ECHINOCOCCOSIS

Tissue infestation by larvae of Echinococcus granulosus. It is transmitted through direct contact with dogs or by ingesting water and food contaminated by dog faeces.

Clinical features

  • Cough, chest pain
  • Liver cysts may be asymptomatic but may also give abdominal pain, palpable mass and jaundice (if the bile duct is obstructed) Rupture of cysts may cause fever, urticaria, or anaphylactic reaction
  • Pulmonary cysts can be seen on chest X-ray and may rupture to cause cough, chest pain and haemoptysis

Differential diagnosis

  • Amoebiasis, hepatoma
  • Other causes of liver mass and obstructive jaundice
  • Tuberculosis (TB)

Investigations

  • Skin test
  • Ultrasound
  • Chest X-ray: for pulmonary cysts
  • Serological tests
  • Needle aspiration under Ultrasound Sonography (US) or CT-scan guidance

Management

Refer for specialist management

  • Surgical excision

Prior to surgery or in cases not amenable to surgery

  • Albendazole
    • Child >2 years and adults: 7.5 mg/kg every 12 hours for 3-6 months

Prevention

  • Food hygiene
  • Health education
  • Proper disposal of faeces