specific antibodies in the serum. To do this, put the immunoassay reaction or the reaction of indirect hemagglutination. At the beginning of the disease, the result may be negative. As the cyst grows, these analyzes reveal liver echinococcosis in 90% of cases, lung echinococcosis in 60%;
  • Biochemical blood test to determine the level of metabolites formed or destroyed in the liver (this analysis allows us to determine the degree of liver failure);
  • Liver ultrasound is a very effective method for detecting hepatic echinococcus;
  • Radiography of the lungs allows you to identify a parasitic cyst;
  • CT, MRI can determine the prevalence of the process and the nature of any organ.

Often, echinococcosis is detected by chance with liver ultrasound, prophylactic fluorography, as well as some other helmitic infections . This is due to the presence of an asymptomatic stage of the disease.

Treatment of liver echinococcosis

Treatment of liver echinococcosis

The main method for late detection is surgery. Surgical treatment is urgently carried out to remove superficial cysts, with a high probability of rupture during the compression of organs and ducts, the presence of large and infected tumors.

In case of jaundice symptoms during echinococcosis, the treatment also consists in the urgent carrying out of an operation with simultaneous prescription of symptomatic therapy. In case of multiple cysts, the operation is carried out in several stages. Hard-to-reach, small cysts, as well as dying formations that subject to calcification, do not operate.

Drug treatment can complement the surgery, and may be independent, with the impossibility of the operation. With echinococcosis, treatment with the drug albendazole is prescribed for 1-1.5 years, in courses of 28 days with intervals of 2 weeks.

During treatment, a blood test (general clinical and biochemical) should be performed every 5–7 days, as the drug is toxic and may cause a decrease in white blood cells and toxic hepatitis.

Conservative therapy of echinococcosis is a rather complicated task requiring an individual approach.

Complications of echinococcosis

Often, only the development of complications can lead to the diagnosis of echinococcosis - these conditions drastically change the general condition of a person and make it necessary to urgently consult a doctor.

The severity and nature of the negative effects of finding echinococcus in the body can be different. Mostly it depends on the location of the cyst.

1. Complications of a cyst in the liver are as follows:

Death of the larvae and suppuration of the hydatid cyst. In this case, there is a general weakness, intoxication, fever, pain in the liver.

Rupture of a cyst as a result of impact, fall, weight lifting, too active probing. The appearance of a sharp pain is characteristic, then a severe allergic reaction can occur - anaphylactic shock.

The danger of cyst rupture also lies in the mass distribution of larvae throughout the body, as a result, multiple foci can form in other organs.

The manifestation of complications occurs 1-2 years after the rupture of a cyst. Damage to a suppurative cyst is dangerous by the development of peritonitis.

Squeezing of the bile ducts leads to inflammation of the biliary tract - cholangitis, manifested by fever, pain in the hypochondrium, then jaundice develops. Often, cirrhosis and amyloidosis (deposition of “harmful” amyloid protein in the organs) can become the final echinococcosis of the liver.

Squeezing the portal vein with a large cyst leads to an increase in pressure in the vein system - portal hypertension. Manifested by the expansion of the veins on the front wall of the abdomen, weakness and an increased risk of bleeding from the veins of the esophagus, which can be fatal.

2. The cyst is located in the lungs - around it is the expansion and deformation of the bronchi, there are areas of seals, there may be pulmonary bleeding. There is also a real chance of developing acute cardiovascular insufficiency.

When a cyst is located closer to the ribs, the development of acute pleurisy occurs, and in severe cases anaphylactic shock develops - a deadly allergic reaction.

A breakthrough of a cyst in the large bronchi leads to a sharp appearance of a strong cough up to asphyxiation, an allergic reaction. In the future, aspiration pneumonia may develop.

3. The growth of cysts in bone tissue leads to the gradual destruction of bones and pathological fractures.

4. A small cyst in the heart muscle can lead to weakness of the heart activity, and its breakthrough into the pericardial cavity causes sudden death.

The negative consequence of echinococcosis is a rapid, rapid course of the disease. This happens in people with a weakened immune system, when a person is already infected with a serious illness, in pregnant women, as well as in those who have contacted a region that is not affected by echinococcosis, and is not its indigenous person.

Echinococcosis prevention

The main measures to prevent infection consist of washing hands after “talking” to dogs. Also, when keeping dogs, an important preventive measure is the annual dehelmization with special veterinary drugs. Prevent echinococcosis drugs: Milbimaks, Dirofen, Gelmintal, Kanikvantel, etc.

Persons from risk groups should carefully observe hygienic measures after work, hiking in the woods, and hunting. When picking berries in the forest before use, they should be washed.

In areas with a high incidence of echinococcosis, routine medical examination is carried out. Moreover, not only non-specific prophylaxis, mentioned above, but also specific, has recently become widespread. It involves the introduction of a vaccine against echinococcosis in risk groups.

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