Echinococcosis medical therapy: Difference between revisions
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! rowspan="2" |CE1 | ! rowspan="2" |CE1 | ||
| rowspan="2" |Unilocular unechoic cystic lesion with double line sign | | rowspan="2" |Unilocular unechoic [[Cystic|cystic lesion]] with double line sign | ||
| rowspan="2" |Active | | rowspan="2" |Active | ||
|<5 cm | |<5 cm | ||
|Albendazole alone | |[[Albendazole]] alone | ||
|PAIR | |PAIR | ||
|- | |- | ||
|>5 cm | |>5 cm | ||
|Albendazole + PAIR | |[[Albendazole]] + PAIR | ||
|PAIR | |PAIR | ||
|- | |- | ||
!CE2 | !CE2 | ||
|Multiseptated, "rosette-like" "honeycomb" cyst | |Multiseptated, "rosette-like" "honeycomb" [[cyst]] | ||
|Active | |Active | ||
|Any | |Any | ||
|Albendazole + either modified catheterization or surgery | |[[Albendazole]] + either modified catheterization or surgery | ||
|Modified catheterization | |Modified [[catheterization]] | ||
|- | |- | ||
! rowspan="2" |CE3a | ! rowspan="2" |CE3a | ||
| rowspan="2" |Cyst with detached membranes (water-lily sign) | | rowspan="2" |[[Cyst]] with detached membranes (water-lily sign) | ||
| rowspan="2" |Transitional | | rowspan="2" |Transitional | ||
|<5 cm | |<5 cm | ||
|Albendazole alone | |[[Albendazole]] alone | ||
|PAIR | |PAIR | ||
|- | |- | ||
|>5 cm | |>5 cm | ||
|Albendazole + PAIR | |[[Albendazole]] + PAIR | ||
|PAIR | |PAIR | ||
|- | |- | ||
!CE3b | !CE3b | ||
|Cyst with daughter cysts in solid matrix | |[[Cyst]] with daughter cysts in solid [[matrix]] | ||
|Transitional | |Transitional | ||
|Any | |Any | ||
|Albendazole + either modified catheterization or surgery | |[[Albendazole]] + either modified catheterization or surgery | ||
|Modified catheterization | |Modified [[catheterization]] | ||
|- | |- | ||
!CE4 | !CE4 | ||
|Cyst with heterogenous hypoechoic/hyperechoic contents; no daughter cysts | |[[Cyst]] with heterogenous hypoechoic/hyperechoic contents; no daughter cysts | ||
|Inactive | |Inactive | ||
|Any | |Any | ||
Revision as of 21:39, 21 August 2017
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Echinococcosis Microchapters |
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Treatment |
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Case Studies |
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Echinococcosis medical therapy On the Web |
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American Roentgen Ray Society Images of Echinococcosis medical therapy |
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Risk calculators and risk factors for Echinococcosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Both cystic echinococcosis and alveolar echinococcosis are complicated to treat, sometimes requiring extensive surgery and/or prolonged drug therapy. There are 3 options for the treatment of cystic echinococcosis: anti-infective drug treatment, percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique and surgery.[1]
Medical Therapy
Cystic echinococcosis stage 1 of less than 5 cm
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 1 of more than 5 cm
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and Puncture, Aspiration, Injection, Re-aspiration (PAIR)
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 2 of any size
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and either modified catheterization or surgery
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 3 of any size
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and either modified catheterization or surgery
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
World Health Organization classification of cystic echinococcosis and treatment stratified by cyst stage [2][3]
PAIR: puncture, aspiration, injection, reaspiration
| WHO stage | Description | Stage | Size | Preferred treatment | Alternate treatment |
|---|---|---|---|---|---|
| CE1 | Unilocular unechoic cystic lesion with double line sign | Active | <5 cm | Albendazole alone | PAIR |
| >5 cm | Albendazole + PAIR | PAIR | |||
| CE2 | Multiseptated, "rosette-like" "honeycomb" cyst | Active | Any | Albendazole + either modified catheterization or surgery | Modified catheterization |
| CE3a | Cyst with detached membranes (water-lily sign) | Transitional | <5 cm | Albendazole alone | PAIR |
| >5 cm | Albendazole + PAIR | PAIR | |||
| CE3b | Cyst with daughter cysts in solid matrix | Transitional | Any | Albendazole + either modified catheterization or surgery | Modified catheterization |
| CE4 | Cyst with heterogenous hypoechoic/hyperechoic contents; no daughter cysts | Inactive | Any | Observation | - |
| CE5 | Solid plus calcified wall | Inactive | Any | Observation | - |
References
- ↑ Mihmanli M, Idiz UO, Kaya C, Demir U, Bostanci O, Omeroglu S, Bozkurt E (2016). "Current status of diagnosis and treatment of hepatic echinococcosis". World J Hepatol. 8 (28): 1169–1181. doi:10.4254/wjh.v8.i28.1169. PMC 5055586. PMID 27729953.
- ↑ 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.
- ↑ 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.