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Echinococcus ( granulosus and multilocularis ) . Abdi Rahman Gulaid. Introduction . Echinococcosis : Echinococcosis commomly known as Hydatid Disease or Hydatidosis , is caused by a parasitic cestodes (tapeworms) of the genus Echinococcus . . - PowerPoint PPT Presentation
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A B D I RA H M A N G U L A I D
ECHINOCOCCUS (GRANULOSUS AND MULTILOCULARIS)
INTRODUCTION
Echinococcosis:
Echinococcosis commomly known as Hydatid Disease or Hydatidosis, is caused by a parasitic cestodes (tapeworms) of the genus Echinococcus.
Four species of Echinococcus cause infection in humans are:
E. granulosus causes cystic echinococcosis
E. multilocularis causes alveolar echinococcosis
E. vogeli causes polycystic echinococcosis
E. oligarthrus is an extremely rare cause of human echinococcosis.
THE GEOGRAPHIC DISTRIBUTION
Echinococcus granulosus is widely distributed across Canada and more frequent in rural, grazing areas.
Echinococcus multilocularis occurs in the northern hemisphere, including central Europe and the northern parts of Europe, Asia, and North America.
E. vogeli and E. oligarthrus occur in Central and South America.
Size Definitive Intermediate
E. granulosus Usually 3 to 6 mm long and consist of a scolex with suckers and hooks, as well as at least three proglottid segments.
Adult worm: (adult worm): wolves, coyotes, domestic dogs
Larval worm: Sheep, Goat, Camel, cattle, Goat, and Horse .
E. Multilocularis 1.2-3.7 mm long with two to six proglottic segments.
Adult worm: Arctic and red foxes, coyotes, sometimes domestic dogs and cats.
Larval worm: rodents (voles, mice, muskrats).Humans
E.GRANULOSUS HOST& E.MULTILOCULARIS HOST
TRANSMISSION AND LIFE CYCLE OF ECHINOCOCCUS
The Hydatid Tapeworm Life Cycle Diagram1. Adult worm present in intestine of definitive host2. Eggs passed in feces, ingested by humans or
intermediate host3. Onchosphere penetrates intestinal wall, carried via
blood vessels to lodge in organs4. hydatid cysts develop in liver, lungs, brain, heart5. After ingestion, the protoscolices attach to the
intestine.6. Ingested protoscolices attach to small intestine and
develops into adult worm and the cycle starts all over again.
LIFECYCLE:
ECHINOCOCCUS EGG IN FECES
SYMPTOMS• E. granulosus
• Can remain silent for years• It is the enlarging cysts that cause symptoms in organs
• Hepatic involvement (75%) (abdominal pain, mass in the hepatic area, biliary duct obstruction)
• Pulmonary involvement (chest pain, Cough, hemoptysis)• Brain, bone, and heart (10-20%)
• Rupture of cyst (fever, hives, pus, anaphylactic shock, and the cyst spreads throughout body cavity)
• E. multilocularis• Affects the liver as a slow growing destructive tumor• Abdominal pain, biliary obstruction, and sometimes metastatic
lesions in lungs and brain are common symptoms
A SECTION OF HUMAN LUNG SHOWS MULTIPLE PROTOSCOLECES LIBERATED FROM A RUPTURED HYDATID CYST
E. MULTILOCULARISSIGNS AND SYMPTOMS OF ALVEOLAR HYDATID
DISEASE
No early symptoms Cysts in multiple body organs Symptoms of liver infestation: upper abdominal
pain , weakness , weight loss , chest pain , cough, coughing blood , jaundice
Symptoms of brain infestation: Blindness Epilepsy
Symptoms of ruptured cysts: Allergic rash Fever
DIAGNOSIS
• Imaging (CT, MRI, and ultrasound)
• Serologic testing (enzyme immunoassay, immunofluorescent assay)
• Examination of cyst fluid
Protoscoleces in a hydatid cyst removed from lung tissue
TREATMENT
Surgical removal via laparoscopy, can be curative for the treatment of echinococcosis
Medication is sometimes effective to keep the cyst from growing back
Praziquantel for definitive host (dog) Albendazole, mebendazole
intermediate host (sheep, other host)
REMOVAL BY SURGERY
CONTROL METHOD
• interrupt lifecycle by an possible means. • Destroy stray dogs
• General education program
• Sheep herders should not live closely with their dogs
- Center of Disease Control. http://www.dpd.cdc.gov/dpdx/html/Echinococcosis.htm
- journals.cambridge.org/production/action/cjoGetFulltext?fulltextd... by JD SMYTH - 1964 - Cited by 64 - Related articles
- www.sciencedirect.com/science/article/pii/0166685185900167 by DP McManus - 1985 - Cited by 42 - Related articles
- www.springerlink.com/index/MD4LQW968V6TUBPE.pdf by CP Nunes - 2004 - Cited by 12 - Related articles
http://www.fao.org/docrep/t1300t/t1300T0m.htm by A. Permin and J.W. Hansen
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