Hydatid disease

Suggested Alternatives for Differential Diagnosis Sheep Scrapie, pregnancy toxemia, hypocalcemia, tetanus, listeriosis, tick pyemia, hypocuprosis, rabies, hydatid disease, and various plant poisons. Cattle Malignant catarrhal fever, listeriosis, pseudorabies, bovine spongiform encephalopathy, rabies, hypomagnesemia, hypocalcemia, acute lead poisoning, and certain plant poisons. 

Alterations in the pattern of the serum immunoglobulin concentration in patients suffering from hydatid disease (human echinococcosis) occur mainly in the IgG and to a lesser extent in the IgM. Both complementfixing and hemagglutinating antibodies of human hydatid disease were also associated with the IgG and IgM (S7). 

Sertanidids, B., and Angelopoulos, B., Serum immunoglobulins in hydatid disease. Clin. Chim. Acta 31, 311-313 (1971). 

Adverse effects are very rarely seen after doses needed for antinematodal effects. Some nausea and diarrhoea may occur. After the high doses which are needed for hydatid disease skin rashes, renal toxicity and blood dyscrasias are reported. 

Albendazole has an even broader spectrum of activity than mebendazole. Its indications include pin-worm infection, ascariasis, trichuriasis, strongyloidiasis and hookworm infections. It is the preferred agent for inoperable cases of hydatid disease. 

Albendazole selectively blocks glucose uptake and depletes glycogen stores. ATP formation is thus inhibited. It should be administered on an empty stomach for intraluminal parasites and with a fatty meal for tissue parasites. It is metabolized to an active sulfoxide metabolite resulting in very low Albendazole blood levels. Albendazole sulfoxide is excreted in the urine with an elimination half-life of about 8 h. Used for 1-3 days in doses recommended for intestinal worms the incidence of adverse effects is similar in treatment and control groups. Hepato-toxicity may occur, especially after the higher doses that are needed for hydatid disease. Also alopecia has been reported. 

Mebendazole is used primarily for the treatment of A. lumbricoides, T. trichiura, E. vermicularis, and hookworm infections, in which it produces high cure rates. It is an alternative agent for the treatment of trichinosis and visceral larva migrans. Owing to its broad-spectrum anthelmintic effect, mixed infections (ascariasis, hookworm infestation, or enterobiasis in association with trichuriasis) frequently respond to therapy. High doses have been used to treat hydatid disease, but albendazole is now thought to be superior. 

Ascarlasis, ankylostomiasis and trichuriasis 400 mg single dose Taenlasis strongyloldosis 400 mg x 3 days Neurocysticercosis 15 mg/kg/dally x 1 month Hydatid disease 400 mg BD X 1 month (If required repeat after 2 wks). Trichinosis and strongyloldosis 25 mg/kg/day In two divided doses X 2 days after meal (If required repeat after 2 days) Ascarlasis and hookworm Infestation 50-150 mg single dose. Taenlasis 0.5-2 g (After breakfast 1 g to be chewed and swallowed with water followed by 1 g after 1 hr) For H. nana Infestation 2 g dose Is repeated dally for 5 days. 

Echinococcus granulosus (hydatid disease) Echinococcus multilocularis Albendazole ... 

Albendazole, a broad-spectrum oral antihelminthic, is the drug of choice and is approved in the USA for treatment of hydatid disease and cysticercosis. It is also used in the treatment of pinworm and hookworm infections, ascariasis, trichuriasis, and strongyloidiasis. 

Benzimidazoles are thought to act against nematodes by inhibiting microtubule synthesis. Albendazole also has larvicidal effects in hydatid disease, cysticercosis, ascariasis, and hookworm infection and ovicidal effects in ascariasis, ancylostomiasis, and trichuriasis. 

When used for 1-3 days, albendazole is nearly free of significant adverse effects. Mild and transient epigastric distress, diarrhea, headache, nausea, dizziness, lassitude, and insomnia can occur. In long-term use for hydatid disease, albendazole is well tolerated, but it can cause abdominal distress, headaches, fever, fatigue, alopecia, increases in liver enzymes, and pancytopenia. 

Most patients treated with niclosamide for H diminuta and Dipylidium caninum infections are cured with a 7-day course of treatment a few require a second course. Praziquantel is superior for Hymenolepis (dwarf tapeworm) infection. Niclosamide is not effective against cysticercosis or hydatid disease. 

In hydatid disease, praziquantel kills protoscoleces but does not affect the germinal membrane. Praziquantel is being evaluated as an adjunct with albendazole pre- and postsurgery. In addition to its direct action, praziquantel enhances the plasma concentration of albendazole. 

Note Albendazole is approved in the USA for the treatment of cysticercosis and hydatid disease. 

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-... 

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. 

McManus, D.P., Zhang, L.H., Castrodale, L.J., Le, T.H., Pearson, M. and Blair, D. (2002) Short report molecular genetic characterization of an unusually severe case of hydatid disease in Alaska caused by the cervid strain of Echinococcus granulosus. American Journal of Tropical Medicine and Hygiene 67, 296-298. 

Zhang, W., Li, J. and McManus, D.P. (2003) Concepts in immunology and diagnosis of hydatid disease. Clinical Microbiology Reviews 16, 18-36. 

Rausch, R.L. (1 995) Life cycle patterns and geographical distribution of Echinoccocus species. In Thompson, R.C.A. and Lymbery, A.J. (eds) Echinoccocus and Hydatid Disease. CAB International, Wallingford, UK, pp. 89-134. 

Ayles, H.M., Corbett, E.L., Taylor, I., Cowie, A.C., Bligh, J., Walmsley, K. and Bryceson, A.D. (2002) A combined medical and surgical approach to hydatid disease 12 years experience at the hospital for tropical diseases. Annals of the Royal College of Surgery, England 84, 100-105. 

Bekhti, A. and Pirotte, J. (1987) Cimetidine increases serum mebendazole concentrations. Implications for treatment of hepatic hydatid disease. British Journal of Clinical Pharmacology 24, 390-392. 

Mohamed, A.E., Yasawy, M.l. and Al Karawi, M.A. (1998) Combined albendazole and praziquantel versus albendazole alone in the treatment of hydatid disease. Hepatogastroenterology 45, 1690-1694. 

E. multilocularis is the cause of alveolar hydatid disease (alveolar echinococcosis) and... 

Lawson, J.R. (1 994) Hydatid disease and sheep measles the history of their control and the economics of a recent change of control policy. New Zealand Journal of Zoology 21, 83-89. 

Woollard, D.J., Heath, D.D. and Lightowlers, M.W. (2000b) Assessment of protective immune responses against hydatid disease in sheep by immunization with synthetic peptide antigens. Parasitology 121, 145-153. 

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. 

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