Echinococcus Multilocularis: Description Of The Parasite, Diagnosis And Treatment

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Echinococcus Multilocularis: Description Of The Parasite, Diagnosis And Treatment
Echinococcus Multilocularis: Description Of The Parasite, Diagnosis And Treatment

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Video: Echinococcus multilocularis lecture 2023, February

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  • Life cycle
  • Morphology
  • The mechanism and ways of infection with echinococcus
  • Symptoms of echinococcosis in humans

    • Symptoms of liver echinococcosis in humans
    • Symptoms of echinococcosis in the respiratory system
  • Analyzes and diagnostics
  • Echinococcosis treatment
  • You can defeat parasites!

Echinococcus Multilocularis is a small tapeworm widespread in the northern hemisphere. E. multilocularis, along with other members of the genus Echinococcus (especially E. granulosus), cause echinococcosis. Unlike E. granulosus, E. multilocularis produces many small cysts that spread to all internal organs in the infected animal.

What to do in such a situation? To get started, we recommend reading this article. This article details the methods of dealing with parasites. We also recommend contacting a specialist. Read the article >>>

Life cycle

Life Cycle Essence:

  1. The adult worm is present in the intestines of the final host
  2. eggs passed into feces, absorbed by humans or an intermediate host
  3. onchosphere penetrates the intestinal wall, is carried through the blood vessels to feed into the organs
  4. hydatid cysts develop in the liver, lungs, brain, heart
  5. protoscolices (echinococcosis sand) absorbed by the final host
  6. Oral protoscolices attach to the small intestine and develop into an adult worm
Development cycle inside a person
Development cycle inside a person


The adult parasite is a small tapeworm, 3-6 mm long, and lives in the small intestine of dogs. The segmented worm contains a scolex with suction cups and hooks that allow attachment to the mucous membrane wall, since tapeworms do not have a gastrointestinal tract.



The mechanism and ways of infection with echinococcus

The larva of echinococcus enters the organisms of carriers mainly through alimentary and contact-household routes. Invasion occurs when:

  • close contact with sick animals - often Echinococcus parasitizes in the body of the human host;
  • walks in the habitat of infected wild animals - spheres, echinococcus cysts can enter the body when picking mushrooms, fruits and berries, eating them without washing;
  • work in a slaughterhouse, in a carcass processing workshop - echinococcus is often found in meat;
  • eating food (kebabs, liver) without sufficient heat treatment is a common way of transmitting echinococcus.

At all stages of the development cycle of echinococcus, the parasite is dangerous. Mechanical infection of the intermediate host occurs, as a rule, upon ingestion of oncospheres. The structure of the echinococcus is such that a segment with mature eggs breaks away from the individual and their shells are destroyed. The embryos that are formed from the oncospheres penetrate into the gastrointestinal tract (intestine) mucosa and the portal circulation system. Therefore, when detecting echinococcosis, ultrasound of the liver, kidneys and other organs will not give a 100% reliable result.

Some part of the embryos gets into the systemic circulation. From where they penetrate into vital organs, causing diseases of the lungs, liver, and also:

  • echinococcosis of the spleen;
  • echinococcosis of the pelvic organs;
  • echinococcosis of the brain;
  • echinococcosis of the intestines, omentum, kidneys and so on.

Echinococcus most often affects the liver and lungs. However, not only these organs are affected, but also health in general. When localized in the human body, echinococcus affects it in different ways.

Symptoms of echinococcosis in humans

The clinical picture in echinococcosis is variable and is determined by the localization of the cysts, their size, the prevalence of the process, the growth rate, and the degree of compression of the surrounding tissues / organs.

Symptoms of liver echinococcosis in humans

The clinic of liver echinococcosis is determined by the stage of development of the disease. In the initial stage, there are practically no symptoms. Echinococcus of the liver is detected at this stage, as a rule, by accident during X-ray / ultrasound examination of the abdominal organs. Echinococcosis of the liver with uncomplicated cysts manifests itself in the form of complaints of heaviness in the right hypochondrium, dull pain caused by stretching of the glisson capsule by an increasing cyst, compression of the liver vessels and adjacent organs, the development of an inflammatory process in the parenchyma / fibrous capsule of the liver.

In the presence of multiple cysts, the liver is enlarged in all sizes. Less often during this period, allergic manifestations (urticaria) are observed. Sometimes at this stage, patients complain of general malaise, loss of body weight. Palpation with a superficial location of the cyst, the liver of unequal consistency, soft, elastic; when the cyst is localized deep in the parenchyma, it is dense. Below is a photo of the liver with liver echinococcosis.

Rash with worms
Rash with worms

When cysts are located in the posterior parts of the liver, large vessels are compressed with the development of stagnation in the portal vein system, which leads to the expansion of the veins of the abdomen, ascites and edema of the lower extremities. Yellowness of the sclera / skin may be observed.

With the development of complications (suppuration / perforation of cysts), there is an increase in temperature, severe sweating, chills, heaviness / pain in the upper abdomen, general weakness, in the blood - leukocytosis, eosinophilia. In cases of perforation of echinococcal cysts of the liver, a large amount of echinococcal fluid is released into the abdominal / pleural cavity / digestive tract, which is accompanied by anaphylactic shock, coma, convulsions, respiratory distress, fever up to 39-40 ° C, and in the absence of timely medical care in the next few hours are fatal. When the contents of the cyst break through into the biliary tract, a condition similar to the clinic of an attack of gallstone disease with cholangitis (chills, sharp pains, fever) develops.

Symptoms of echinococcosis in the respiratory system

Echinococcus in the respiratory organs is manifested mainly by pulmonary echinococcosis. The pathological process affecting the respiratory organs can be complicated by the breakthrough of the echinococcal cyst into the pleural cavity, into the bronchi, suppuration of the lung cyst. Echinococcosis of the lungs clinically manifests as the size of the cyst increases and the surrounding tissues are compressed.

Echinococcosis of the lungs in the initial period is manifested more often by persistent nocturnal cough (dry at first, then with phlegm), hemoptysis, stabbing, aching chest pain, unexpressed shortness of breath. Less commonly, with pulmonary echinococcosis, allergic manifestations are observed.

With large cysts, there may be swelling of the intercostal spaces, deformation of the chest. Echinococcal cyst is often complicated by dry / exudative pleurisy, cyst suppuration. The breakthrough of the contents of the cyst into the bronchi is accompanied by a strong paroxysmal cough mixed with blood and light sputum, cyanosis, and a feeling of lack of air.

When a cyst breaks into the pleural cavity - acute pain in the chest, the patient has difficulty breathing, chills appear, an increase in body temperature, less often anaphylactic shock develops. On the roentgenogram, a cyst in the lung tissue is determined (Fig. Below).

What is the danger of echinococcosis in dogs?
What is the danger of echinococcosis in dogs?

Analyzes and diagnostics

The diagnosis is established on the basis of epidemiological analysis data, patient complaints, physical examination and laboratory and instrumental examination data. Laboratory analysis for echinococcus includes:

  • KLA (moderate leukocytosis, intermittent eosinophilia, increased ESR).
  • BAC (increased levels of total protein bilirubin, alkaline phosphatase, ACaT and ALaT).
  • Serological diagnostics: ELISA (detection of IgG antibodies to echinococcus antigens).

If possible, parasitological analysis of sputum, ascitic fluid, and also in the fluid obtained during surgery can be performed.

From instrumental examination methods are used: plain chest x-ray in various projections; Ultrasound of the abdominal organs; ECG; CT scan.

Echinococcosis treatment

Medicines for echinococcus damage the germ layer of echinococcal cysts. The effect of treatment is assessed by ultrasound - folds appear in the cyst.

  • Albendazole - 10-15 mg / kg per day for 3-6 months.
  • Mebendazole - 40-50 mg / kg per day for 3-6 months.

Side effects of drugs: increased liver transaminases, thrombocytopenia, neutropenia, alopecia.

Echinococcal cysts cut out or completely remove the affected organ in case of large superficial cysts (risk of rupture), infected cysts, cysts connecting to the bile ducts and when the volumetric process acts on vital organs - lungs, heart, brain, kidneys, etc.

It is recommended to take albendazole or mebendazole 4 days before surgery and 3 months after surgery.

If the cyst is opened during the operation, then the protoscolexes give a new growth, which is discovered several years later.

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