Cystic hydatid disease

McManus, D.P. (2002) The molecular epidemiology of Echinococcus granulosus and cystic hydatid disease. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, SI 51 —1 57. 

Chemale, G., van Rossum, A.J., Jefferies, J.R., Barrett, J., Brophy, P.M., Ferreira, H.B. and Zaha, A. (2003) Proteomic analysis of the larval stage of the parasite Echinococcus granulosus causative agent of cystic hydatid disease. Proteomics 3, 1 533-1535. 

Echinococcosis (hydatid disease) is a nearcosmopolitan zoonosis caused by adult or larval stages of dog cestodes belonging to the genus Echinococcus (family Taeniidae). The two major species of medical and public health importance are Echinococcus granulosus and E. multilocularis that, respectively, cause cystic echinococcosis (CE) and alveolar echinococco-... 

Gottstein, B. Epidemiology and systematik of cystic and alveolar hydatid disease. Chirurg 2000 71 1-8... 

Nahmias, J., Goldsmith, R., Soibelman, M., El-On, J. Three-to 7-year follow-up after albendazole treatment of 68 patients with cystic echinococcosis (hydatid disease). Ann. Trop. Med. Parasitol. 1994 88 ... 

Humans are one of several intermediate hosts for larval forms q/" Echinococcus species that cause cystic (E. granulosus) and alveolar" (E. multilocularis and E. vogeli) hydatid disease. Parasite eggs from canine stools are a major source in associated livestock (e.g., sheep and goats). 

Low doses of praziquantel can be used successfully to treat intestinal infections with adult cestodes (e.g., a single oral dose of 25 mg/kg for H. nana and 10—20 mg/kg for D. lamm, T. sagi-nata, or T. soUum). Retreatment after 7—10 days is advised for individuals heavily infected with H. nana. While albendazole is preferred for therapy of human cysticercosis, the tissue infection with intermediate cyst larvae of T. soUum, prolonged high-dose therapy with praziquantel remains an alternative treatment. Neither the cystic nor alveolar hydatid diseases caused by larval stages of Echinococcus tapeworms respond to praziquantel here, too, albendazole is effective. 

Clinical use Niclosamide is one of two drugs of choice (with praziquantel) for infections caused by beef, pork, and fish tapeworm infections. However, it is not effective in cysticer-cosis (for which albendazole or praziquantel is used) or hydatid disease caused by Echinococcus granulosus (for which albendazole is used). Scoleces and cestode segments are killed, but ova are not. Niclosamide is effective in the treatment of infections due to small and large intestinal flukes. 

Albendazole 10 mg/kg/day has been used to treat cystic echinococcosis (hydatid disease) in 11 children aged 4—14 years, with at least 10 cysts in the same organ [8 ]. The children had a total of 296 cysts located mostly in the liver (178 cysts) and the lungs (78 cysts). With exclusive albendazole therapy, 58% of pulmonary cysts, 96% of peritoneal cysts, but only 32% of hepatic cysts were cured. There were no adverse events related to treatment, apart from slight rises in serum aminotransferase activities in two cases, which normalized without withdrawal of albendazole. The high rate of viable cysts after medical therapy is problematic and in this case was attributed to poor diffusion of albendazole into the cysts, because of their multiplicity and contiguity, variable sensitivity of each cyst to albendazole, and/or insufficient duration of treatment resistance to albendazole was unlikely. 

These lesions include simple (bile duct) cyst, autosomal dominant polycystic liver disease, biliary hamartoma, Caroli s disease, pyogenic and amoebic abscesses, intrahepatic hydatid cyst, biliary cystadenoma and cystadenocarcinoma, cystic subtypes of primary liver neoplasms, cystic metastases, and intrahepatic hematoma and biioma. 

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