Echinococcosis classification: Difference between revisions

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{{Echinococcosis}}
{{Echinococcosis}}


{{CMG}} '''Associate Editor-In-Chief:''' {{CZ}}; {{KD}}
{{CMG}} '''Associate Editor-In-Chief:''' {{MIR}} {{CZ}}; {{KD}}
==Overview==
==Overview==
[[Echinococcosis]] is classified based on; the site of [[Infection (disambiguation)|infection]] and the type of [[Tapeworms|tapeworm]], causing the infection into [[cystic echinococcosis]] and [[alveolar echinococcosis]]. It can also be classified based on the [[ultrasound]] findings and appearance.
[[Echinococcosis]] is classified based on the site of [[Infection (disambiguation)|infection]] and the type of [[Tapeworms|tapeworm]] causing the [[infection]], into [[cystic echinococcosis]] and [[alveolar echinococcosis]]. It can also be classified based on the [[ultrasound]] findings and appearance. Based on [[WHO]] classification, [[cystic]] echinococcus can be classified to 5 stages: CE1, CE2, CE3a, CE3b, CE4, CE5.
==Classification==
==Classification==
*Based on international classification of [[ultrasound]] images in [[cystic echinococcosis]] (for application in clinical and field epidemiological settings) [[cystic echinococcosis]] is classified into:<ref name="Working Group2003">{{cite journal|last1=Working Group|first1=WHO Informal|title=International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings|journal=Acta Tropica|volume=85|issue=2|year=2003|pages=253–261|issn=0001706X|doi=10.1016/S0001-706X(02)00223-1}}</ref>
Based on the site of infection, [[echinococcosis]] can be classified into:<ref name="Working Group2003">{{cite journal|last1=Working Group|first1=WHO Informal|title=International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings|journal=Acta Tropica|volume=85|issue=2|year=2003|pages=253–261|issn=0001706X|doi=10.1016/S0001-706X(02)00223-1}}</ref>  
**'''Cystic echinococcosis cyst type 1 and 2'''  
*[[Cystic]] [[echinococcosis]]
***Cysts are active fertile cysts and contain viable protoscoleces.
**Due to the [[infection]] with the larvae of ''[[Echinococcus granulosus]]''
**'''Cystic echinococcosis type 3'''
*[[Alveolar]] [[echinococcosis]]
***Cysts in transitional stage, as a result of host immune response or therapy.
**Due to the [[infection]] with the larvae of [[Echinococcus multilocularis|''Echinococcus multilocularis'']]
**'''Cystic echinococcosis cyst type 4 and 5'''  
Based on an international classification, [[cystic echinococcosis]] can be classified based on the ultrasound features into 5 categories:<ref name="Working Group2003" />
***Inactive cysts which have lost their fertility and are degenerative.
*Type 1 and 2
*Based on the '''site of infection''', [[echinococcosis]] can be classified into:
**Active fertile [[cysts]] that contain viable protoscoleces
**'''Cystic echinococcosis:'''
*Type 3  
***It is due to infection of the host by the larval stage of ''[[Echinococcus granulosus]].'' It causes a chronic asymptomatic infection affecting the [[lungs]] and [[liver]]. Infection will lead to the formation of enlarging cysts in the liver and lungs.
**Transitional stage [[cysts]], as a result of host [[immune response]] or [[therapy]]
**'''Alveolar echinococcosis:'''
*Type 4 and 5   
***It is due to the infection of the host by the larval stage of [[Echinococcus multilocularis|''Echinococcus multilocularis'']]. It is common in [[Endemic (epidemiology)|endemic]] areas and results in the formation of [[parasitic]] tumors in the [[liver]], [[Lung|lungs]] and [[brain]].
**Inactive and [[degenerative]] [[cysts]] which have lost their [[fertility]]
This classification system can be helpful for application in clinical and field epidemiological setting.
==== World Health Organization classification of cystic echinococcosis based on cyst stage <ref name="pmid18784219">{{cite journal |vauthors=Junghanss T, da Silva AM, Horton J, Chiodini PL, Brunetti E |title=Clinical management of cystic echinococcosis: state of the art, problems, and perspectives |journal=Am. J. Trop. Med. Hyg. |volume=79 |issue=3 |pages=301–11 |year=2008 |pmid=18784219 |doi= |url=}}</ref><ref name="pmid19931502">{{cite journal |vauthors=Brunetti E, Kern P, Vuitton DA |title=Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans |journal=Acta Trop. |volume=114 |issue=1 |pages=1–16 |year=2010 |pmid=19931502 |doi=10.1016/j.actatropica.2009.11.001 |url=}}</ref>====
<span style="font-size:85%">'''CE:''' cystic echinococcus.
</span>
{| class="wikitable"
! style="background: #4479BA; color: #FFFFFF; " |WHO stage
! style="background: #4479BA; color: #FFFFFF; " |Description
! style="background: #4479BA; color: #FFFFFF; " |Stage
! style="background: #4479BA; color: #FFFFFF; " |Size
|-
! rowspan="2" style="background: #DCDCDC; " |CE1
| rowspan="2" |Unilocular unechoic [[Cystic|cystic lesion]] with double line sign
| rowspan="2" |Active
|<5 cm
|-
|>5 cm
|-
! style="background: #DCDCDC; " |CE2
|Multiseptated, "rosette-like" "honeycomb" [[cyst]]
|Active
|Any
|-
! rowspan="2" style="background: #DCDCDC; " |CE3a
| rowspan="2" |[[Cyst]] with detached membranes (water-lily sign)
| rowspan="2" |Transitional
|<5 cm
|-
|>5 cm
|-
! style="background: #DCDCDC; " |CE3b
|[[Cyst]] with daughter cysts in solid [[matrix]]
|Transitional
|Any
|-
! style="background: #DCDCDC; " |CE4
|[[Cyst]] with heterogenous hypoechoic/hyperechoic contents; no daughter cysts
|Inactive
|Any
|-
! style="background: #DCDCDC; " |CE5
|Solid plus calcified wall
|Inactive
|Any
|}


== References ==
== References ==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 21:32, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Mahshid Mir, M.D. [2] Cafer Zorkun, M.D., Ph.D. [3]; Kalsang Dolma, M.B.B.S.[4]

Overview

Echinococcosis is classified based on the site of infection and the type of tapeworm causing the infection, into cystic echinococcosis and alveolar echinococcosis. It can also be classified based on the ultrasound findings and appearance. Based on WHO classification, cystic echinococcus can be classified to 5 stages: CE1, CE2, CE3a, CE3b, CE4, CE5.

Classification

Based on the site of infection, echinococcosis can be classified into:[1]

Based on an international classification, cystic echinococcosis can be classified based on the ultrasound features into 5 categories:[1]

This classification system can be helpful for application in clinical and field epidemiological setting.

World Health Organization classification of cystic echinococcosis based on cyst stage [2][3]

CE: cystic echinococcus.

WHO stage Description Stage Size
CE1 Unilocular unechoic cystic lesion with double line sign Active <5 cm
>5 cm
CE2 Multiseptated, "rosette-like" "honeycomb" cyst Active Any
CE3a Cyst with detached membranes (water-lily sign) Transitional <5 cm
>5 cm
CE3b Cyst with daughter cysts in solid matrix Transitional Any
CE4 Cyst with heterogenous hypoechoic/hyperechoic contents; no daughter cysts Inactive Any
CE5 Solid plus calcified wall Inactive Any

References

  1. ↑ 1.0 1.1 Working Group, WHO Informal (2003). "International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings". Acta Tropica. 85 (2): 253–261. doi:10.1016/S0001-706X(02)00223-1. ISSN 0001-706X.
  2. ↑ Junghanss T, da Silva AM, Horton J, Chiodini PL, Brunetti E (2008). "Clinical management of cystic echinococcosis: state of the art, problems, and perspectives". Am. J. Trop. Med. Hyg. 79 (3): 301–11. PMID 18784219.
  3. ↑ Brunetti E, Kern P, Vuitton DA (2010). "Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans". Acta Trop. 114 (1): 1–16. doi:10.1016/j.actatropica.2009.11.001. PMID 19931502.

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