Echinococcus/Echinococcosis

Echinococcosis is a parasitic disease caused by Echinococcus tapeworms. Infection most often occurs from the ingestion of Echinococcus eggs in food or water contaminated with dog feces. Signs and symptoms are caused by hydatid cyst development in visceral organs and depend on the species. E. granulosus causes cystic echinococcosis, which can involve any organ. The most notable presentations involve the liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver or lungs Lungs Lungs are the main organs of the respiratory system. Lungs are paired viscera located in the thoracic cavity and are composed of spongy tissue. The primary function of the lungs is to oxygenate blood and eliminate CO2. Lungs, resulting in RUQ abdominal pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain, hepatomegaly, cough, or dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea. E. multilocularis causes alveolar echinococcosis, which typically involves the liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver. Serology and imaging may be used for the diagnosis, the latter of which can show characteristic findings of hydatid cysts. Management depends on the size and complexity of the cysts but can involve observation, anthelmintic therapy, percutaneous drainage, or surgery.

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Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Table of Contents

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General Characteristics and Epidemiology

General features of Echinococcosis

Echinococcosis is a parasitic disease caused by Echinococcus tapeworms. Features include:

Eggs:

  • Small
  • Round
  • Thick-shelled
  • Contain a 6-hooked (hexacanth) embryo

Adults:

  • Small (1.2–7 mm long, depending on the species)
  • Ribbon-like body shape:
    • Scolex: 
      • Hook-filled rostellum
      • 4 lateral suckers
    • Neck
    • Strobila with 3–6 proglottids:
      • Segmented
      • Contain sets of reproductive organs
  • Can reproduce by self- fertilization Fertilization To undergo fertilization, the sperm enters the uterus, travels towards the ampulla of the fallopian tube, and encounters the oocyte. The zona pellucida (the outer layer of the oocyte) deteriorates along with the zygote, which travels towards the uterus and eventually forms a blastocyst, allowing for implantation to occur. Fertilization and First Week
  • Absorb nutrients:
    • No mouth or anus
    • No digestive system

Clinically relevant species

  • Cystic echinococcosis: E. granulosus (most common)
  • Alveolar echinococcosis: E. multilocularis
  • Polycystic echinococcosis:
    • E. vogeli
    • E. oligarthrus

Epidemiology

E. granulosus:

  • Geographic distribution:
    • South America
    • Middle East
    • Eastern Mediterranean
    • Sub-Saharan Africa
    • Western China
    • Australia and New Zealand
  • Prevalence: 2%–6% in endemic regions
  • Incidence: Approximately 50 cases per 100,000 persons per year in endemic regions
  • Average age: 30–40 years

E. multilocularis:

  • Geographic distribution:
    • Northern and Central Europe
    • Siberia
    • Asia
    • North America
  • Incidence: 1–20 cases per 100,000 persons per year in endemic regions
  • Average age: > 50 years

E. vogeli and E. oligarthrus:

  • Geographic distribution: Central and South America
  • Rare

Pathogenesis

Hosts

E. granulosus:

  • Definitive hosts: dogs
  • Intermediate hosts:
    • Sheep
    • Horses
    • Goats
    • Deer
    • Camels
  • Humans are incidental hosts.

E. multilocularis:

  • Definitive hosts: 
    • Dogs
    • Foxes
    • Coyotes
  • Intermediate hosts: rodents
  • Humans are incidental hosts.

Transmission

Transmission occurs through ingestion of eggs, usually from food or water contaminated with animal feces.

Life cycle

E. granulosus:

  • Adult tapeworm dwells in the definitive host’s small intestine Small intestine The small intestine is the longest part of the GI tract, extending from the pyloric orifice of the stomach to the ileocecal junction. The small intestine is the major organ responsible for chemical digestion and absorption of nutrients. It is divided into 3 segments: the duodenum, the jejunum, and the ileum. Small Intestine → releases eggs → passed in feces
  • Ingested by an intermediate host → eggs hatch in the small intestine Small intestine The small intestine is the longest part of the GI tract, extending from the pyloric orifice of the stomach to the ileocecal junction. The small intestine is the major organ responsible for chemical digestion and absorption of nutrients. It is divided into 3 segments: the duodenum, the jejunum, and the ileum. Small Intestine
  • Oncospheres penetrate the intestinal wall → bloodstream → reach visceral organs
  • Development of hydatid cyst → produces protoscolices and daughter cysts
  • Definitive host ingests infected organs.
  • Protoscolices leave cyst → attach to the intestine → develop into adult worms → cycle continues
Echinococcus granulosus life cycle echinococcosis

The life cycle of Echinococcus granulosus

Image: “Life Cycle of Cystic Echinococcosis” by CDC. License: Public Domain

E. multilocularis:

  • Adult tapeworm dwells in the definitive host’s small intestine Small intestine The small intestine is the longest part of the GI tract, extending from the pyloric orifice of the stomach to the ileocecal junction. The small intestine is the major organ responsible for chemical digestion and absorption of nutrients. It is divided into 3 segments: the duodenum, the jejunum, and the ileum. Small Intestine → releases eggs → passed in feces
  • Ingested by an intermediate host → eggs hatch in the small intestine Small intestine The small intestine is the longest part of the GI tract, extending from the pyloric orifice of the stomach to the ileocecal junction. The small intestine is the major organ responsible for chemical digestion and absorption of nutrients. It is divided into 3 segments: the duodenum, the jejunum, and the ileum. Small Intestine
  • Oncospheres penetrate the intestinal wall → bloodstream → reach visceral organs
  • Development of mutilocular, thin-walled (alveolar) hydatid cyst → proliferation by outward budding → production of protoscolices
  • Definitive host ingests infected organs. 
  • Protoscolices leave cyst → attach to the intestine → develop into adult worms → cycle continues
Echinococcus multilocularis life cycle echinococcosis

The life cycle of Echinococcus multilocularis

Image: “Alveolar Echinococcosis (Echinococcus multilocularis)” by CDC. License: Public Domain

Pathophysiology

  • Human ingestion of eggs → release of oncospheres in the intestine
  • Migration to visceral organs → hydatid cysts
  • Cyst rupture → protoscolices are released → secondary cysts can develop in other sites

Clinical Presentation

Both cystic and alveolar echinococcosis are characterized by asymptomatic incubation periods (months to years).

Cystic echinococcosis

Symptoms depend on:

  • Parasite load
  • Site of cysts (any organ can be infected)
  • Size of cysts (can cause complications from mass effect and obstruction)
  • Note: Rupture of cysts can cause anaphylactic shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock.

Liver (75% of cases):

  • General signs and symptoms:
    • Abdominal pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain 
    • Nausea and vomiting
    • Hepatomegaly
    • Abdominal mass
    • Jaundice Jaundice Jaundice is the abnormal yellowing of the skin and/or sclera caused by the accumulation of bilirubin. Hyperbilirubinemia is caused by either an increase in bilirubin production or a decrease in the hepatic uptake, conjugation, or excretion of bilirubin. Jaundice
    • Fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever
  • Complications of cyst rupture into the biliary tree:
    • Biliary colic
    • Obstructive jaundice
    • Cholangitis
    • Pancreatitis
  • Complications of mass effect on bile ducts or veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins:
    • Cholestasis
    • Portal hypertension Portal hypertension Portal hypertension is increased pressure in the portal venous system. This increased pressure can lead to splanchnic vasodilation, collateral blood flow through portosystemic anastomoses, and increased hydrostatic pressure. There are a number of etiologies, including cirrhosis, right-sided congestive heart failure, schistosomiasis, portal vein thrombosis, hepatitis, and Budd-Chiari syndrome. Portal Hypertension
    • Budd–Chiari syndrome

Lungs (5%–15% of cases):

  • General signs and symptoms:
    • Chronic cough 
    • Dyspnea 
    • Chest pain Chest Pain Chest pain is one of the most common and challenging complaints that may present in an inpatient and outpatient setting. The differential diagnosis of chest pain is large and includes cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychiatric etiologies. Chest Pain
    • Hemoptysis Hemoptysis Hemoptysis is defined as the expectoration of blood originating in the lower respiratory tract. Hemoptysis is a consequence of another disease process and can be classified as either life threatening or non-life threatening. Hemoptysis can result in significant morbidity and mortality due to both drowning (reduced gas exchange as the lungs fill with blood) and hemorrhagic shock. Hemoptysis
  • Complications of cyst rupture:
    • Pneumothorax Pneumothorax A pneumothorax is a life-threatening condition in which air collects in the pleural space, causing partial or full collapse of the lung. A pneumothorax can be traumatic or spontaneous. Patients present with a sudden onset of sharp chest pain, dyspnea, and diminished breath sounds on exam. Pneumothorax
    • Pleural effusion Pleural Effusion Pleural effusion refers to the accumulation of fluid between the layers of the parietal and visceral pleura. Common causes of this condition include infection, malignancy, autoimmune disorders, or volume overload. Clinical manifestations include chest pain, cough, and dyspnea. Pleural Effusion
    • Secondary bacterial infection

Brain: 

  • Headache
  • Dizziness 
  • Decreased level of consciousness
  • Seizures Seizures A seizure is abnormal electrical activity of the neurons in the cerebral cortex that can manifest in numerous ways depending on the region of the brain affected. Seizures consist of a sudden imbalance that occurs between the excitatory and inhibitory signals in cortical neurons, creating a net excitation. The 2 major classes of seizures are focal and generalized. Seizures

Other organ systems:

  • Heart: pericardial tamponade
  • Kidneys Kidneys The kidneys are a pair of bean-shaped organs located retroperitoneally against the posterior wall of the abdomen on either side of the spine. As part of the urinary tract, the kidneys are responsible for blood filtration and excretion of water-soluble waste in the urine. Kidneys: hematuria
  • Bones: pathologic fractures
  • Eyes: ocular cysts

Alveolar echinococcosis

  • Malaise
  • Weight loss
  • RUQ pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain
  • Hepatomegaly
  • Jaundice Jaundice Jaundice is the abnormal yellowing of the skin and/or sclera caused by the accumulation of bilirubin. Hyperbilirubinemia is caused by either an increase in bilirubin production or a decrease in the hepatic uptake, conjugation, or excretion of bilirubin. Jaundice
  • Cholangitis
  • Portal hypertension Portal hypertension Portal hypertension is increased pressure in the portal venous system. This increased pressure can lead to splanchnic vasodilation, collateral blood flow through portosystemic anastomoses, and increased hydrostatic pressure. There are a number of etiologies, including cirrhosis, right-sided congestive heart failure, schistosomiasis, portal vein thrombosis, hepatitis, and Budd-Chiari syndrome. Portal Hypertension
  • Budd–Chiari syndrome

Diagnosis

Imaging

Imaging of hydatid cysts is the mainstay of diagnosis.

Ultrasonography: 

  • 90%–95% sensitivity
  • Findings for cystic echinococcosis:
    • Round, anechoic, smooth cyst
    • Internal septations → daughter cysts
    • Fine, echogenic contents (“hydatid sand”) → protoscolices
    • “Eggshell calcifications” → cysts with calcified rim
  • Findings for alveolar echinococcosis:
    • Irregular cysts without well-defined walls
    • Central necrosis
    • Irregular wall calcifications

CT:

  • Best for determining the number, size, and location of cysts
  • Better than ultrasound in:
    • Detecting extrahepatic cysts
    • Assessing for complications (e.g., rupture)

MRI:

  • Not usually required
  • No major advantage over CT

Serology

Serologic tests are used for diagnosing echinococcosis and for monitoring after treatment.

  • More sensitive for E. multilocularis than for E. granulosus
  • Options:
    • Indirect hemagglutination 
    • ELISA 
    • Indirect immunofluorescence 
    • Immunoblot
    • Latex agglutination

Management and Prevention

Management

There are 4 management strategies: observation, medical therapy, percutaneous drainage, and surgery.

Observation is appropriate:

  • With inactive liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver cysts
  • In the absence of complications

Medical therapy:

  • Definitive therapy for small, single-compartment cysts
  • Often used as adjunctive therapy with percutaneous drainage and surgery
  • Options:
    • Albendazole (preferred)
    • Mebendazole
    • Praziquantel

Percutaneous drainage:

  • Involves drainage of fluid and injection of hypertonic saline (scolicidal) into the cyst cavity
  • Risk of anaphylaxis

Surgery:

  • Treatment of choice for complicated cysts
  • Goal is to remove the whole cyst.
  • Hypertonic saline is injected into the cyst before attempting surgical excision.

Prevention

  • Do not allow dogs to feed on livestock or rodents.
  • Control stray dog populations.
  • Avoid contact with foxes, coyotes, and stray dogs.
  • Wash hands after contact with dogs.
  • Improve water sanitation.
  • Avoid consumption of contaminated food.

Comparison of Tapeworm Species

Table: Characteristics and diseases of different tapeworm species
Organism Diphyllobothrium Diphyllobothrium Diphyllobothriasis represents an intestinal parasitic infection caused by the cestode Diphyllobothrium. Diphyllobothriasis is acquired by ingestion of late larvae in undercooked or raw fish. The clinical presentation of diphyllobothriasis varies from asymptomatic, nonspecific symptoms to intestinal obstruction, and/or vitamin B12 deficiency. Diphyllobothrium/Diphyllobothriasis latum Taenia Taenia Taenia belong to the Cestoda class of helminths. Humans are infected with these tapeworms by eating undercooked beef (T. saginata) or pork (T. solium and T. asiatica). Taeniasis is often asymptomatic, but the ingestion of larvae can cause abdominal discomfort, nausea, and constipation or diarrhea. Taenia/Taeniasis saginata Echinococcus granulosus
Characteristics
  • Approximately 10 m long
  • No hooks
  • Bothria present
  • > 3000 proglottids
  • < 5 m long
  • No hooks
  • No neck
  • Approximately 1000 proglottids
  • 2–7 mm long
  • Hooks present
  • 3–6 proglottids
Transmission Eating raw infected fish Eating raw infected beef Fecal–oral (ingestion of contaminated food or water)
Disease Diphyllobothriasis Diphyllobothriasis Diphyllobothriasis represents an intestinal parasitic infection caused by the cestode Diphyllobothrium. Diphyllobothriasis is acquired by ingestion of late larvae in undercooked or raw fish. The clinical presentation of diphyllobothriasis varies from asymptomatic, nonspecific symptoms to intestinal obstruction, and/or vitamin B12 deficiency. Diphyllobothrium/Diphyllobothriasis Taeniasis Taeniasis Taenia belong to the Cestoda class of helminths. Humans are infected with these tapeworms by eating undercooked beef (T. saginata) or pork (T. solium and T. asiatica). Taeniasis is often asymptomatic, but the ingestion of larvae can cause abdominal discomfort, nausea, and constipation or diarrhea. Taenia/Taeniasis Cystic echinococcosis
Clinical
  • Abdominal discomfort
  • Weight loss
  • Vitamin B12 deficiency
  • Bowel obstruction
  • Usually asymptomatic
  • Mild GI symptoms
Depends on location and size of hydatid cysts
Diagnosis Eggs or proglottids in stool Eggs or proglottids in stool
  • Imaging
  • Serology
Management
  • Praziquantel
  • Niclosamide
  • Praziquantel
  • Niclosamide
  • Albendazole
  • Percutaneous drainage
  • Surgical excision
Prevention
  • Freeze fish.
  • Thoroughly cook fish.
  • Water sanitation measures
Beef should be cooked thoroughly.
  • Personal hygiene
  • Avoid contact with stray dogs.
  • Avoid potentially contaminated food.
  • Improve water sanitation.

Differential Diagnosis

  • Ascariasis Ascariasis Ascariasis is most often caused by A. lumbricoides. If symptomatic, characteristics typically follow 2 phases, which correlate with the migration of the parasite through the body. The early phase may include cough, dyspnea, and wheezing. The late phase typically includes abdominal discomfort, bloating, nausea, and intermittent diarrhea. Ascaris/Ascariasis: infection caused by the parasitic roundworm Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis lumbricoides: Transmission occurs from ingestion of water or food that is contaminated with Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis eggs. Patients may be asymptomatic or may experience cough and hemoptysis. A large worm burden can cause intestinal obstruction and impair growth in children. Examination of the stool may show the presence of worms or eggs.  Management is with anthelmintic therapy.
  • Hepatocellular carcinoma Hepatocellular carcinoma Hepatocellular carcinoma (HCC) typically arises in a chronically diseased or cirrhotic liver and is the most common primary liver cancer. Diagnosis may include ultrasound, CT, MRI, biopsy (if inconclusive imaging), and/or biomarkers. Hepatocellular Carcinoma (HCC) and Liver Metastases: the most common primary liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver cancer: usually arises in a chronically diseased or cirrhotic liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver: Constitutional symptoms are rare and RUQ pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain does not often occur. Imaging will show a well-defined mass with enhancement during the arterial phase and washout during the venous phase. The mainstay of treatment is liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver resection.
  • Pyogenic liver abscess Pyogenic liver abscess A pyogenic liver abscess is a polymicrobial infection arising from contiguous or hematogenous spread. Pyogenic liver abscess is the most common type of visceral abscess. Patients may present with a triad of fever, malaise, and RUQ pain. Pyogenic Liver Abscess: polymicrobial infection that arises from contiguous or hematogenous spread: Patients can present with a triad of fever, malaise, and RUQ pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain. Imaging will reveal solitary or multiple lesions on ultrasonography or CT scan. These lesions are generally well defined and rim enhancing on contrast imaging.  Diagnosis requires aspiration with Gram stain and culture. A combination of drainage and IV antibiotic therapy is the primary method of treatment.
  • Cirrhosis: late stage of hepatic necrosis and scarring: Symptoms of cirrhosis Cirrhosis Cirrhosis is a late stage of hepatic parenchymal necrosis and scarring (fibrosis) most commonly due to hepatitis C infection and alcoholic liver disease. Patients may present with jaundice, ascites, and hepatosplenomegaly. Cirrhosis can also cause complications such as hepatic encephalopathy, portal hypertension, portal vein thrombosis, and hepatorenal syndrome. Cirrhosis are often nonspecific (e.g., fatigue, anorexia, weight loss). Decompensation occurs late in the disease, with manifestations including jaundice, ascites Ascites Ascites is the pathologic accumulation of fluid within the peritoneal cavity that occurs due to an osmotic and/or hydrostatic pressure imbalance secondary to portal hypertension (cirrhosis, heart failure) or non-portal hypertension (hypoalbuminemia, malignancy, infection). Ascites, portal hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension, and liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver failure. Unlike in echinococcosis, ultrasonography will show nodularity of the liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver. Diagnosis often requires liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver biopsy. Management is mostly supportive, with liver Liver The liver is the largest gland in the human body. The liver is found in the superior right quadrant of the abdomen and weighs approximately 1.5 kilograms. Its main functions are detoxification, metabolism, nutrient storage (e.g., iron and vitamins), synthesis of coagulation factors, formation of bile, filtration, and storage of blood. Liver transplantation being the only curative treatment.
  • Lung cancer Lung cancer Lung cancer is the malignant transformation of lung tissue and the leading cause of cancer-related deaths. The majority of cases are associated with long-term smoking. The disease is generally classified histologically as either small cell lung cancer or non-small cell lung cancer. Symptoms include cough, dyspnea, weight loss, and chest discomfort. Lung Cancer: malignant transformation of lung tissue: Symptoms include cough, dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, weight loss, and chest discomfort. Regional and metastatic spread cause additional symptoms and complications depending on the location and organs affected. Definitive diagnosis and staging Staging Cancer is the 2nd leading cause of death in the US after cardiovascular disease. Many malignancies are treatable or curable, but some may recur. Thus, all malignancies must be assigned a grade and stage in order to guide management and determine prognosis. Grading, Staging, and Metastasis are made by biopsy, genetic mutation Mutation Genetic mutations are errors in DNA that can cause protein misfolding and dysfunction. There are various types of mutations, including chromosomal, point, frameshift, and expansion mutations. Types of Mutations with biomarker testing, and imaging. Management is guided by the cancer stage and associated molecular profile.
  • Tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis: disease caused by Mycobacterium Mycobacterium Mycobacterium is a genus of the family Mycobacteriaceae in the phylum Actinobacteria. Mycobacteria comprise more than 150 species of facultative intracellular bacilli that are mostly obligate aerobes. Mycobacteria are responsible for multiple human infections including serious diseases, such as tuberculosis (M. tuberculosis), leprosy (M. leprae), and M. avium complex infections. Mycobacterium tuberculosis: Symptoms include fever, productive cough, night sweats, and weight loss. Cavitary lung lesions, which could resemble a hydatid cyst, may be seen on imaging. Diagnosis is made with identification of acid-fast bacilli on sputum culture. Multiple antimicrobial medications are required for management, including isoniazid, rifampin, pyrazinamide, and ethambutol.

References

  1. World Health Organization. (n.d.). Echinococcosis  https://www.who.int/health-topics/echinococcosis/
  2. Ravis, E., Theron, A., Lecomte, B., Gariboldi, V. (2018). Pulmonary cyst embolism: a rare complication of hydatidosis. Eur J Cardiothorac Surg 53(1):286–287. http://reference.medscape.com/medline/abstract/28977397
  3. Wang, N., Zhong, X., Song, X., et al. (2017). Molecular and biochemical characterization of calmodulin from Echinococcus granulosus. Parasit Vectors 10(1):597. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716380/
  4. Siracusano, A., Delunardo, F., Teggi, A., Ortona, E. (2012). Host-parasite relationship in cystic echinococcosis: an evolving story. Clin Dev Immunol 2012:639362. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206507/
  5. Wang, K., Zhang, X., Jin, Z., Ma, H., Teng, Z., Wang, L. (2013). Modeling and analysis of the transmission of Echinococcosis with application to Xinjiang Uygur Autonomous Region of China. J Theor Biol 333:78–90. http://reference.medscape.com/medline/abstract/23669505
  6. Torgerson, P. R. (2013). The emergence of echinococcosis in Central Asia. Parasitology 140(13):1667–1673. https://www.zora.uzh.ch/id/eprint/78236/
  7. Moro, P. L. (2019). Epidemiology and control of echinococcosis. In Baron, E. L. (Ed.), UpToDate. Retrieved April 16, 2021, from https://www.uptodate.com/contents/epidemiology-and-control-of-echinococcosis
  8. Moro, P. L. (2019). Clinical manifestations and diagnosis of echinococcosis. In Baron, E. L. (Ed.), UpToDate. Retrieved April 16, 2021, from https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-echinococcosis
  9. Moro, P.L. (2020). Treatment of echinococcosis. In Baron, E. L. (Ed.), UpToDate. Retrieved April 16, 2021, from https://www.uptodate.com/contents/treatment-of-echinococcosis
  10. Pearson, R. D. (2020). Echinococcosis. MSD Manual Professional Version. Retrieved April 16, 2021, from https://www.msdmanuals.com/professional/infectious-diseases/cestodes-tapeworms/echinococcosis
  11. Huzaifa, M., Sharman, T. (2020). Echinococccus. StatPearls. Retrieved April 16, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK557623/
  12. Centers for Disease Control and Prevention (2019). Parasites—Echinococcosis. Retrieved April 19, 2021, from https://www.cdc.gov/parasites/echinococcosis/biology.html
  13. The Australian Society for Parasitology Inc. (n.d.). Echinococcus. Retrieved April 19, 2021, from http://parasite.org.au/para-site/text/echinococcus-text.html

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