Uhehinokokkoz is a parasitic disease caused by the tape worms of the genus Echinococcus , is characterized by the formation of cysts in different organs. The disease is widespread. Russia hydatid disease is mainly found in the southern regions of the state, the Volga region, Siberia.
Ways of infection
Distinguish between single-chamber echinococcosis (gigatonnes) and multi (alveolar). Gigatonnes echinococcosis is invoked by the tape worm Echinococcus granulosus, and alveolar — Echinococcus multilocularis. Both these diseases are the doctors considered in the framework of echinococcosis occur as they are similar.
Echinococcus undergoes its own life cycle. In the body of infected animals (dogs, foxes, wolves, jackals) in the gut is Mature Echinococcus. The adult worms produce eggs that are excreted with the feces into the environment.
Man is infected by eating vegetables contaminated with eggs of Echinococcus. In addition, eggs of the parasite can stay in the dog’s fur on the tongue. And if we stroke an infected dog, it won’t wash our hands or will to kiss her (as do many hosts), ingestion of eggs of worms can not be avoided. So the person becomes ill with echinococcosis.
After ingestion of eggs of Echinococcus, they enter the intestine. From the eggs come the larvae, which actively “drill” the intestinal wall and penetrate into the blood vessels. The bloodstream Echinococcus is logged in the internal organs, where it forms a cyst with fluid, which can reach twenty centimeters in diameter. The cyst is full of scolexes (heads of the parasite).
The first barrier to the advancement of Echinococcus is the liver. In most cases, Echinococcus “stuck” in the liver, forming tissue cysts. If the worms manage to pass this barrier, it travels to the lungs. In rare cases the “journey” of Echinococcus continues and then from the lungs it blood is stored in the brain, kidneys, heart, bones.
Can be infected with echinococcosis person from an infected person? No, it can’t. So to avoid any contact with an infected person is not necessary.
The symptoms of echinococcosis gigatonnes
Hydatid disease can be asymptomatic for years. Observed only toxic-allergic symptoms are: weakness, fatigue, itchy skin, rashes, periodic fevers. The occurrence of these phenomena is associated with a toxic effect produced by Echinococcus waste products. Unfortunately, these nonspecific signs diagnosis of echinococcosis it is impossible. Clinically significant symptoms occur when the cyst will increase and thereby impair the function of internal organs.
Hydatid cyst of the liver
More than 50% of reported cases of echinococcosis observed damage liver, and often the cyst is localized in the right lobe of the organ. Patients lose their appetite, lose weight, complain of decreased performance, expressed weakness, fever. Then there is aching pain in the abdomen, feeling of heaviness in the right hypochondrium, vomiting, disorders of stool.
Characteristics of the clinical picture of the disease depends on where it is located hydatid bubble. So, if the cyst compresses the biliary duct, jaundice occurs. When squeezing a cyst of the inferior Vena cava develops portal hypertension, manifested by dilatation of the stomach, ascites (abdominal enlargement).
Affected by Echinococcus, the liver is enlarged, firm to the touch and painless. When a cyst is formed on the front surface of the liver, the doctor can even be felt through the skin.
Is to be feared complications of liver echinococcosis:
- Suppuration of hydatid of the bladder with formation of liver abscess and its further opening to the abdominal cavity;
- The gap anagnosis bladder with the development of allergies (up to anaphylaxis) and spread tapeworm.
Echinococcosis of the lungs
More than 20% of all registered cases of echinococcosis affects the lungs. The clinical picture of disease can be divided into two stages. The first is a stage nelepova hydatid cysts. At this stage, the sick complain of chest pain, at first intermittent, then permanent. Also having shortness of breath, cough at first dry, then moist with the Department of Muco-purulent sputum, hemoptysis. All these symptoms are caused by compression of the growing cyst of the lung tissue, bronchi, blood vessels. The bubble may suppurate. In this case, a lung abscess.
The second stage is the period of the opened cysts. At the break of the cyst into the bronchus, a strong cough, dyspnea, cyanosis of the skin. Sputum is sometimes possible to detect impurities of blood, fragments of the cyst membrane in the form of films. These symptoms persist for a few days and burdened with heavy allergies. When a breakthrough cystic masses in the pleural cavity occur severe pain in the chest, a pronounced rise in body temperature, chills. If broken, a viable cyst with tapeworm scolexes, then the parasites spread around with the development of secondary echinococcosis. Secondary hydatid disease clinically manifested after a couple of years.
Hydatid disease of other organs
Hydatid cysts can form in the brain, heart, kidney, spleen, bones and muscles. About hydatid cyst of the brain may be suspected on such grounds as headaches, dizziness, vomiting, seizures, paralysis of limbs, mental disorders.
When hydatid cyst of the kidney patient is concerned about the high fever, aching lower back pain, and sometimes renal colic. Echinococcosis of the heart is accompanied by chest pain, heart rhythm disturbances. Compression by cysts of the coronary vessels may lead to myocardial infarction. When cyst rupture possible embolism of pulmonary artery, accompanied by chest pain, cough, hemoptysis.
Echinococcosis of the bone is recorded very rarely. The symptoms of this pathological condition are bone fractures in the area of implementation of the helminth.
The symptoms of alveolar echinococcosis
While alveolar echinococcosis is formed a multi-chamber cyst. In fact it is a conglomerate of small bubbles. The size of the cyst can be from one to thirty centimeters in diameter. Most often, when alveococcosis liver is affected.
Bubbles of alveoli grow quickly and penetrate into surrounding organs (diaphragm, kidney, pancreas, pericardium). This feature alveococcosis reminds uncontrollable growth of malignant tumors. While the clinical picture of alveococcosis similar to that in gigatonnes echinococcosis.
The first signs of the disease can be considered as a dull pain in the right side, nausea, impaired chair. The patient’s condition deteriorates, you experience weakness, loss of appetite, weight loss, jaundice. The decay of the cyst increased pain in the right hypochondrium, the temperature rises, increasing weakness. Alveococcosis metastatic to the formation of new cysts in other organs.
The clinical picture with echinococcosis are nonspecific, the same symptoms may occur with a variety of diseases. To determine the exact diagnosis of the patient has to undergo studies:
- Clinical analysis of blood — determined by the increase of eosinophils and ESR acceleration;
- Biochemical analysis of blood — violation of the ratio of blood proteins, reduced albumin and prothrombin, increased gamma-globulins;
- Direct microscopic examination of urine, sputum , identified fragments of Echinococcus;
- The Casoni test and diagnostic allergopharma, to be positive which indicate infection with Echinococcus;
- Immunological methods (Phragmites, XRD, ELISA) — determined antigens of Echinococcus antibodies to it;
- Instrumental methods (ultrasound, CT, MRI, x-rays) are determined with rounded formations (cyst) in the tissue of the affected organ.
Treatment of hydatid disease, surgery
The prognosis of echinococcosis is always serious. Existing cyst does not resolve with time, but rather may suppurate and rupture. Therefore, the detection of the disease, we can’t wait, you need to start treatment.
The main method of treatment is surgical. If the cyst is on the surface of the body, the surgeon during surgery to completely remove the cyst with sheath and adjacent tissues. When the cyst is situated deep in the body, the surgeon opens the cyst and removes it from the liquid and process the cavity with a disinfectant solution. Sometimes the surgeon have to remove part of the organ. In cases of liver Echinococcus, given the location of the cyst, its size, the surgeon may perform the surgery with dissection of the abdominal cavity (laparotomy) or minimally invasive percutaneous method (laparoscopy).
Before or after surgery, the patient can assign Anthelmintics — Albendazole. The dosage and duration of taking the medicine the doctor determines, given the characteristics of the course of the disease.
Preventive measures for the prevention of echinococcosis is quite simple. It is necessary to observe personal hygiene: wash vegetables, hands before eating, do not drink water from open water bodies are not in contact with street dogs. In particular, it is very important to explain to children the need to respect hygiene. If the person lives at home with the dog, then the animal should be regularly dewormed.
Valery Grigorov, medical columnist