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| {{SK}} Alveolar echinococcosis, AE, echinococcosis alveolar, echinococciasis multilocular | | {{SK}} Alveolar echinococcosis, AE, echinococcosis alveolar, echinococciasis multilocular |
| ==Overview== | | ==[[Alveolar hydatid disease overview|Overview]]== |
| '''Alveolar hydatid disease''' is a disease that originates from the parasitic flatworm [[Echinococcus multilocularis]]. This disease is not to be confused with the similar [[Echinococcosis]], which originates from the parasite [[Echinococcus granulosus]]
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| ==Pathophysiology==
| | ==[[Alveolar hydatid disease historical perspective|Historical Perspective]]== |
| ===Infestations of Animals=== | | |
| Wild foxes, coyotes, and cats get infected when they eat Echinococcus multilocularis larvae in infected rodents, field mice, or voles. Cats are less susceptible than dogs, but because they catch and eat rodents often, may also become infected. Once the animal becomes infected, the tapeworm matures in its intestine, produces eggs, and the infected animal passes eggs in the stool. These tapeworm eggs, which are directly infectious to other animals, are too tiny to see, and will stick to anything with which they come in contact. Coyotes, foxes, dogs, and cats are not harmed by the tapeworm and do not have symptoms of AE.
| | ==[[Alveolar hydatid disease pathophysiology|Pathophysiology]]== |
| Routine fecal examinations are not sufficient to diagnose E. multilocularis infection. Infection with the E. multilocularis tapeworm and other tapeworms may occur at the same time. Eggs of Taenia species tapeworms and Echinococcus tapeworms are similar in shape and size and are very difficult to tell apart.
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| ===Infestation of Humans=== | | ==[[Alveolar hydatid disease causes|Causes]]== |
| By accidentally swallowing the eggs of the E. multilocularis tapeworm. Humans can be exposed to these eggs in two main ways, both of which involve "hand-to-mouth" transfer or contamination:
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| * By directly ingesting food items contaminated with stool from foxes or coyotes. This might include grass, herbs, greens, or berries gathered from fields.
| | ==[[Alveolar hydatid disease differential diagnosis|Differentiating Alveolar hydatid disease from other Diseases]]== |
| * By petting or handling household cats and dogs infected with the E. multilocularis tapeworm. These pets may shed the tapeworm eggs in their stool, and their fur may be contaminated. Some dogs "scent roll" in foreign material (such as wild animal feces) and may become contaminated this way.
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| ===Associated Conditions=== | | ==[[Alveolar hydatid disease epidemiology and demographics|Epidemiology and Demographics]]== |
| *Cardiac and vascular conditions such as [[myocarditis]] or [[pericarditis]]
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| *Hypersensitivity type 1 reactions such as [[Anaphylaxis]]
| | ==[[Alveolar hydatid disease risk factors|Risk Factors]]== |
| *Neurologic conditions such as [[aseptic meningitis]]
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| *Infection and infective conditions such as a [[lung abscess]] and lung cavitation
| | ==[[Alveolar hydatid disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| ==Epidemiology and Demographics== | | |
| Alveolar hydatid disease is found worldwide, mostly in northern latitudes. Cases have been reported in central Europe, Russia, China, Central Asia, Japan, and North America. In North America E. multilocularis is found primarily in the north central region from eastern Montana to central Ohio, as well as Alaska and Canada. Human cases have been reported in Alaska, the province of Manitoba, and Minnesota. Prevalence among wild foxes and coyotes is high, and may reach over 50% in some areas; however, even in these areas, transmission to humans has been low. | |
| ==Diagnosis== | | ==Diagnosis== |
| ===History and Symptoms===
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| AE is caused by tumor-like or cyst-like tapeworm larvae growing in the body. AE usually involves the liver, but can spread to other organs of the body. Because the cysts are slow-growing, infection with AE may not produce any symptoms for many years.
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| *Pain or discomfort in the upper abdominal region.
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| *Weakness.
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| *Weight loss may occur as a result of the growing cysts.
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| *Symptoms may mimic those of liver cancer and cirrhosis of the liver.
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| *[[Hemoptysis]] may be present.
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| ===Physical Examination===
| | [[Alveolar hydatid disease history and symptoms|History and Symptoms]] | [[Alveolar hydatid disease physical examination|Physical Examination]] | [[Alveolar hydatid disease laboratory findings|Laboratory Findings]] | [[Alveolar hydatid disease x ray|X ray]] | [[Alveolar hydatid disease CT|CT]] | [[Alveolar hydatid disease MRI|MRI]] | [[Alveolar hydatid disease ultrasound|Ultrasound]] | [[Alveolar hydatid disease other imaging findings|Other Imaging Findings]] | [[Alveolar hydatid disease other diagnostic studies|Other Diagnostic Studies]] |
| On physical examination,
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| * [[Abdominal mass]] may be present.
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| * [[Ascites]] may be present.
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| * [[Hepatomegaly]] may be present.
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| * [[Hydrocephalus]] may be present.
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| ===Laboratory tests===
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| Laboratory tests findings are
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| * [[Eosinophilia]]
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| * [[Cholestatic jaundice]]
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| ==Other Imaging findings==
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| * Intracranial calcification
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| ==Treatment== | | ==Treatment== |
| ===Surgery===
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| Surgery is the most common form of treatment for AE, although removal of the entire parasite mass is not always possible. After surgery, medication may be necessary to keep the cyst from growing back. | | [[Alveolar hydatid disease medical therapy|Medical Therapy]] | [[Alveolar hydatid disease surgery|Surgery]] | [[Alveolar hydatid disease primary prevention|Primary Prevention]] | [[Alveolar hydatid disease secondary prevention|Secondary Prevention]] | [[Alveolar hydatid disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Alveolar hydatid disease future or investigational therapies|Future or Investigational Therapies]] |
| ===Prevention===
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| If you live in an area where E. multilocularis is found in rodents and wild canines, take the following precautions to avoid infection:
| | ==Case Studies== |
| * Don't touch a fox, coyote, or other wild canine, dead or alive, unless you are wearing gloves. Hunters and trappers should use plastic gloves to avoid exposure.
| | :[[Alveolar hydatid disease case study one|Case #1]] |
| * Don't keep wild animals, especially wild canines, as pets or encourage them to come close to your home.
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| * Don't allow your cats and dogs to wander freely or to capture and eat rodents.
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| * If you think that your pet may have eaten rodents, consult your veterinarian about the possible need for preventive treatments.
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| * After handling pets, always wash your hands with soap and warm water.
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| * Fence in gardens to keep out wild animals.
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| * Do not collect or eat wild fruits or vegetables picked directly from the ground. All wild-picked foods should be washed carefully or cooked before eating.
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| ==References== | |
| {{reflist|2}}
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| ==External Links==
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| * [http://www.cdc.gov/ncidod/dpd/parasites/alveolarechinococcosis/factsht_alveolarechinococcosis.htm The Division of Parasitic Diseases]
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| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |