Parasitic diseases can hardly be considered a rarity in the modern world. And often in medical practice are faced with a disease called echinococcosis. What it is? In fact, it is a relatively rare ailment that develops on the background of the penetration of the larva of the Echinococcus Echinococcus glanda into the body.
The disease is accompanied by the formation of cysts within the human body, which spread, affecting certain organs, which, respectively, leads to disruption of their work. In the absence of timely and correct treatment, the illness leads to severe, dangerous complications.
Epidemiology of the disease
As already mentioned, echinococcosis today is considered a relatively rare disease. On the other hand, it is extremely common in some countries and regions. For example, disease outbreaks are often observed in the countries of South America, including Chile, Uruguay, Brazil, Argentina. The disease is also often diagnosed in residents of North Africa, New Zealand, Australia, Southern Europe, India, Japan and some others.
As for Russia, there are outbreaks of echinococcosis, mainly recorded in regions where animal husbandry is developed. These are the Samara, Orenburg, Volgograd and Rostov Regions, as well as the Stavropol, Altai, Khabarovsk Territory, Tatarstan, Bashkorstan and some other zones. In Ukraine, the disease is spread mainly in the southern regions.
Description of the adult form of the pathogen
Echinococcus granulosis is the causative agent of the disease called echinococcosis. The photo shows the adult form of the parasite. In fact, it is the smallest tapeworm, whose body length does not exceed 8–9 mm. The sexually mature form of the worm has a head, neck, and body consisting of 3–4 segments. The head of the parasite is “equipped” with four suckers and two rows of hooks.
Getting into the body of the final host, echinococcus with suckers and hooks is fixed on the mucous membrane of the small intestine, where it reaches puberty and begins to multiply. As a rule, the last segment on the body of the parasite contains eggs. These segments break off from time to time, with the result that the eggs fall into the external environment along with the animal feces.
Echinococcal cyst and features of its vital activity
Man is an intermediate host for echinococcus - in his body the parasite does not reach puberty and does not reproduce. That is why in modern medicine the defeat of a person by this parasite is a kind of biological dead end.
After penetration into the body, the development of the worm larva begins. By the way, echinococcosis is most often diagnosed in children, since the probability of infection increases with non-compliance with the rules of hygiene, which is not uncommon in young patients. Under the influence of digestive juices, the embryo is released from the membrane and penetrates the mucous tissues of the gastrointestinal tract. Already from here it easily enters the blood and lymph, along with the current of which it is quickly spread to different organs. Most often it is the liver and lungs, although defeat and any other structure. Here the germ is transformed into a bubbly shaped larva, which is called a cyst.
How does the infection occur?
As already mentioned, the final owners of echinococcus are dogs, less often - cats. The eggs of mature chains are released along with the faeces, then get into the external environment: on the ground, grass, vegetables, fruits, etc.Of course, it is possible to pick up an infection by eating unwashed food, which in one way or another has been in contact with infected feces.
In addition, the pathogen enters the human body along with insufficiently roasted or boiled meat. And the infection is transmitted through physical contact with infected dogs. By the way, this is why echinococcosis in children occurs quite often, because they often forget to wash their hands.
The main symptoms of the disease
Echinococcosis is most often diagnosed in children, although the likelihood of the appearance of the disease in older adults is also quite high. Today, it is customary to single out four stages of the development of the disease:
- The latent stage at which the subjective symptoms are practically absent. At this time, human infection, localization of the oncosphere and its gradual growth occur. It should be noted that the duration of this stage depends largely on the location of the cyst - for some people, the disease does not make itself felt for many years.
- At the second, initial stage of echinococcosis, subjective symptoms appear. This may be occasional pain, discomfort or weakness. Most often, patients blame everything on general malaise, nutritional errors, etc.
- The third stage is accompanied by severe symptoms, which is associated with a significant increase in the size of the cyst. Education begins to squeeze adjacent tissues, including blood vessels, nerve endings, bile ducts, etc.
- The fourth stage is indicated in cases when patients have complications. The most dangerous is the gap cyst.
Hepatic form of the disease
Most often, echinococcosis (photo presented above) affects the liver. According to statistics, in more than 70% of cases, oncospheres of the pathogen are localized precisely in the tissues of the liver. In the early stages, the disease proceeds without any symptoms.
In the second stage, symptoms such as nausea and vomiting, loss of appetite. Patients also complain of permanent weakness and decreased performance. From time to time, stabbing pains in the right hypochondrium. Sometimes the pain extends to the epigastric zone. Changes in stool are also observed, which is associated with impaired normal digestive processes.
In the third stage, the patient's well-being deteriorates significantly. Possible development of an abscess, severe pain in the upper abdomen, as well as fever. Cyst rupture is the most dangerous complication to which liver echinococcosis can lead. The treatment in this case should be carried out immediately, since the contents of the cyst enter the tissues and the blood is fraught with an intense allergic reaction up to the development of anaphylactic shock.
Pulmonary echinococcosis is the second most common form of this disease. As in the previous case, small cysts may not cause any inconvenience. But as this structure grows, the tissues of the lung, bronchi, and vessels are squeezed.
In the initial stages, echinococcosis of the lungs is accompanied by breathing problems. In particular, patients often complain of shortness of breath and occasional chest pain. In addition, there is a cough. At first it is dry and worries the patient mainly at night. But then, during cough, purulent sputum begins to stand out.
Cyst rupture is extremely dangerous and is accompanied by a strong cough, cyanosis, aspiration pneumonia and severe allergic reactions. If a cyst breaks into the pleura, the likelihood of anaphylactic shock and instant death is high.
As already mentioned, hoofed animals are intermediate hosts for echinococcus, but dogs, wolves, and foxes less often act as final ones.Echinococcosis of animals may look different - it all depends on the number of cysts in the body, as well as the quality of care for pets.
At the initial stages, gradual exhaustion, as a rule, develops, which is associated with impaired digestion. Herbivorous ungulates often exhibit symptoms of damage to the liver and lungs. As for the final owners of the parasite, they can be noted the appearance of signs of exhaustion, as well as persistent diarrhea, constipation, itching in the anus.
Modern diagnostic methods
Human echinococcosis is a rather dangerous disease. That is why so important diagnostics. Today, medicine offers many ways to detect the disease. The most informative analysis for echinococcosis is the so-called Katsoni reaction, which gives correct results in 90% of cases. During the procedure, a small amount of hydatid fluid is injected into the patient under the skin. In case of a positive reaction, a pronounced redness appears at the injection site.
Naturally, the patient also undergoes blood, urine and feces tests. Serological tests are also carried out, the specificity of which is quite high. All these studies help to establish the presence of echinococcosis.
But with such a disease, it is important to find the location of cysts. For this purpose, various procedures are used, including computed tomography, angiography of the celiac artery (for suspected echinococcosis of the liver), as well as scanning with radioactive isotopes and some other techniques.
Disease treatment methods
Most often in modern medicine, liver echinococcosis occurs. Treatment in any case is carried out exclusively by surgery. Taking antiparasitic drugs does not have the desired effect, as cysts still remain in the body, and there is always a risk of purulent damage. Naturally, conservative therapy is necessary, but is used as a prophylaxis. Patients are prescribed medications before and after the removal of hydatid cysts.
So how is echinococcosis treated? The operation is performed under general anesthesia and only after all cysts have been detected during the diagnostic process. During the procedure, it is extremely important to remove the pathogen completely, with all the membranes and to prevent its contents from falling onto the surrounding tissues. The most effective surgical intervention is in the initial stages. If a human body is affected by a large number of cysts, then their removal is carried out in several stages: during the first operation, the most dangerous formations are eliminated, and after some time (usually from three to six months), the procedure is repeated.
To prevent complications and inflammation after surgery, patients are prescribed antiparasitic and antibacterial drugs.
Are there effective prevention methods?
Unfortunately, there are no vaccines that can permanently protect against such ailment. However, by following some preventive recommendations, you can reduce the risk of developing a disease such as echinococcosis. What is it and how does effective prevention look like?
Firstly, it is extremely important to adhere to all sanitary and hygienic standards in agricultural areas where animals are raised. Since dogs are most often the source of the pathogen for humans, it is necessary to regularly carry out appropriate checks of watchdogs.
As for personal prevention, experts recommend washing hands thoroughly before eating, as well as after any direct contact with the animal. You can not drink water from natural ponds or polluted sources, eat unwashed berries, fruits and vegetables, as well as eat insufficiently heat-treated meat products.
What is echinococcosis, how to determine the symptoms and whether it is possible to cure the disease without surgery
At the reception of an infectious disease disease, quite often such a diagnosis as echinococcosis sounds, that not all patients know this. The disease is parasitic in nature and can affect the liver, kidneys, lungs and any other organs. At the same time, the larvae of the chain of Echinococcus granulosus enter the human body. The disease is difficult to diagnose and difficult to cure. It is important for the patient to seek medical help on time. In the absence of adequate therapy, echinococcosis can cause dangerous complications. An infected person is the carrier of the parasite larva and can infect others. To avoid the development of such a disease, it is necessary to carefully monitor the observance of personal hygiene and not to neglect preventive measures.
Description of echinococcosis
According to recent medical research, predominantly southern people suffer from echinococcosis. The disease is widespread in the countries of the former USSR, South Africa, South America, Australia, European countries. What is echinococcosis, to date, not many people know. Faced with a similar diagnosis, people just shrug their shoulders and wonder.
An important task of the Ministry of Health is to increase public awareness of this parasitic disease. To impede the growth of the number of patients, it is necessary to conduct familiarization lectures and promote preventive measures.
Echinococcosis can affect absolutely all organs in the human body. However, kidneys, livers and lungs are most often at risk. This is followed by the spinal cord, bone, brain. The larvae of parasites can live in the region of the organs of the genitourinary system.
Carriers of the parasite are animals. Helminth lives in canine, wolf, fox bodies. Houseware suffers from it: cows, sheep, goats. Infection of a person most often occurs through canine feces. When the parasite in the body of the animal reaches a mature period, segments (larvae) begin to move away from it, which are released along with the faeces. When the dog lives in the apartment or in the yard, the owner can easily bring the helminth eggs into the house. Next, the larvae enter the food, and with the food reach the human body.
Humans are not the final link in the parasite development chain. Man is only an intermediate carrier of the larva. However, thanks to modern technical progress and a conscious way of life, the existence of eggs of this worm in the human body is the final stage of their development.
When a larva gets into a certain organ, it begins to grow actively. In this case, the cavity of the eggs is filled with liquid. They concentrate in one place and form a cyst. This neoplasm does not disturb the patient until he begins to put pressure on nearby organs.
The grub period can vary from a few months to tens of years. In the end, cysts burst. To eliminate the effects necessary to do the operation. Surgical intervention is by far the most effective method of therapy, since worm eggs are resistant to almost all antiparasitic programs.
The main stages of the disease
The manifestations are completely dependent on the stage of the disease. In order to decide on the most effective course of therapy, it is necessary to determine how developed the pathological process is, what structural and chemical changes are present in the body. In modern medicine, there are four main stages of echinococcosis:
- 1First stage. All processes are hidden, without severe symptoms. That is why this stage is called latent. It lasts from the entry of the larvae into the body and until the first signs appear.
- 2Second stage.At this time there are minor violations, weakening of the immune system, the deterioration of the general condition of the body. All manifestations are subjective and relative.
- 3Third stage. During this period, characteristic symptoms of the disease begin to appear acutely. The general condition worsens, the periods of an aggravation are possible. Then the disease becomes chronic again.
- 4th fourth stage. At this stage there are complications. The disease affects the nearby organs, disrupted the harmonious work of the body. Failure to consult a doctor is possible fatal.
The disease begins to develop immediately after an echinococcus enters the body. Symptoms do not appear immediately. This largely depends on the nature of the lesion and the organ that has been infected. In the human liver, the larvae can live for tens of years, while slowly increasing in size.
Complaints of the patient on pain in the abdomen, nausea begin only when the cyst reaches an impressive size and puts pressure on the organs that are located nearby. At the same time, not only the impaired functioning of the affected organ is noted, but also the disorder of other systems. To establish an accurate diagnosis, the doctor prescribes the patient a comprehensive examination of all organs. Such a diagnosis is carried out in order to see all the affected tissue.
When the disease reaches a critical point, doctors insist on the operation. Radical treatment gives the patient a chance for full recovery. In addition, after resection of any cyst in the human body, it is necessary to carefully study the composition of the tumor. Without special laboratory tests, it is almost impossible to see the difference between an ordinary cyst and one that was formed from a helminth egg.
Causes and clinical manifestations
The main reason for the development of echinococcosis in the human body is direct contact with dogs.
These animals are the ultimate carriers of the chain and potential carriers of helminth larvae. Eggs may be present in animal fur, on the nose, tongue. Normal hand stroking of a dog can be a cause of a dangerous illness for a person.
The second reason is the eating of contaminated meat of certain animals. If the product has not undergone sufficient heat treatment, live larvae of various helminths may remain on its surface. The development of echinococcosis can provoke the use of veal, lamb, less pork and chicken.
In addition, the disease can be infected through dirty hands. Every day a person is in contact with many potentially dangerous bacteria and viruses. Among them are often found oncospheres, that is, eggs of various worms. In the presence of strong immunity, the larva may not settle down. If the defenses of the human body are weakened, then the pathological process begins to develop.
Modern medicine highlights the various symptoms of this disease. They depend on the form in which echinococcosis occurs, and on the affected organ. If the larva has taken root in the liver, then the patient complains of aching pain in the abdomen, discomfort in the hypochondrium, abnormal stool, nausea, vomiting, pain during palpation of the organ. In case of rupture of a cyst, a sharp cutting pain, fever is noted. In this case, an urgent need for an operation.
If the disease affects the lungs, then the patient has shortness of breath, cough. After some time, purulent sputum is formed. On examination, the doctor notes the external defects of the chest. It is flattened, the intercostal space is practically invisible. In the third or fourth stage of pulmonary echinococcosis, the cyst bursts. Content flows into the bronchi or into the pericardium. If fluid enters the bronchi, breathing difficulties are noted. When the pericardium suffers, it can be fatal.
Echinococcosis of other organs is rare.However, at risk are the kidneys, spleen, bone marrow, muscle, brain. Signs of these forms resemble the development of an ordinary tumor process. The treatment started in time significantly increases the patient's chances for recovery and prolongs his life.
The development of modern technologies in the field of medicine allows doctors to determine the presence of echinococcosis in the early stages. However, this is not possible in all cases. It is easiest to diagnose a liver infection. To do this, the patient is assigned to undergo the following procedures:
- transumbilical portohepatography,
- radioactive isotope scanning
- selective angiography of the celiac artery,
The damage to the organs of the larvae of worms is a disorder that occurs in a chronic form. There may be periods of improvement and subsequent periods of severe exacerbation. Diagnosis is best done during periods of relapse, since then the clinical picture of echinococcosis is best seen.
In addition, a skin test is performed to determine the presence of larvae in the body. It is called the Katzon reaction. This is a study in which a sterile liquid of the pathogen is injected under the skin of a potential patient. If within a few minutes after the injection, the epithelium becomes red, and after another hour the allergic reaction spreads to the whole arm, then the probability of having the disease is 85%.
Doctors resort to a serological reaction. In this case, a specific antigen is administered to the patient. If an allergic reaction to a vaccine is observed, then there is every chance to suggest the development of a parasitic disease.
The feasibility of a radical method of treatment in the form of an operation is determined depending on the form and stage of the disease, which are determined during contrast diagnostics. Tomography allows you to see the size of the cyst and the nature of the structure. Also during the computer examination, you can determine the exact location of the operation.
Types of liver echinococcosis
In gastroenterological practice, there are 2 types of the disease. There are alveolar and hydatid echinococcosis of the gland. These species have their own characteristics.
The hydatid form does not have a bright clinic for a long time. Most often, the first signs begin to bother a person when one or multiple cysts become large in size. Depending on the location of the lesion, this form is divided into varieties - anterior, ascending and descending. The symptoms of the disease appear within a year after infection.
The alveolar form is characterized by a chronic course. For 10 years or more, invasion may not manifest at all. Subsequently, multiple cysts are formed, which leads to a loss of liver function.
Degrees of parasitic ailment:
- Easy Symptomatology is absent.
- Medium heavy. Signs are expressed slightly, there is no pain during palpation of the liver. Pain syndrome occurs when a cyst reaches a critical size.
- Heavy Bright clinic, rapidly developing complications.
Regardless of the form of the echinococcosis, if there is no treatment, the parasites infect the abdominal organs, the spinal cord / brain, the heart, the lungs.
Etiology of helminthic disease
The main factor leading to the development of the disease is the penetration of echinococcus into the human body. There are several ways of penetration of parasites:
- Non-compliance with the rules of hygiene after contact with dogs. The worms are the mongrels, and even pets.
- Consumption of vegetables, fruits without prior washing.
- The use of raw water from natural sources.
- Hunting for wild animals, which act as intermediate hosts. So, infection can occur during the cutting of the carcass of the animal, or after eating infected meat.
At risk are small children, people who are in contact with farm animals.
At first, the helminth eggs enter the human stomach, and then through the circulatory system they reach the liver, in which the process of reproduction begins. It can last for years. By itself, the parasite is small in size, but it provokes the formation of a cyst - from 1 to 50 centimeters. Around it forms a dense shell of a fibrous character.
Principles of treatment
This disease is usually not amenable to traditional methods of therapy. It is also extremely risky to use traditional medicine without consulting a doctor. They are not effective. The patient will only lose time when it was possible to completely cut a cyst within healthy tissue.
Doctors recommend not to delay and immediately remove the tumor using surgery. It does not guarantee full recovery. Similar tumors can reappear in the body. To avoid this, a comprehensive diagnosis is necessary before surgery. If the tumor is not single, then it is likely that the operation will be multiple.
There are two options for radical therapy. The first option is to remove a cyst along with a fibrous membrane. The second option is to remove the fluid and crosslink the tumor walls. During the operation, it is extremely important to ensure that the extracted hydatid fluid does not get into other organs. The larvae can remain in the body and provoke the re-development of the cyst.
Treatment of echinococcus is a difficult and long process. A certain period of time the patient is in the hospital. After discharge from the hospital, the doctor may prescribe a fortifying vitamin complex, a therapeutic diet. After surgery, the body can not be overloaded, so it is important to monitor diet, sleep and rest.
If the patient wants to use the methods of traditional medicine to combat this disease, it is necessary to consult with your doctor. After surgery, you can use some tools for this purpose. Useful decoctions of wormwood, ginger tinctures. Lemon, garlic have antiparasitic properties.
Treatment of echinococcus is a difficult and long process. To overcome the disease is possible only with the help of competent infectious diseases surgeons. The main task of the patient is not to ignore the symptoms and consult a doctor in time.
What is echinococcus: symptoms and treatment of echinococcosis
Often in the human body is detected echinococcus, the symptoms of which are quite nonspecific. To date, studied a large number of different parasitic worms. All of them can be divided into 3 types: round, flat (flukes) and tape. Echinococcus is a tape parasite. Unlike other members of this group (bovine and porcine tapeworm), this parasite is small in size. Nevertheless, its presence in the internal organs of a person presents a certain danger. What are the features of echinococcus, and how is echinococcosis characterized?
Characteristics of echinococcus
These helminths are parasitic in the body of humans and some animals. Man is an intermediate owner. In our country, dogs play the role of the final host of echinococcus. Livestock (cows, pigs) can become an intermediate owner. For humans, Echinococcus granulosis is most important in the development of the disease. The size of a mature individual is about 3-5 mm. The body of an echinococcus consists of several parts (joints). In addition, there are suckers, hooks (bothria) and head. In the second and third segment genitals are located, and in the latter - the eggs.
Echinococci are able to separate their segments. The latter can move independently. This is important in the process of infection. The parasite cycle is uncomplicated.The final owner (dog) releases together with feces eggs of Echinococcus. Those fall into the soil, on the grass, in the water.
Next, the eggs should fall into the body of the intermediate host. Infection of herbivorous pets occurs in the process of eating grass.
At the same time, the segments of the parasite can also enter the body if they are located on grass. After that, the larvae (oncospheres) come out of eggs. The larvae penetrate the intestinal mucous layer and are carried by blood to various organs. Most often affects the liver and lungs. There are 2 types of echinococcus: alveolar and hydatious. In the internal organs of the larvae are formed in the Finns. Often, the Finns reach 5-10 cm or more.
Mechanism of human infection
A person becomes infected by the oral route. Most often this is observed with close contact with dogs. Currently in Russia, dogs, wolves and foxes are the main owners of echinococcus. Children who play with pets are also at risk for getting sick. In the human body can get parasite eggs or its segments. The latter are often found on dog hair. They get there after defecation of animals. Segments can burst, and eggs can be released outside and spread to surrounding objects. In this case, the eggs are put into the person’s mouth with dirty hands or with food.
Echinococcus eggs cannot be detected with the naked eye. They have microscopic dimensions. After entering the bloodstream, the eggs are deposited in the liver, bones, muscles, and lung tissue. Bubbles are formed from oncospheres. Finns are growing very slowly. For six months they reach a size of about 1 cm. Sometimes giant bubbles are formed, filled with nutrient fluid. It contains a lot of larvae. In some people, echinococcal cysts have been present for 10 years or more. However, there are no specific symptoms of the disease.
There is another way of infecting a person. The larvae can get into the stomach and intestines of a person by eating infected meat (beef, pork) or liver.
A prerequisite is that the meat must be at the stage of the larvae Finns, and they must be viable.
The predisposing factor in this situation is insufficient heat treatment of the meat. That is why it is so important to boil well and roast meat, especially large pieces.
The effect of echinococcus on the body
The negative impact of the parasite on humans is manifested in the following:
- in the formation of specific cystic formations in the internal organs,
- in the formation of allergic reactions,
- in mechanical action.
Cysts can be found in any organ. Liver damage occurs in about 8 out of 10 people. In medical practice, there have been isolated cases when echinococcal cysts were in the pericardial bag. Large bubbles are very dangerous for humans. Under certain circumstances, they may burst with the release of liquid contents and larvae.
This is often the cause of anaphylactic shock.
Allergic action associated with the release of various toxic substances. As a result, slow and immediate type reactions are formed.
Large echinococcal bubbles can squeeze the tissues of the body, causing atrophy.
Fibrosis may develop in the liver (replacement of normal connective tissue), and pneumosclerosis is often observed in the lungs. At the same time, the airiness of the lung tissue decreases.
Clinical signs of echinococcosis
The symptoms of this helminthiasis for a long time may be absent. If the body has echinococcus, the symptoms may include:
- loss of appetite
- pain syndrome in the location of the cyst,
- violation of the stool type of diarrhea,
- appearance of a rash on the body,
- an increase in the size of the abdomen and its pain on palpation.
Localization of pain in echinococcosis is different. Most often, pain is felt in the right hypochondrium or epigastrium. When conducting a medical examination is often detected an increase in the size of the liver and spleen. In some patients, the cyst is palpable. It is defined as a dense education. There is no increase in temperature in echinococcosis (except for complications). Fever may be due to the addition of a secondary bacterial infection.
Damage to the liver by the parasite is dangerously possible formation of an abscess. In cases of squeezing of the bile ducts of the liver, mechanical jaundice develops. In this situation, the skin and visible mucous membranes become yellowish. The color of urine may change (it becomes dark). There is a discoloration of fecal masses. If a person has a cyst in the lung, the following symptoms are possible:
- difficulty breathing
- pain syndrome in the chest,
- blue skin.
Most often, eggs, when ingested, rush into the portal vein system and into the pulmonary circulation. Hence, the frequency of detection of cystic formations in the liver and lungs.
Diagnosis and treatment of echinoccosis
Before treating an echinococcus, it is required to make the diagnosis. Diagnosis of the disease includes collecting anamnesis of life, epidemiological and anamnesis of the disease. The fact of contact with animals or eating insufficiently cooked meat is important.
At risk are persons in contact with wild and domestic animals (foresters, shepherds, hunters, dog handlers). Laboratory diagnosis involves a blood test. General analysis and biochemical can reveal eosinophilia, increased levels of enzymes (AST, ALT), bilirubin. To detect the causative agent, serological methods are used (ELISA, RNAA) or polymerase chain reaction.
Treatment of echinococcosis is most often surgical. Conservative therapy can be used only with small sizes of cystic formations.
Surgical treatment involves the removal of a cyst and restoration of the function of the affected organ.
The safest method is to remove a cyst without opening it, because otherwise there is a risk of the spread of echinococcus. Be sure to conduct insulation of fabrics. When surgical treatment is not possible, anthelmintic drugs are used. The most powerful drug is Albendazole.
The drug is contraindicated in liver failure, retinal pathology, during gestation and feeding of the child. It should also not be given to children under 6 years old. An alternative is the use of Mebendazole.
Disease prevention includes veterinary supervision, periodic examination of dog breeders, foresters, livestock breeders, washing vegetables and fruits, personal hygiene, and careful heat treatment of meat and liver of dead animals. Thus, echinococcosis requires timely detection and treatment.
Liver echinococcosis - effective treatments
Echinococcus in the human body has a detrimental effect on all systems and organs in general, and echinococcosis of the liver is a very serious problem. The greatest harm from this parasite gets the liver. He chooses the liver as his temporary residence in 85% of cases from 100% possible. The organ damage may be minor, but there are cases of particular seriousness that can be fatal. The worm develops in a capsule that attaches to the human liver, and it can reach the size of a baby’s head, which becomes a significant obstacle for the health of the body. Man is not a permanent carrier of the parasite, but only a temporary host, but such a neighborhood brings great harm to his liver, other systems and organs.
What is liver echinococcosis?
Having heard the diagnosis of liver echinococcosis, few will answer it the first time. Under this definition lies such a process as living in the human body of one of the types of tapeworms - Echinococcus. This individual, in the form of a larva, gets to the person through oral contamination, if he did not wash his hands well, ate unpeeled vegetable, did not process the meat well enough. After the parasite enters the body, the following occurs:
- semi-mature individual enters the human digestive system,
- the larva gradually penetrates into one of the blood vessels,
- with the blood the worm gets to one of the organs - in this case the liver will be such
- an underdeveloped individual clings to one of the walls of the organ,
- a capsule forms around the larva, resembling a cyst in its structure,
- there is a slow growth of the capsule, its increase in volume, compaction,
- the capsule ripens, breaks, and mature individuals of the parasites emerge.
This process is called liver echinococcosis. He is of different types and degrees of complexity.
Note! The initial stages of the disease are almost asymptomatic, the disease manifests itself in more severe stages, which in itself requires surgical intervention. Early diagnosis, timely start of treatment will help avoid surgery, get rid of the parasite along with the capsule.
Symptoms and early signs of the disease
Man and cattle are intermediate hosts of echinococcus helping their full development. Signs of a problematic situation and its obvious symptoms manifest themselves when the capsule with parasites reaches large sizes.
The first signs of a problem can be:
- common problems with well-being,
- having problems with the digestive system,
- a clear presence under the right hypochondrium seals,
- frequent diarrhea,
- changes in the person's appearance, a sharp loss in weight.
Symptoms that will indicate the presence in the human body of a capsule with a parasite or several capsules are considered to be:
- enlarged spleen,
- decreased liver motility
- jaundice and urticaria.
The presence of these problems is a direct indication to visit the doctor's office. If they are already pronounced, and the parasite capsule is large enough, surgical intervention will be the only way to solve the problem.
Note! Conservative treatment of liver echinococcosis is performed only at the initial stages of the development of the problem, when drugs can remove the parasite along with its shell. If the capsule hardens, conservative methods of exposure will be ineffective and even meaningless.
Methods of diagnosis of liver echinococcosis
Correct, timely diagnosis of a problem is something that always contributes to its quick and effective solution. The methods for detecting the presence of a tapeworm in the human liver include such measures:
- Blood test by ELISA.
- External examination of the patient.
- Test Cony.
The latter method gives one hundred percent result, even if the unwanted neighbor of a person is at the initial stage of its development.
External examination of a person can detect. The envelope of a person that has increased in volume, which is easily palpable, resembles a cyst in its structure. Ultrasound, X-ray, MRI and CT scan show compaction, make it possible to determine the location of the dangerous parasite.
After diagnosis, doctors are prescribed the most productive treatment for a particular case and patient. You can combine treatment with pills and folk remedies.
Attention! The experience of specialists in the field of medicine shows that the right part of the liver most often becomes the location of parasites.First of all, it is necessary to look for the problem in this particular zone.
Methods of treating liver echinococcosis - surgery, pills and traditional medicine
The process that involves the treatment of liver echinococcosis, is quite long. It can be performed conservatively or surgically — often using a combination of both of the methods presented. Means of traditional medicine have a high productivity, and in combination with pills, they give a double effect. The operation is required when the echinococcus reaches its final stage of development - the bladder or envelope covering the parasites is too large.
Herbal bath for children
To rid the child of this parasite, parents can prepare the following bath for him:
- take 7 tbsp. l pericarp beans, 2 tbsp. l comfrey, 3 tbsp. l thyme, 4 tbsp. l celandine, 4 tbsp. l oat straw
- boil water, it should be enough for a bath,
- pour water to the herbs, give a little brew, sit the child in the bath,
- after 40 minutes of bathing, it is better if it lasts more than an hour, it can leave the bath.
The technique will be more effective if the parents after the bath massage the child's back and shoulders with a mixture of honey and wheat flour. All small parasites must go through the skin. For adults, the technique does not apply.
Attention! A mixture of honey and flour should be applied exclusively on the shoulders and back. The application on the chest and lungs is strictly prohibited.
Herbal infusion for the treatment of echinococcosis
Treatment of folk remedies such problems as liver echinococcosis takes a long enough period. To solve this problem in the early stages of its development, use this tool:
- take 100 g of birch buds, 75 g immortelle leaves and 75 g mint leaves,
- mix herbs in equal quantities
- take one and a half tablespoons of the collection of herbs,
- all pour 300 ml of boiled water,
- let it stand for an hour.
If the drug is used to treat liver echinococcosis in children, parents should give 50 ml of infusion to the child four times a day. For adults, the dosage reaches 100 ml, but the number of times for use remains unchanged.
Infusion of tansy
For the preparation of funds, the intermediate host of the parasite will need to take 2 tbsp. l dry plant flowers. Raw materials pour two glasses of boiling water, insist 2 hours. Take a teaspoon half an hour before meals, use 4 times a day.
Be careful! Tansy is a plant that contains toxic substances. Do not abuse doses and take more than allowed, the dosage for children of different ages should be checked with specialists.
Vodka tincture of birch buds and celandine
Alcohol and vodka tinctures help get rid of various parasites, with liver echinococcosis, they can defeat the worm when it is still of very small size. Anyone can prepare the preparation in the following way:
- In equal parts take fresh birch buds and celandine.
- Put the herbs in a dry jar.
- Pour vodka in the ratio of 1: 5.
- Close tightly, carry to a dark place, leave for a week.
Take tincture should be an hour before or after meals. Enough on a tablespoon three times a day, and the whole lasts 2 weeks.
Conservative Medication Treatment
For conservative treatment of liver echinococcosis, preoperative prophylaxis, the following tablets are used:
Drugs help to completely get rid of parasites, but if the size of the capsule in which they were too large, and the sheath dense surgical treatment of liver echinococcosis is a necessity.
Note! Do not self-medicate using different drugs. Only a doctor will be able to determine what kind of treatment is suitable for the patient and how long it will be.
Echinococcosis of the liver in 95% of cases is treated exclusively by surgery, but this is not a sentence, because only an experienced doctor knows how to treat this disease. If surgical intervention is performed, its initial stage is to extract the contents of the capsule - pumping out parasites. Then the surgeons carefully remove the cyst along with the affected part of the organ. Then everything is neatly sutured. The procedure is simple, does not take much time. If echinococcosis of the liver and pregnancy are combined - surgery is performed after delivery, and medication is not taken at all.
If the echinococcus in the human liver has already begun to grow rapidly, surgical intervention will help solve the problem. But it is better to prevent the disease than to undergo a long course of treatment and rehabilitation. To prevent people from having single-chamber and alveolar echinococcosis of the liver - the second form is more complicated, because it strongly affects the cells of the organ, the following rules should be followed:
- Wash hands thoroughly after contact with any animals.
- Get rid of the larvae of parasites helps washing vegetables and herbs.
- Any meat should be hard heat treated.
- It is impossible to contact animals too closely.
Such simple actions are a guarantee that a person will not be able to become infected with liver echinococcosis from his pet or while using a certain product. If the problem is already present, and the parasite larvae transplanted into the liver took place - long-term treatment can not be avoided. Echinococcosis is an insidious problem that strikes at the most unexpected moment. Its prevention is the best way to never face the unpleasant effects of the parasites in the human body.
Are you still sure that it is difficult to clean your body of parasitic organisms?
If you read these lines, then your struggle with parasites apparently was not so successful.
Have you thought about drastic measures to combat the disease? Surely - yes, because parasites are very dangerous - they are able to multiply quickly and live a long time, because of this, the diseases that they provoke often become chronic and proceed with a constant relapse. Frequent nervousness, lack of appetite, sleep disturbances, problems with the immune system in general, intestinal dysbiosis. surely all these points are well known to you.
But it may be better to treat not the symptoms, but the cause of the disease? It will be very useful to read the work of Sergei Rykov, who heads the University of Parasitology, the newest ways to combat parasitic diseases. Read completely
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What is echinococcosis?
The echinococcus worm in the sexually mature state parasitizes the intestine of the final host, the dog. The number of worms in the body of the final owner can reach several thousand. The worm consists of a head with four suckers and hooks, two or three segments, the last of which contains a uterus filled with parasite eggs. The number of eggs reaches 400. Each egg has a dense chitinous shell and contains a larva. Echinococcus eggs are released into the environment, where they are eaten by intermediate hosts (sheep, cows, pigs, and camels). An intermediate stage of the parasite, cystic, develops in their bodies. After the death or slaughter of intermediate hosts, the diseased organs of animals are eaten by dogs, in the body of which sexually mature worms develop. Thus, the development cycle of echinococcus closes.
A person becomes infected with echinococcus by accidentally eating the parasite's eggs. After the echinococcus eggs enter the human body, their shell under the influence of gastric juice dissolves, and the released larva penetrates through the gastric or intestinal wall into the blood stream and enters the capillaries of the liver.In 80% of infected patients there it gets stuck and starts to develop. If the larva passes the capillaries of the liver, then it is carried by the blood flow into the capillaries of the lungs, where it can also linger and cause lung damage. A similar situation is observed in about 15% of cases. If the larva passes the capillaries of the lungs or enters the systemic circulation through the open oval window, then it can be entered into any organ or tissue of the body (spleen, kidney, brain, subcutaneous tissue, etc.).
In the liver, the parasite larva actively grows, turning into a bubble with a diameter of up to 1 mm in a month, and in five months the bubble can reach 55 mm. Echinococcus bladder is constantly growing due to the nutrients of the host and ultimately can reach a volume of 10-20 and even 30 liters. Echinococcal cyst has a characteristic structure and has an appositional growth, pushing the surrounding tissues, but not germinating them. It is filled with clear liquid containing succinic acid. The inside is lined with a single layer of cubic epithelium (germ layer). To the outside of it is a dense chitinous shell - the product of the parasite. It has a white color and is similar in appearance to the protein of boiled eggs. Outside, the cystic formation is surrounded by a dense connective tissue fibrous capsule, which consists of the tissues of the host's body and separates it from the parasite. With the continued existence of a cyst, the fibrous membrane can reach a thickness of up to 1 cm or more. Within an echinococcal cyst from the germ layer, daughter bubbles buds, from which, in turn, grandchild blisters buds, etc. In addition, it contains many parasite embryos (echinococcal sand) that float in the liquid.
Echinococcosis is prevalent mainly in countries with developed animal husbandry. People associated with the maintenance of domestic animals get sick - shepherds, milkmaids, as well as people who have contact with dogs, especially children who play with them and allow their pets to lick their faces and sniff food.
Echinococcosis is most common in Latin American countries, where up to 7.5 diseases per 100,000 population per year are registered. It is also detected in Central Asia, Australia, New Zealand and Europe. From European countries, the disease is common in Italy, Bulgaria and Iceland. In Russia, it is recorded mainly in the Caucasus, along the middle and lower reaches of the Volga, in Western Siberia, Yakutia (Sakha) and in Chukotka. Mostly people of young working age get sick, but the disease is also detected in young children and in old people. Recently, the disease is also registered outside of endemic foci, which is associated with an increase in population migration.
How is echinococcosis?
Echinococcosis and its manifestations depend on the location and size of cysts.
In the first period of the disease (in the asymptomatic stage), allergic reactions to the invading parasite can disturb the patient: pruritus, urticaria, papules on the skin. These symptoms are characteristic of any worm infestation and are especially pronounced in children. When a patient is physically examined at this stage, it is usually impossible to identify any abnormalities. To help in the diagnosis can only special laboratory and instrumental examination.
In the stage of uncomplicated course, patients with echinococcosis complain of dull constant pain and a feeling of heaviness in the right hypochondrium, dyspeptic phenomena and a feeling of fullness in the stomach after meals. In an objective study, in some patients, a rounded form, dense-elastic consistency and slightly painful on palpation are detected in the liver.
In the stage of pronounced clinical manifestations and complications, the clinical picture of the disease is quite pronounced.Patients with echinococcosis are worried about constant dull pains and a feeling of heaviness in the right hypochondrium. On palpation in the liver, it is possible to determine a “tumor” of a round shape, of a densely elastic consistency, sometimes reaching large sizes. Occasionally, a “hydatid shake noise” can be observed over a tumor. In children with large cyst often observe chest deformity - "echinococcal hump." Further manifestations depend on the nature of the developed complications.
Liver echinococcosis may undergo aseptic necrosis with subsequent calcification. In this case, a stony density knot is formed in the liver, which can be detected by palpation and special research methods. The general condition of the patients suffers little, and the clinical picture is limited by the presence of pain, a feeling of heaviness in the right hypochondrium and appetite disturbances with progressive weight loss. With suppuration of the cyst, the symptoms correspond to manifestations of liver abscess: a severe condition of the patient, hectic temperature with signs of an inflammatory reaction in the blood test, severe persistent pain in the right hypochondrium.
A growing cystic formation can squeeze the biliary tract. In such a situation, the patient is diagnosed with mechanical jaundice with icteric staining of the skin and sclera, skin itching, discoloration of feces and darkening of urine. Patients become lethargic and adynamic. In case of compression of the veins, portal hypertension is present in the liver gates with the appearance of ascites, splenomegaly, esophageal and hemorrhoidal bleeding.
Due to a minor injury, a large cystic formation can break into the free abdominal or pleural cavity and even into the pericardial cavity, as well as into the biliary tract. Breakthrough cysts are characterized by the development of severe allergic shock, which can be fatal. If a patient with echinococcosis survives, then he develops echinococcal peritonitis, pleurisy, or pericarditis. At the same time, daughter bubbles and scolex of the parasite that have poured into the cavity are fixed on the peritoneum and pleura, where they begin to progress and develop. The number of such cysts in the abdominal cavity can reach several dozen. When cyst breaks into the biliary tract after anaphylactic shock, violently flowing cholangitis and mechanical obstruction of the biliary tract develop with the development of obstructive jaundice.
In about 5-7% of cases, when a cyst is located on the diaphragmatic surface of the liver, the lung merges with the diaphragm, and when a cyst breaks through, a message forms between its cavity and the bronchial tree. Formed gall-bronchial fistula. The clinical picture of this complication is quite typical. Complaints to cough with the release of a large number of transparent sputum and films - fragments of chitinous shell of the cyst. In the future, sputum becomes biliary. The amount of her increases after meals and in the position of the patient lying, which causes patients to sleep while sitting.
The lung echinococcosis manifests itself with chest pains and shortness of breath. An abscess of the lung is possible with the suppuration of the bladder;
With echinococcosis of other sites, the symptoms of a volume organ damage dominate.
Due to the late diagnosis of echinococcosis, the incidence of complications in patients is high and usually amounts to 10-15%.
Echinococcosis is a helminthic disease from the group of cestodosis, caused by parasitism in the human body of echinococcus in the oncosphere stage. In the world, the highest incidence of echinococcosis is noted in Australia, New Zealand, North Africa, South America, Southern Europe, and Central Asia.In Russia, helminthiasis occurs in the Volga, Ural, Stavropol and Krasnodar regions, Western Siberia, and the Far East. In endemic regions, the incidence of echinococcosis in the population reaches 5-10%. The prevalence of echinococcosis is closely related to the development of animal husbandry. Given the fact that with echinococcosis, various internal organs can be affected, and the only radical method of treatment is surgery, the disease lies in the sphere of interests of thoraco-abdominal surgery, neurosurgery, and cardiac surgery.
Causes of echinococcosis
Human echinococcosis is caused by the larval stage of the tapeworm of Echinococcus granulosus - the laurus cyst. The final owners of sexually mature worms are animals (dogs, foxes, wolves, lions, lynx, etc.), in which the cestodes parasitize. Human, domestic and wild herbivores (cattle, pigs, horses, deer, moose, etc.) are intermediate hosts of the larval stages and at the same time biological dead ends, since they do not release echinococcus eggs into the environment and cannot be a source of invasion.
Adult echinococcus individuals are small worms 2.5–8 mm long and 0.5–10 mm wide, having a head with four suckers and two rows of hooks, a neck, and several segments. Mature segments contain eggs of an echinococcus with oncospheres and a six-hook larva-embryo inside. Oncospheres survive in a large range of temperatures (from -30 ° C to + 30 ° C), they remain in the soil for several months, but soon die under the action of sunlight. From the intestine of the final host, the eggs with feces are excreted into the external environment. Infection of people with echinococcosis occurs via alimentary (when using vegetables and fruits contaminated with faeces, water) or by contact (when cutting carcasses or contact with animals invaded by echinococcus). Persons engaged in animal husbandry and animal care (livestock breeders, hunters, slaughterhouse workers, etc.) have a high risk of echinococcosis.
Pathogenesis of echinococcosis
In the human gastrointestinal tract, under the action of digestive enzymes, the shell of the egg and oncosphere dissolves and the larva emerges. With the help of hooks, it is embedded in the intestinal mucosa, from where it enters the venous bloodstream and into the portal system. Most of the oncospheres are deposited in the liver, sometimes through the inferior vena cava of the oncospheres into the right parts of the heart, and from there into the pulmonary circulation and lungs. More rarely, through the pulmonary veins and the left parts of the heart, the embryos find themselves in the large circulation and can be transferred to any organ: brain, spleen, kidneys, muscles, etc. - echinococcosis of the lungs, in other cases there is a lesion of other organs.
After the echinococcus embryo subsides in a particular organ, the vesicular or hydatid stage of development of the parasite begins. Echinococcal bladder is a cyst covered with a two-layer membrane consisting of the inner (embryonic) and outer (chitinous) layers. The cyst slowly grows in size (about 1 mm per month), but after years it can reach gigantic sizes. Inside the hydatid bladder contains a clear or whitish opalescent fluid in which daughter blisters and scolexes float. Child echinococcus bubbles can form outside the chitinous membrane, their total number can reach 1000.
Manifestations of echinococcosis are associated with the sensitizing effect of parasitic antigens and mechanical pressure of the cyst on organs and tissues. Parasitism of echinococcus is accompanied by the release of metabolic products, which leads to the development of intoxication and an allergic reaction of the delayed type.In the event of a complete rupture of a cyst, its contents enter the pleural or abdominal cavity, which can cause anaphylactic shock. An echinococcal cyst that is growing in size puts pressure on the surrounding structures, disrupting the function of the affected organ. In some cases, suppression of the cyst develops, less likely spontaneous death of echinococcus and recovery.
Symptoms of echinococcosis
Echinococcosis may be asymptomatic for years and decades, in the event of clinical symptoms, pathognomonic signs are absent. Regardless of the localization of the parasite in the body, echinococcosis goes through three stages in its development: I is asymptomatic, II is the stage of clinical manifestations and III is the stage of complications. The course of the latent period begins from the moment of oncosphere insertion into the tissue and continues until the first clinical signs of echinococcosis appear. During stage II patients suffer from pain at the site of cyst localization, weakness, urticaria, pruritus, as well as the specific symptoms caused by the parasitism of the cystic form of echinococcus in a particular organ. In the stage of complicated echinococcosis, a cyst rupture and the discharge of contents into the abdominal or pleural cavity with the development of peritonitis, pleurisy can occur. At suppuration of an echinococcal cyst high fever, heavy intoxication join. Compression of a cyst of organs and tissues can cause the development of obstructive jaundice, ascites, dislocations, pathological fractures.
For echinococcosis of the liver are characterized by complaints of nausea, loss of appetite, recurrent diarrhea, heaviness and pain in the right hypochondrium. Objectively, hepatosplenomegaly is detected, sometimes an echinococcal cyst of the liver is palpated in the form of a round dense formation. In the case of compression of the cyst by the bile duct, mechanical jaundice develops, ascites and portal hypertension occur during compression of the portal vein. Adherence of the secondary bacterial flora can lead to the formation of a liver abscess. The most severe complication of the liver echinococcosis is the perforation of the cyst with the development of a clinic of acute abdomen, peritonitis and severe allergic reactions. When this happens, dissemination of echinococcus occurs, as a result of which secondary echinococcosis develops with multiple localization.
Pulmonary echinococcosis occurs with fever, intoxication syndrome, chest pain, cough, hemoptysis. The pressure of the cyst on the lung tissue leads to the formation of lung atelectasis. When the blister breaks through into the bronchi, a strong cough, cyanosis develops, and often aspiration pneumonia. An extremely dangerous complication of pulmonary echinococcosis is a breakthrough of the cyst into the pleura and pericardium, which can lead to anaphylactic shock, a sharp displacement of the mediastinum, cardiac tamponade and sudden death. Infection of an echinococcal cyst is accompanied by the formation of a lung abscess.
The blade echinococcosis of the brain is characterized by hypertensive syndrome and focal neurological symptoms (impaired sensitivity, limb paresis, epileptiform seizures). When echinococcosis of the heart is worried chest pain, resembling angina. Compression of cysts of the coronary arteries can cause the development of myocardial infarction. Often there are disturbances of rhythm and conduction: ventricular tachycardia, incomplete and complete blockade of the bundle of the bundle of His, complete transverse blockade of the heart. Malignant arrhythmias, heart failure, cardiac tamponade, cardiogenic shock, pulmonary embolism, postembolic pulmonary hypertension, etc. can cause death of a patient with echinococcosis of the heart.
Symptoms of parasitic disease
The presence of echinococcus in the liver for a long time does not manifest itself, and is often found by chance, during a prophylactic examination or due to another disease.
Symptoms of a parasitic disease are directly determined by the location, size, growth rate of the cyst, the degree of its impact on neighboring organs and tissues. During pregnancy, immunodeficiency, lack of vitamins in the body, concomitant diseases invasion is more severe.
The disease is classified into three stages of the course. At the first stage (from the moment of helminth penetration into the body and until the first signs appear), patients do not complain of anything. Cyst or small cyst size. Some patients may develop an allergic reaction - burning and itching of the skin, no rash.
At the second stage, significant hepatomegaly is detected, and this leads to a violation of the functionality of the liver, provokes clinical manifestations:
- Nausea, bouts of vomiting (most often they are associated with eating, occur after eating fatty, salty and spicy foods).
- Breathe heavily.
- Discomfort, heaviness or pain in the area of the projection of the liver. Periodically pain syndrome is localized in the upper part of the peritoneum (usually after eating, physical activity).
- Heartburn, cough.
- Loss of appetite, weight loss.
- General malaise - weakness, constant fatigue.
- Discoloration of feces as a violation of bile secretion.
If at the second stage the corresponding anthelmintic therapy is not started, then complications develop - this is already the 3rd stage.
Echinococcosis: pathogen and methods of infection
Echinococcosis is a common parasitic disease. He is more prone to animals. But rodents, dogs, foxes and wolves, which are carriers of the causative agent of this disease - Echinococcus, can infect a person. Therefore, echinococcosis is also found in humans.
The disease is common throughout the world, but it is more common in agricultural regions.
The causative agent of the disease, echinococcus - tapeworm. The average size of these organisms does not exceed a few millimeters. They can often be seen even without the use of special devices. Getting into the intestines of the animal, the worm begins to parasitize in it.
Since humans are only intermediate organisms for these helminths, they do not observe adult individuals, but ribbon larvae of echinococcus. They cause echinococcosis in people, the treatment of which is associated with certain difficulties.
Today distinguish two types of illness:
Parasitic in the body of the carrier (animal), the worms constantly lay eggs. They enter the environment during feces. A person can become infected after contact with an animal or its stool, if it does not follow the rules of personal hygiene.
After infection, the parasite's eggs enter the gastrointestinal tract. In the human intestine of the eggs appear larvae, distributed to various organs through the circulatory system.
After hitting one of the organs, the larva turns into an echinococcal cyst (Finn). This is a small bubble with two shells. It is the development of the parasite.
Inside the Finn is filled with a liquid in which the worm develops.
Since the inner shell of the bubble has areas that reproduce new parasites, the size of the Finns is gradually increasing. There is a compression of the tissues around the formation, and the violation of their functions.
IMPORTANT! Parasites affect the liver, although they are often found in the lungs. Much less brain damage occurs.
As already mentioned, parasites can get into the human body after contact with an infected animal or its feces and non-observance of general hygiene rules.
And it can happen after eating the raw food product with which this animal has been in contact.
Echinococcus can penetrate into the human body and through the use of infected meat, if it succumbs to insufficient thermal processing.
Clinical signs of the disease
Echinococcosis is difficult to diagnose. This is caused by the very slow development of an echinococcus cyst. For the same reason, an infected person may develop asymptomatic diseases over a long period of time.
For example, a worm larva that has fallen into one of the peripheral parts of the liver can develop over several years.
In this regard, the presence of worms in the human body is often detected during prophylactic examinations or during X-ray / ultrasound. But the larger the size of a Finn, the more expressive are the signs of her presence in the body.
It is important to know the clinical signs of the disease, because if an echinococcus is detected, treatment should begin immediately. Otherwise, death is possible.
Symptoms of the disease depends on the location of the cyst in the human body. But there are several common clinical signs of the disease, independent of the site of the parasitic action of the echinococcus. Among them:
- constant feeling of weakness and fatigue, resulting in reduced overall performance of the patient,
- headaches that occur with a certain frequency,
- manifestations on the skin of small red spots,
- short-term increases in body temperature.
ATTENTION! Since these symptoms are characteristic of many other diseases, the patient often undergoes unnecessary treatment before making a correct diagnosis.
Approximately sixty percent of cases of an echinococcal cyst are found in the patient's liver.
If there are Finns in this body, the following symptoms may occur:
- loss of appetite, with weight loss,
- nausea, vomiting,
- recurrent diarrhea,
- change in skin tone (it becomes yellowish), itching sensation, discoloration of urine,
- pain in the area of the heart muscle, loss of consciousness, disorders in the kidneys.
With the defeat of the lungs in patients may experience the following symptoms:
- cough, dry first, then wet. At the same time, an unpleasant smell is emitted from the oral cavity,
- pain in the chest,
- allergic reactions and frequent pneumonia,
- shortness of breath, feeling of lack of air,
- sudden temperature fluctuations (up to thirty-nine degrees), accompanied by fever, muscle pain, increased sweating.
Regardless of the affected organ, the symptoms do not appear simultaneously. Specific signs of the disease occur depending on the stage of its development.
Echinococcosis Treatment Methods
When a disease is detected, it is necessary to begin treating echinococcus as early as possible. There is a conservative and surgical treatment of echinococcosis.
During surgery, an echinococcus cyst is removed along with its capsule and the tissues that surround the formation. Tissue removal is carried out due to the negative influence of the Finns, which has led to pathological changes.
The surgical procedure is carried out only if the Finn is located shallowly, close to the surface of the organ.
FEATURES! Unlike a number of other parasitic diseases, in which self-healing is sometimes observed, echinococcosis never resolves on its own.
If the formation is located deep in the organ, with a similar procedure there is a possibility of damage to the vessels and bile ducts. Therefore, in this case, resort to using a different operational approach, which does not involve the removal of the cyst itself.
Instead, the Finn is punctured and sucked its contents. After that, the inner layers of the formation are cleaned.The cavity is treated with a 2% formalin solution and sutured.
In some cases, resort to the use of palliative surgery.. A part of the most voluminous cysts is removed so that they compress the healthy parts of the affected organ less.
With the help of palliative operations, it is possible to increase the patient's life span and improve his well-being.
The search for a treatment of echinococcosis without surgery began in the seventies of the last century. In 2002 alone, more than two thousand cases of successful treatment of the disease through the use of drugs without surgery were recorded in the world.
Thirty percent of the sick Finns disappeared completely. Even in seventy, they have significantly decreased in size.
For the medical treatment of the disease are used benzimimidazoles. Chemotherapy gives a good effect in the treatment of young patients.
Previously, mebendazole was a popular remedy. But due to the large number of negative effects, albendazole has supplanted it today. This drug is distributed throughout the body and penetrates into the cyst.
REFERENCE! The older the patient, the greater the likelihood of low efficacy of chemotherapy.
The drug is often used as an adjunct to surgery. But if it is impossible (a large number of small cysts in different organs, the presence of formations in the spine, pelvic bones), chemotherapy is performed, which is the only possible therapeutic agent in such circumstances.
In addition, benzimimidazoles are actively used as a prophylaxis against relapses.
Thus, the causative agent of echinococcosis are tapeworms echinococcus. After being ingested, their larvae transform into cysts, which, with their growth, lead to a significant deterioration in the patient's condition.
A surgical method is used to treat the disease. Chemotherapy is used to treat inoperable patients.
There are three clinical stages of echinococcosis:
- asymptomatic stage
- stage of uncomplicated flow
- stage of complications.
The diameter of the cyst is divided into the following:
- small (up to 5 cm)
- medium (5-10 cm),
- large (11-20 cm),
- giant (21 cm and more).
Screening studies are possible and feasible in the foci of echinococcosis among the most susceptible population groups (breeders, herders, agricultural workers). Inspect, perform immunological reactions and ultrasound.
The third stage is characterized by the development of various complications. These include suppuration or rupture of a parasitic cyst, which leads to purulent peritonitis, severe intoxication.
The skin, mucous membranes turn yellow, liver failure develops. At the stage of complications in a patient revealed a significant increase in body temperature, feverish state.
Other complications - anaphylactic shock, epileptic seizures, massive internal bleeding, liver cirrhosis, paralysis, impaired visual perception, ascites - accumulation of fluid in the human abdominal cavity. Complications lead to disability, death.
Diagnosis of echinococcosis
Correctly diagnosed echinococcosis contributes to a detailed epidemiological history, indicating a close human contact with animals, the endemicity of infection. If any localization of echinococcosis is suspected, serological tests of the blood (ELISA, HINF, RNGA) are prescribed, allowing detection of specific antibodies to echinococcus. The specificity and sensitivity of the tests reaches 80-98%. In approximately 2/3 of the cases, an allergic skin test is informative - the Kazoni reaction.
The range of instrumental diagnostics of echinococcosis includes ultrasound, x-ray, tomographic, radioisotope methods. When liver echinococcosis informative ultrasound of the hepatobiliary system, angiography of the celiac trunk, liver MRI, scintigraphy, diagnostic laparoscopy, etc. Recognize pulmonary echinococcosis allows for chest X-ray and CT scan of the chest, bronchoscopy, diagnostic thoracoscopy. The leading diagnostic methods for echinococcosis of the brain are CT or MRI. If heart failure is suspected, echocardiography, coronary angiography, ventriculography, and MRI of the heart are performed. When an echinococcal cyst breaks through into the lumen of hollow organs, the parasite's scolex can be found in the examined duodenal contents, sputum. Also in these cases, resort to performing bronchography, cholecystography, puncture cholangiography. Echinococcal cyst must be differentiated from alveococcosis, bacterial abscesses, cysts of non-parasitic etiology, tumors of the liver, lungs, brain, etc.
Treatment and prevention of echinococcosis
Radical cure of echinococcosis is possible only by surgery. The best way is to conduct echinococcectomy - exfoliation of the cyst without compromising the integrity of the chitinous membrane. In the presence of a large bladder, an intraoperative puncture is first performed with aspiration of the contents. The residual cavity is carefully treated with antiseptic solutions, plugged, drained or sutured tightly. During the operation, it is important to prevent the contents of the bladder from falling onto the surrounding tissues in order to avoid dissemination of the echinococcus. In case of impossibility of excision of a cyst in case of lung echinococcosis, a wedge resection, lobectomy, and pneumonectomy are performed. A similar tactic is used in liver echinococcosis. If excision of an echinococcal cyst of the liver is technically impossible, regional, segmental, lobar resection, hemihepatectomy is performed. In the pre- and postoperative period, antiparasitic therapy with praziquantel, albendazole, mebendazole is prescribed.
In the case of radical removal of echinococcal cysts and the absence of re-infection, the prognosis is favorable, there is no recurrence of echinococcosis. In the case of intraoperative dissemination of scolex after 1-2 years, a relapse of the disease may occur with the formation of multiple echinococcal bubbles and a poor prognosis. The measures to prevent human invasion are veterinary monitoring and the improvement of animals (conducting periodic de-worming of dogs, vaccination of sheep, improving the hygienic conditions of livestock, etc.). Hunters, livestock breeders, dog breeders should be informed about the danger of infection with echinococcosis, the need for personal hygiene. Patients undergoing echinococcosis are under observation for 8-10 years with annual serological tests, ultrasound and X-ray examinations.
Laboratory and instrumental diagnostics
Unlike other helminthic invasions, it is difficult to diagnose echinococcosis of the gland. To confirm the diagnosis, the patient should visit a number of specialists - a gastroenterologist, infectious diseases specialist, hepatologist, surgeon.
First of all, the doctor collects the patient's history, asks about complaints. Next is a physical examination, palpation of the liver, tapping of the organ (percussion method). Diagnosis is differential, since it is necessary to distinguish echinococcosis from other tumors in the liver.
Laboratory tests include KLA and biochemical blood tests. A Katsoni serological test is being performed - this is an allergic test. The doctor puts an antigen under the patient's skin. With a positive reaction they say about infection.
Additionally, an immunological test is recommended to detect antibodies to echinococcus. The urine and sputum are examined for pathogens in biological fluids.
Instrumental research is carried out by such methods:
- MRI - using research to identify pathological changes in the soft tissues of the liver, determine the size of the parasitic neoplasm.
- Ultrasound is a simple and informative method that will show the presence of cysts, their location, number and size.
- CT - you can find out the size of the cyst, density, structure.
When in doubt, a biopsy is collected for histological examination. The doctor with a puncture needle makes a puncture, takes a small piece of liver tissue.
Treatment of liver echinococcosis
Echinococcosis is a serious disease that can be diagnosed in an adult woman, a man, or a child. Pathology requires an integrated approach - medicines as a single agent will not help. Combined treatment involves surgery and antiparasitic appointments.
At the preparatory stage and during the rehabilitation period, anthelmintic drugs are prescribed - Nemozol, Mebendazole. Dosage is determined individually. Antiparasitic drug slows the increase in cysts, reduces the likelihood of recurrence of the disease.
The best treatment is mechanical removal of the parasite. But the intervention is associated with a high risk of dissemination of larvae to neighboring tissues, therefore it should be carried out only by highly qualified specialists.
- Radical echinococcectomy - doctors completely remove cysts along with the fibrous membrane.
- Cutting a cyst in order to pump out fluid, eliminate affiliated tumors and chitinous membrane. The cavity is disinfected with a solution of glycerin, put drainage, sew.
- Drainage with an endoscope.
To prevent recurrence of the disease, germicides are injected into the resulting cavity - their effectiveness is 80-90%.
Medicines after surgery
It is impossible to get rid of echinococcus cysts only by medical methods. In the postoperative period, the patient is prescribed drugs:
- Anesthetic properties.
- Tablets against vomiting.
- Hepatoprotectors to protect liver cells, restore full body function.
With a high likelihood of relapse after surgery, antihelminth drugs may be prescribed - Vermox, Gelmadol. It is also necessary diet food - appoint table number 5.
Therapy folk remedies
Folk remedies as a mono means will not help. Used in combination with a preventive purpose.
- Broth based on wormwood. It is necessary to add 2 tablespoons of chopped herbs to 500 ml of hot water. In a closed container insist 5 hours, then filtered. Drink 3 times a day, the dosage is 20 ml. Reception - before meals. The course of treatment is 14 days. It is not recommended to drink broth to pregnant women who are nursing moms.
- Tansy has anthelmintic properties. It is used as a decoction. It is necessary in 250 ml (1 cup) of water to pour 10 g of the plant. Insist 60 minutes. Drink 4-5 times a day, 50 ml (1/5 cup). The duration of therapy is 15 days.
In the treatment of non-traditional methods still use dried lemon peel, cloves, garlic, natural honey.
Prognosis and prevention
With timely surgical intervention, the prognosis is favorable. If the disease is detected at a late stage, when complications have developed, the operation helps to remove the hydatid cyst, but the patient's quality of life worsens. In severe cases, the probability of death is high. Relapses are detected in 7% of patients.
As the ways of infection with echinococcosis are known, preventive measures have been developed. It is recommended to observe personal hygiene, to wash hands with soap after contact with street and pets.Hands should be washed before each meal. Proper processing of meat can prevent parasitic ailment.
If a person is in a risk group, then it is recommended to regularly undergo preventive examinations, to pass the appropriate tests.
Laboratory and instrumental studies
In the presence of live echinococcal cyst in the blood, changes characteristic for helminthic invasion (eosinophilia and elevated ESR) are observed. With the development of liver failure, the activity of transaminases increases (aspartate aminotransferase and alanine aminotransferase). With obstructive jaundice, the concentration of direct serum bilirubin and urine urobilin increases.
In a special place in the diagnosis of echinococcosis are immunological reactions. In 1911, Tomaso Kazoni proposed a reaction that subsequently received his name. He injected intracutaneously 0.1 ml of echinococcal fluid into the patient, and isotonic sodium chloride solution in the opposite forearm. Redness appeared on the side of fluid injection and a papule formed. Since then, this reaction has become widely used for the diagnosis of echinococcosis.
Kazoni’s reaction is positive in about 90% of patients, but its specificity is too low. In this regard, a number of other immunological reactions (hemagglutination, complement fixation, etc.) have been proposed to improve the diagnosis. The possibility of developing anaphylactic shock, especially when conducting repeated immunological reactions, significantly limits their use in everyday clinical practice. With the introduction of new diagnostic instrumental methods into practice, these reactions have lost their original meaning.
Currently, the "gold standard" in the diagnosis of echinococcosis is considered ultrasound. Due to its non-invasiveness, accessibility and effectiveness, it is very convenient, and it is usually sufficient to establish an accurate diagnosis. At the same time, it is possible to detect the presence of cysts in the liver, their size, location, the presence of daughter bubbles, and to clarify the nature of blood flow in the cyst area during a Doppler study.
During calcification of a cyst, a radiographic examination reveals a rounded shadow in the liver, sometimes with a rim. CT has a high diagnostic value, which helps to solve many tactical treatment issues.
With the introduction of ultrasound and CT in a wide clinical practice, such invasive methods for diagnosing echinococcosis, such as celiaography, portohepatography, laparoscopy and radioisotope examination of the liver, have lost their significance.
Echinococcosis usually requires differential diagnosis with other focal organ lesions - cysts, benign and malignant neoplasms and alveococcosis. When suppurating cysts should be differentiated from bacterial abscess, and with mechanical jaundice - with other reasons. Crucial importance in the differential diagnosis should be given to the history and modern instrumental methods of research.
The epidemiological history (place of residence, nature of work, contact with dogs), the presence of eosinophilia and the identification of the focal nature of damage to the liver, lungs, or other organs make it possible to clarify the diagnosis.
Methods of surgical treatment
For surgery on the liver more often use the two-legged access, allowing to inspect all parts of the liver and carry out the intervention. Many surgeons are limited to midline laparotomy or oblique incision in the right hypochondrium.
The most radical surgery is liver resection within healthy tissues. Indications for its implementation are:
- multiple echinococcosis with localization of cysts within the lobe or half of the liver,
- regional location of the cyst,
- recurrent echinococcosis.
Pericystectomy is the operation of excision of a cyst together with a fibrous capsule with minimal damage to the liver tissue.The operation is quite radical, it can be accompanied by severe blood loss, therefore, it is necessary to use modern methods of hemostasis.
Echinococcectomy is considered the most common and sufficiently safe for the patient operation. With this type of surgery, a cyst is initially punctured and an anti-parasitic agent is introduced into its lumen, for example, iodine tincture. Then the cyst is opened and the contents (daughter blisters, liquid and echinococcal sand) together with the chitinous membrane are removed. Next, the walls of the fibrous capsule are treated with glycerol, formalin or tincture of iodine and the remaining cavity is closed by suturing (capiton), gluing or tamponade with a gland on the leg. In recent years, there have been reports that quite frequent relapses after such an intervention are associated with the penetration of the parasite's scolex into the cracks of the fibrous cap. To improve the results of echinococcectomy, it was proposed to partially dissect the walls of the fibrous capsule and treat the remaining tissues with glycerol, a laser beam, or a cryodestructor (Fig. 34-8). Nowadays, in some patients, echinococcectomy has been performed using laparoscopic techniques.
Percutaneous puncture of a cyst with the removal of its contents and the introduction of sclerosing substances is permissible in exceptional cases when the cystic formation is single, of the marginal location and without daughter bubbles. This intervention is fraught with the development of anaphylactic shock and generalization of the process when echinococcal fluid enters the abdominal cavity.
After radical interventions for such a disease as echinococcosis, patients need inpatient treatment for two weeks. In cases where the residual cavity heals for a long time by secondary intention, inpatient treatment is increased to a month or more. If the postoperative period is favorable, one month after the operation the patient can start work that is not related to physical exertion. The latter are valid 3-6 months after the patient recovers.
All patients after interventions for echinococcosis due to a relatively high risk of relapse (10-30%) recommend treatment with albendazole and follow-up follow-up. Control ultrasound should be carried out 3-6 months after the operation for the timely detection of a possible recurrence of the disease. After radical interventions for echinococcosis and conducting courses of drug treatment, patients, as a rule, are practically healthy and able-bodied. In identifying the recurrence of the disease echinococcosis, repeated intervention is necessary.
How to prevent echinococcosis?
The main role in parasite infection is played by non-compliance with hygiene rules. Prevention measures are well developed and include government and personal prevention. State prevention consists in decreeing a ban on household slaughter. Livestock should be slaughtered only at meat processing plants or special veterinary sites with culling and destruction of organs affected by echinococcus. Impact on echinococcosis of final hosts in endemic foci includes the destruction of stray dogs and the deworming of service and domestic dogs twice a year. Personal prevention - strict adherence to good personal hygiene, especially after contact with animals.