What is echinococcosis? This is a parasitic invasion of echinococcus, carried out by tape helminth in the larval stage. This condition is fraught with damage to internal organs. In simple terms, this is a disease in which echinococcal cysts form in the lungs, liver, heart, brain and tissues.
What leads to the beginning of its development? What are the symptoms? Is it possible to get rid of it? These and many other questions are answered in our article.
Causes
What is echinococcosis, we described above. What are the causes of the defeat of this helminth?
The final owners of mature worms are animals in the intestines of which cestodes parasitize. Wild and domestic herbivores, as well as humans, are intermediate hosts of the larval stages. They are also considered a kind of biological dead end, since they do not secrete echinococcal eggs into the environment, and therefore cannot be sources of invasion.
Omitting the details of the development of parasites, one should go directly to the issue of infection. How is it going? The final host secretes eggs into the external environment along with bowel movements, which infect humans. There are two ways:
- Alimentary. It is enough for a person to consume water, fruits or vegetables contaminated with infected feces.
- Contact. In this case, you need to have contact with an animal infected with echinococcus, or to carve its carcass.
Based on this, we can conclude regarding what echinococcosis is. This is a disease that people infected with caring for animals, activities related to them (slaughterhouse workers, hunters, breeders, etc.) usually become infected. Also at risk are those people who are not used to being responsible for processing processed foods.
Pathogenesis
The causative agent of echinococcosis is Echinococcus granulosus or Alveococcus multilocularis. What happens when infected eggs enter the human body?
In the digestive tract, their membrane dissolves. As a result, larvae come out, which, with the help of the hooks on their body, penetrate the intestinal mucosa.
From there, these creatures enter the venous bloodstream, and then into the portal system. Some of them settle in the liver. Less commonly, parasites pass through the inferior vena cava into the right heart, and then penetrate into the pulmonary circulation and into the lungs.
More often it turns out that the embryos penetrate into a large circle of blood circulation. This is fraught with their entry into any organs. They can affect the muscles, kidneys, spleen, brain.
In 70-80% of cases, the liver is affected. 15% have lungs. In other rare cases, other internal organs are affected.
When the embryos settle, the bubble (hydatidous) stage of development of the causative agent of echinococcosis begins in the organ. Cysts with a two-layer membrane form. They begin to slowly increase in size (growth rate is approximately 1 mm / month). Some patients ignore their condition for years, so their cysts can be gigantic.
These bubbles are filled with an opalescent liquid of a white hue, inside which scolexes and daughter bubbles float. Often their number reaches 1000.
What is echinococcosis is now clear. What is the mechanism of its formation, we have considered. What causes its manifestations? The sensitizing effect exerted by parasitic antigens, as well as the mechanical pressure exerted by the cyst on tissues and organs.
It should be noted that parasitization of echinococcus is accompanied by the release of its metabolic products, which is why intoxication and allergy begin to develop in the carrier. If the cyst bursts, the contents will be in the abdominal or pleural cavity, and this is fraught with anaphylactic shock.
Even without such a phenomenon, the patient's condition will worsen. The cyst will continue to put pressure on the surrounding structures, as a result of which the functions of the affected organ will be violated more and more. Her suppuration may develop. Sometimes a real miracle happens - Echinococcus dies spontaneously, recovery comes.
Symptoms
Talking about what echinococcosis is, it should be noted that it can be asymptomatic in humans for decades. If clinical symptoms occur, then pathognomonic signs do not appear.
Whether it is echinococcosis of the brain or liver, there are three stages of development.
The first (latent) begins from the moment when the parasites invade the tissue. This period lasts until the onset of the first symptoms. Then comes the second stage, when the following clinical manifestations make the disease known:
- Pain in the place where the cyst is formed.
- Hives.
- Severe weakness.
- Nausea.
- Poor appetite.
- Recurrent diarrhea.
- Pain and heaviness in the right hypochondrium.
- Itchy skin.
- Other specific manifestations, depending on which organ is affected.
The third stage is complicated. The disease is already running, cyst rupture may occur. This is fraught with severe consequences, such as pleurisy and peritonitis.
If the cyst festers, then severe intoxication and high fever join. Often there is obstructive jaundice, ascites, pathological fractures.
Brain
As already mentioned, echinococcosis in humans can occur in various parts of his body. Each case needs to be considered separately.
The following manifestations characterize brain damage:
- The patient is concerned about headaches, vomiting, dizziness, general epileptic seizures, as well as congestive optic nerves.
- Dementia, depression, and delirium may occur.
- Cortical epileptic seizures often occur, after which paresis develops in the limbs, before which they are affected by a seizure.
- In the cerebrospinal fluid, pleocytosis and elevated protein levels are detected.
- Analyzes show the presence of eosinophilia in the blood.
It is very important to conduct differential diagnosis of echinococcosis. People with similar symptoms also show brain tumors.
Bile ducts
They can also be affected by this disease. As a rule, the process is localized in the gallbladder. The ducts are involved in this process a second time.
If a parasitic cyst erupts, then a number of symptoms occur:
- Hepatic colic.
- Jaundice.
- Vomiting
- Nausea.
- Acholic stool.
- Chills and fever accompanying cholangitis.
- Blockage of the bile ducts.
With this pathology, a very high mortality rate, since damage to the gallbladder with parasites is fraught with the development of cholecystitis, cholangitis and hepatitis.
In this case, surgical treatment is necessary. Surgical intervention helps to restore the free outflow of bile, remove echinococcus and drain the purulent cavity. This can not be done without opening the common bile duct and removing daughter cysts with scraps of parasite tissue.
In rare cases, cholecystectomy is indicated. If the condition is irreparable, then the gallbladder will have to be removed. In parallel, they can drain the liver cyst, or also remove it.
Lungs
This paired organ often becomes the "target" of the disease. If we are talking about the symptoms and diagnosis of echinococcosis in humans, you need to list the signs that indicate its development in this case. They can be distinguished in the following list:
- Dry cough. Over time, sputum begins to appear, sometimes even with blood.
- Severe chest pain of a pressing nature.
- Dyspnea.
- Protrusion of intercostal spaces.
- Chest deformity.
Often this condition is complicated by exudative or dry pleurisy, perifocal inflammation of the lung tissue.
The cyst can fester, break into the pleural cavity or bronchi. This is accompanied by bouts of coughing and the release of light sputum with impurities of blood in huge quantities. Other symptoms appear:
- Lack of air.
- Cyanosis.
- Acute chest pain.
- Fever.
- Chills.
- Anaphylactic shock.
In the early stages, with timely diagnosis in the clinic of echinococcosis, treatment is carried out with medication. But in case of complications, urgent surgery is needed. With timely intervention, the prognosis may be favorable.
Liver
This organ is most often the “target” of diseases of echinococcosis, ascariasis and other conditions associated with the penetration of parasites into the body.
They are deposited in large quantities in small capillaries. Formed cysts grow slowly, breaking into the liver parenchyma. They can even penetrate into the free abdominal cavity or into the bile ducts.
The most pronounced symptom is a feeling of pain and heaviness, concentrating in the right hypochondrium and epigastrium.
If suppuration of the bladder occurs, then an abscess of the liver begins to develop. Opening it may be fraught with peritonitis or purulent pleurisy.
A bursting bladder can lead to the development of allergic reactions or even to anaphylactic shock. You can’t bring it to this, because in the early stages, drug treatment gives a good result.
Kidney
Cysts form in their cortical substance. Most often, the left kidney is affected. Cysts can be open, closed, as well as pseudo-closed.
The neglected state is fraught with displacement of the kidney, as well as deformation and further expansion of the renal calyces and pelvis. The parenchyma may even atrophy.
In the kidneys, parasites often die, after which they are calcified. This process makes itself felt by the following symptoms:
- Weight loss.
- Loss of appetite.
- Severe weakness.
- Fatigue.
- Malaise.
- Intoxication.
- Pain in the hypochondrium of a dull nature, radiating to the lumbar region.
- Renal colic.
- Elevated temperature (usually to subfebrile indicators).
- Itchy skin.
- Hematuria
- Difficulty urinating.
A diagnosis performed after a doctor has examined the suspected symptoms of echinococcosis also shows blood eosinophilia. Often there is an increase in the erythrocyte sedimentation rate and moderate leukocytosis. In rare cases, tests show cylindruria and proteinuria.
It should be noted that the cyst can be palpated. It represents a convex roundness in the hypochondrium, can be smooth or tuberous.
How is this condition treated? Cysts are necessarily removed, after which an echinococcectomy and a kidney resection are performed. In rare cases, nephrectomy is indicated.
What the prognosis will be depends on the degree of intoxication. If the echinococcal bladder bursts and the cavities are seeded, it will worsen at times.
Spleen
Studying the topic relating to the symptoms of echinococcosis and the diagnosis of this disease, it is necessary to consider those cases when this organ is affected.
All visual and structural changes in the spleen can be determined by x-ray, ultrasound, as well as CT and MRI.
Symptoms for this type of parasite lesion are as follows:
- A feeling of pain and heaviness in the upper left abdomen.
- A tumor that goes far into the left hypochondrium.
- Pain in the epigastrium.
- Poor appetite and the appearance of aversion to food.
- Vomiting and nausea.
- General weakness.
Often the liver is involved in the process. Then cholecystitis, cirrhosis begins to develop, diabetes and pancreatitis can join.
The kidneys, on which the spleen covered with cysts exerts pressure, are also involved in the process. They can shift, which is fraught with colic and problems with urination. Often there are symptoms similar to signs of intercostal neuralgia, as well as shortness of breath and cough. This is observed if the diaphragm shifts significantly.
Heart
Parasites rarely infect this organ. At risk are children and people over 20 years old.
Parasites entering the heart through coronary blood flow grow very slowly. The myocardium of the left ventricle is usually affected.
Symptoms are as follows:
- Signs of myocardial ischemia.
- Heart failure.
- Chest pains.
- Heart rhythm disturbances.
- Syncopal conditions.
Myocardial ischemia, vascular compression, obstruction of the outflow tract, impaired conduction of the heart, embolism of the arteries - these are not very difficult consequences of this condition. If the cyst bursts, then sudden death may occur. Sometimes even emergency intervention does not help.
At the slightest alarming symptoms, you need to seek help. Most likely, surgical treatment aimed at direct debridement and excision of cysts will be indicated. Intensive care is also prescribed using Mebendazole and Albendazole.
Spinal cord
The defeat of this body should be studied necessarily. Below we will consider the diagnosis and treatment of echinococcosis.
Spinal cord infection does not occur in the latent stage for long. Even a small cyst can cause compression of this organ, which is fraught with many consequences (dysfunction of the pelvic organs, paralysis and paresis).
Often there are shingles in the chest, discomfort and pain in the limbs. All this is enhanced by coughing, sudden movements.
If the disease progresses, the following consequences will arise:
- Kyphoscoliosis.
- Kyphosis.
- Limited spinal mobility.
- Spastic paraparesis.
- Brown Sekar Syndrome.
It is very important in this case to resort to differential methods for the diagnosis of echinococcosis of the spinal cord, since its symptoms are similar to those observed with spinal tumors and tuberculosis.
The treatment is usually surgical. If the disease is detected at an early stage, then you can fix the problem with medication.
Diagnostics
The examination begins with a general medical examination and a doctor's examination of the anamnesis. Diagnosis of echinococcosis of the lungs, liver, heart and other organs is significantly different.
The doctor reveals the clinical and radiological signs, after which the patient is sent to the following diagnostic procedures:
- CT It allows you to study absolutely all organs, as well as detect the smallest cysts, revealing their exact location. It helps to differentiate them from oncological formations, even measure density.
- MRI Using this procedure, damage can be assessed after surgery.
- Ultrasound Allows you to detect parasitic congestion in absolutely any area of the abdominal or chest. Ultrasound also helps to track the response of cysts to treatment, to analyze the pace of their development.
- X-ray It makes it possible to detect cysts in bone tissue, muscles, lungs, and also to see calcified masses.
Patients are assigned a blood test by ELISA. Thanks to him, it is possible to detect the presence of antibodies to parasites. This method is more effective than a clinical blood test.
Therapy
Regarding the treatment of echinococcosis, recommendations to the patient are given by his personal doctor. He prescribes therapy, taking into account the characteristics of the human body, the specifics of the development of the disease, the results of diagnosis, as well as dozens of other factors. Self-medication is not only unacceptable, but also fraught with serious consequences.
The doctor, as a rule, prescribes drugs in the following groups:
- Painkillers.
- Anthelmintic.
- Hepatoprotective.
- Antiemetic.
- General strengthening.
Combination therapy helps relieve pathological manifestations. If it turns out to be ineffective, then an operation is prescribed. There are several options:
- Radical intervention. It implies excision of the affected area.
- Conditionally radical. In the course of such an operation, a site is removed in which echinococcosis can recur.
- Auxiliary. It is aimed not at treating a patient, but at alleviating his condition.
- Intervention to prevent complications. Typically, organ drainage is required after cyst rupture.
If the operation passes on time and successfully, and the patient does not get infected again, then the prognosis is favorable. In such cases, relapses do not occur.
But patients will be registered at the dispensary for another 8-10 years. Every year they will need to take serological tests, as well as undergo x-ray and ultrasound examinations.
Of course, it is necessary to lead a healthy lifestyle to maintain your body, and also follow all the rules of hygiene in order to protect yourself from re-infection.