Echinococcosis classification
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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]
- Cystic echinococcosis
- Due to the infection with the larvae of Echinococcus granulosus
- Alveolar echinococcosis
- Due to the infection with the larvae of Echinococcus multilocularis
Based on an international classification, cystic echinococcosis can be classified based on the ultrasound features into 5 categories:[1]
- Type 1 and 2
- Active fertile cysts that contain viable protoscoleces
- Type 3
- Transitional stage cysts, as a result of host immune response or therapy
- Type 4 and 5
- 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 [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
- ↑ 1.0 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.
- ↑ 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.