What is echinococcosis? This is a parasitic invasion of Echinococcus, carried out by a tapeworm at the larval stage. This condition is fraught with damage to internal organs. In simple terms, this is a disease in which echinococcal cysts form in the lungs, liver, heart, brain and tissues.
What leads to the beginning of its development? What are the symptoms? Is it possible to get rid of it? These and many other questions are answered in our article.
Reasons
What is echinococcosis, we described above. What are the reasons for the defeat of this helminth?
The final hosts of sexually mature worms are animals in whose intestines cestodes parasitize. Wild and domestic herbivores, as well as humans, are intermediate hosts of larval stages. They are also considered a kind of biological dead end, since they do not release echinococcal eggs into the environment, and therefore cannot be sources of invasion.
Omitting the details of the development of parasites, we should go directly to the issue of infection. How does it happen? The final host allocatesinto the external environment along with the feces of the egg, which infects a person. There are two ways:
- Alimentary. It is enough for a person to consume water, fruits or vegetables contaminated with contaminated feces.
- Contact. In this case, you need to have contact with an animal infected with echinococcus, or butcher its carcass.
Based on this, we can conclude about what echinococcosis is. This is a disease that, as a rule, infects people involved in the care of animals, activities related to them (slaughterhouse workers, hunters, breeders, etc.). Also at risk are those people who are not accustomed to a responsible attitude to the processing of food consumed.
Pathogenesis
The causative agent of echinococcosis is Echinococcus granulosus or Alveococcus multilocularis. What happens when infected eggs enter the human body?
In the gastrointestinal tract, their shell dissolves. As a result, the larvae come out, which, using the hooks on their body, are introduced into the intestinal mucosa.
From there, these beings enter the venous circulation and then into the portal system. Some of them end up in the liver. Less commonly, parasites enter the right side of the heart through the inferior vena cava, and then enter the pulmonary circulation and lungs.
More often it turns out that the embryos penetrate into the systemic circulation. This is fraught with their entry into any organs. They can affect the muscles, kidneys, spleen, brain.
In 70-80% of cases the liver is affected. At 15% -lungs. In other rare cases, other internal organs are affected.
When the embryos settle, the vesicle (hydatidosis) stage of development of the causative agent of echinococcosis begins in the organ. Cysts with a two-layer membrane are formed. They begin to slowly increase in size (growth rate is approximately 1 mm/month). Some patients ignore their condition for years, so their cysts can be gigantic.
These blisters are filled with an opalescent white liquid, inside which scolexes and child blisters float. Often their number reaches 1000.
What is echinococcosis, now it's clear. What is the mechanism of its formation, we examined. What causes its manifestations? The sensitizing effect exerted by parasitic antigens, as well as the mechanical pressure exerted by the cyst on tissues and organs.
It should be noted that the parasitism of echinococcus is accompanied by the release of its metabolic products, due to which the carrier begins to develop intoxication and allergies. If the cyst ruptures, the contents will end up in the abdominal or pleural cavity, and this is fraught with anaphylactic shock.
Even without such a phenomenon, the patient's condition will worsen. The cyst will continue to put pressure on the surrounding structures, as a result of which the functions of the affected organ will be violated more and more. It may develop suppuration. Sometimes a real miracle happens - echinococcus dies spontaneously, recovery occurs.
Symptoms
Talking about what echinococcosis is, it should be noted that it canbe asymptomatic for decades. If clinical symptoms occur, then pathognomonic signs do not appear.
Whether it is echinococcosis of the brain or liver, there are three stages of development.
The first (latent) one begins from the moment when the parasites are introduced into the tissues. This period lasts until the first symptoms appear. Then comes the second stage, when the following clinical manifestations let you know about the disease:
- Pain where the cyst has formed.
- Urticaria.
- Severe weakness.
- Nausea.
- Weak appetite.
- Periodic diarrhea.
- Pain and heaviness in the right hypochondrium.
- Itchy skin.
- Other specific manifestations depending on which organ is affected.
The third stage is complicated. The disease is already running, a cyst rupture may occur. This is fraught with serious consequences, such as pleurisy and peritonitis.
If the cyst fester, then severe intoxication and high fever join. Often there is obstructive jaundice, ascites, pathological fractures.
Brain
As already mentioned, echinococcosis in a person can occur in various parts of his body. Each case must be considered separately.
The following manifestations characterize brain damage:
- Patient complains of headaches, vomiting, dizziness, generalized epileptic seizures, and congestive optic discs.
- Maydementia, depression and delirium occur.
- Cortical epileptic seizures often occur, after which paresis develops in the limbs that were previously affected by convulsions.
- CSF shows pleocytosis and elevated protein levels.
- Tests show the presence of eosinophilia in the blood.
It is very important to conduct a differential diagnosis of echinococcosis. People with similar symptoms also develop brain tumors.
Biliary tract
They can also be affected by this disease. As a rule, the process is localized in the gallbladder. The ducts are involved in this process for the second time.
If a parasitic cyst ruptures, there are a number of symptoms:
- Hepatic colic.
- Jaundice.
- Vomiting.
- Nausea.
- Acholic chair.
- Chills and fever accompanying cholangitis.
- Bile duct blockage.
With this pathology, mortality is very high, since the defeat of the gallbladder by parasites is fraught with the development of cholecystitis, cholangitis and hepatitis.
In this case, surgical treatment is necessary. Surgical intervention helps to restore the free outflow of bile, remove echinococcus and drain the purulent cavity. This cannot be done without opening the common bile duct and without removing the daughter cysts with fragments of parasite tissue.
In rare cases, cholecystectomy is indicated. If the condition is irreparable, then the gallbladder will have to be removed. In parallel, they candrain the liver cyst, or also remove it.
Light
This paired organ often becomes the "target" of the disease. If we are talking about the symptoms and diagnosis of echinococcosis in humans, you need to list the signs that indicate its development in this case. They can be identified in the following list:
- Dry cough. Over time, sputum begins to appear, sometimes even with blood.
- Severe chest pain of a pressing nature.
- Shortness of breath.
- Protrusion of intercostal spaces.
- Chest deformity.
Often this condition is complicated by exudative or dry pleurisy, perifocal inflammation of the lung tissue.
The cyst can fester, break into the pleural cavity or bronchi. This is accompanied by bouts of coughing and the release of light sputum with blood impurities in large quantities. Other symptoms appear:
- Lack of air.
- Cyanosis.
- Sharp chest pain.
- Fever.
- Chills.
- Anaphylactic shock.
In the early stages, with timely diagnosis in the clinic of echinococcosis, treatment is carried out with medication. But in case of development of complications urgent operation is necessary. With timely intervention, the prognosis may be favorable.
Liver
This organ is most often the "target" of diseases echinococcosis, ascariasis and other conditions associated with the penetration of parasites into the body.
They settle in huge quantities in small capillaries. Formed cysts grow slowly,breaking into the liver parenchyma. They may even enter the free abdomen or the bile ducts.
The most pronounced symptom is a feeling of pain and heaviness, concentrating in the area of the right hypochondrium and epigastrium.
If suppuration of the bladder occurs, then an abscess of the liver begins to develop. Its opening may be fraught with peritonitis or purulent pleurisy.
A ruptured bladder can lead to allergic reactions or even anaphylactic shock. You can’t bring it to this, because in the early stages, drug treatment gives a good result.
Kidneys
Cysts form in their cortex. The left kidney is most commonly affected. Cysts can be open, closed, or pseudo-closed.
The neglected state is fraught with displacement of the kidney, as well as deformation and further expansion of the renal calyces and pelvis. The parenchyma may even atrophy.
In the kidneys, parasites often die, after which they undergo calcification. This process makes itself felt by the following symptoms:
- Weight loss.
- Loss of appetite.
- Severe weakness.
- Fatigue.
- Unwell.
- Intoxication.
- Pain in the hypochondrium of a dull nature, radiating to the lumbar region.
- Renal colic.
- Fever (usually subfebrile).
- Itchy skin.
- Hematuria.
- Difficulty urinating.
Carried out after studyingdoctor suspected symptoms of echinococcosis diagnosis also shows blood eosinophilia. Often there is an increase in the erythrocyte sedimentation rate and moderate leukocytosis. In rare cases, tests show cylindruria and proteinuria.
It should be noted that the cyst can be felt. It is a convex roundness in the hypochondrium, can be smooth or bumpy.
How is this condition treated? Be sure to remove cysts, after which echinococcectomy and kidney resection are performed. Rarely, nephrectomy is indicated.
What will be the prognosis depends on the degree of intoxication. If the echinococcal bladder bursts and the cavities become seeded, it will worsen significantly.
Spleen
Studying the topic concerning the symptoms of echinococcosis and the diagnosis of this disease, it is necessary to consider those cases when this organ is affected.
All visual and structural changes in the spleen can be determined by x-ray, ultrasound, as well as CT and MRI.
Symptoms for this type of parasite infection are as follows:
- Feeling of pain and heaviness in the upper left abdomen.
- Tumor extending far into the left hypochondrium.
- Epigastric pain.
- Poor appetite and food aversion.
- Vomiting and nausea.
- General weakness.
The liver is often involved in the process. Then cholecystitis, cirrhosis begins to develop, diabetes and pancreatitis can join.
Kidneys covered with cyststhe spleen exerts pressure, are also involved in the process. They can shift, which is fraught with colic and problems with urination. Often there are symptoms similar to signs of intercostal neuralgia, as well as shortness of breath and cough. This is observed if the aperture is moved significantly.
Heart
This organ is rarely affected by parasites. At risk are children and people over 20.
Parasites entering the heart through the coronary circulation grow very slowly. The myocardium of the left ventricle is usually affected.
Symptoms are as follows:
- Signs of myocardial ischemia.
- Heart failure.
- Chest pain.
- Irregular heart rhythms.
- Syncope.
Myocardial ischemia, vasoconstriction, outflow tract obstruction, cardiac conduction disturbances, arterial embolism - these are not very complex consequences of this condition. If the cyst ruptures, sudden death can occur. Sometimes even emergency intervention does not help.
At the slightest alarming symptoms, seek help. Most likely, surgical treatment aimed at direct debridement and excision of cysts will be indicated. They also prescribe intensive therapy using Mebendazole and Albendazole.
Spinal cord
The defeat of this organ should be studied without fail. Below we will consider the diagnosis and treatment of echinococcosis.
Infection of the spinal cord does not last long in the latent stage. Even a small cyst can cause compression of this organ,which is fraught with many consequences (disorders of the function of the pelvic organs, paralysis and paresis).
Girdle chest pains, discomfort and aching limbs often occur. All this is aggravated by coughing, sudden movements.
If the disease progresses, the following consequences will occur:
- Kyphoscoliosis.
- Kyphosis.
- Limited spinal mobility.
- Spastic paraparesis.
- Brown-Sequard Syndrome.
It is very important in this case to resort to differential methods for diagnosing spinal cord echinococcosis, since its symptoms are similar to those observed in spinal tumors and tuberculosis.
Treatment is usually surgical. If the disease is detected at an early stage, then the problem can be eliminated with the help of medicines.
Diagnosis
The examination begins with a general medical examination and a study by the doctor of anamnesis. Diagnosis of echinococcosis of the lungs, liver, heart and other organs is significantly different.
The doctor identifies clinical and radiological signs, after which the patient is sent for the following diagnostic procedures:
- CT. It allows you to study absolutely all organs, as well as to detect the smallest cysts, revealing their exact location. Helps to differentiate them from oncological formations, even to measure the density.
- MRI. With this procedure, damage can be assessed after surgery.
- Ultrasound. Allows you to detect parasitic accumulations in absolutely any area of \u200b\u200bthe abdominal or chest. Ultrasound also helpsmonitor the reaction of cysts to treatment, analyze the rate of their development.
- X-ray. It makes it possible to detect cysts in bone tissue, muscles, lungs, and also to see calcified masses.
Patients are prescribed a blood test by ELISA. Thanks to him, it is possible to detect the presence of antibodies to parasites. This method is more effective than CBC.
Therapy
As for the treatment of echinococcosis, recommendations to the patient are given by his personal doctor. He prescribes therapy, taking into account the characteristics of the human body, the specifics of the development of the disease, the results of diagnostics, as well as dozens of other factors. Self-medication is not only unacceptable, but also fraught with serious consequences.
The doctor usually prescribes the following groups of drugs:
- Painkillers.
- Anthelmintic.
- Hepatoprotective.
- Antiemetic.
- Fortifying.
Combination therapy helps to relieve pathological manifestations. If it turns out to be ineffective, then an operation is prescribed. There are several options:
- Radical intervention. It implies the excision of the affected area.
- Conditionally radical. During such an operation, a site is removed where echinococcosis can recur.
- Auxiliary. It is not aimed at treating the patient, but at alleviating his condition.
- Intervention to prevent complications. Usually, organ drainage is performed, which is necessary after the rupture of the cysts.
If the operation is successful and on time, and the patient does not get re-infected, then the prognosis is favorable. In such cases, relapses do not occur.
But patients will be registered in the dispensary for another 8-10 years. They will need to undergo serological tests annually, as well as X-ray and ultrasound examinations.
Of course, you need to lead a he althy lifestyle to maintain your body, as well as follow all the rules of hygiene to protect yourself from re-infection.
