Cystic echinococcosis

In the cystic echinococcosis it is a special form of echinococcosis, the cause of which is a parasitic infection. The responsible pathogen is Echinococcus granulosus, which is counted among the tapeworms. The disease occurs when the parasite's fin forms cystic structures in the intermediate host.

What is cystic echinococcosis?

The cystic echinococcosis is sometimes too Echinococcal bladder, Bladder worm and Hydatid cyst called. The cysts spread rapidly, causing the neighboring organic tissue to be displaced. In the majority of cases, humans are infected by the so-called dog tapeworm.

Humans take on the position of intermediate host for this tapeworm, while animal species such as dogs or wolves are potential final hosts. The German Infection Protection Act stipulates that all infections with the corresponding tapeworm must be reported to a doctor.

Basically, Echinococcus granulosus is native to all over the world. However, it is particularly widespread in southern regions such as the Mediterranean region. An infection of humans usually occurs when the affected persons ingest the larvae of the tapeworm into the organism via the oral route.

causes

Cystic echinococcosis develops after the larvae of the tapeworm enter the human body. First, the worm larvae hatch inside the intestine, from where they move to the liver. In the later course of the infestation, they also spread to other organs of the body if possible and prefer the lungs in particular.

The incubation period is comparatively long, so that it takes a long time for the first symptoms to manifest. Capsules of connective tissue that surround the structures are typical of cysts in cystic echinococcosis.

Symptoms, ailments & signs

The symptoms and complaints of cystic echinococcosis cover a relatively wide range. Basically, the disease progresses differently from patient to patient and depends primarily on the area of ​​the body and in which organs the cysts are located. The extent and strength of the organism's immune reaction also affects the symptoms.

In the majority of cases, the cysts are found in the lungs and liver. The cysts are usually characterized by slow growth so that symptoms do not appear for a long time. The symptoms develop primarily when the cysts take up too much space and thereby displace other organs.

In addition, symptoms develop when a superinfection caused by bacteria forms in the affected organism. Finally, the development of fistulas and anaphylactic effects lead to the premature occurrence of symptoms. Otherwise the infestation with the tapeworms and the cystic echinococcosis will go undetected for a long time.

The typical cysts also form in the heart, kidneys or bones much less frequently than in the liver and lungs. In turn, other symptoms occur. In principle, the incubation period is variable and extends over a period of a few months to several years. The age of the affected patient also does not play a role in the infestation with the tapeworms.

However, observations indicate that cystic echinococcosis occurs more frequently in people between the ages of 30 and 50. The fins of the dog tapeworm appear as a bubble that is filled with a liquid. The human body's response to this cyst is to build connective tissue around the bladder. This is how the so-called brood capsules are created. The tapeworms develop in these after a while.

Diagnosis & course of disease

A diagnosis of cystic echinococcosis is made in numerous cases either by chance within the scope of other examinations or relatively late when the disease is already causing considerable symptoms. As soon as the presence of cystic echinococcosis is suspected, the symptoms should be clarified by a doctor.

Here, a thorough anamnesis is first carried out, whereby possible contacts with larvae of the tapeworms are also discussed. On the basis of the patient's descriptions, the attending physician already gains a large number of valuable information that will help him make the diagnosis. Later on, clinical and, above all, imaging methods are used to diagnose cystic echinococcosis.

Cysts and their location can be detected during imaging. Laboratory analyzes provide information about appropriate antibodies. CT and X-ray examinations are also suitable for diagnosing cystic echinococcosis. With regard to the differential diagnosis, the doctor rules out amoebic abscesses or tumors, for example.

Complications

As a rule, there are hardly any complaints when infected with the dog tapeworm. In rare cases, however, complications can even be severe. Only when a large number of cysts have formed can they put pressure on blood vessels and biliary tract. Feelings of tension, abdominal pain and, in some cases, jaundice then occur.

The course of the disease varies because, in addition to the liver, the lungs, kidneys, heart or even the brain can be affected. However, usually only one organ is affected. In severe cases, bleeding and irreversible organ damage can occur in the liver. Dead parasites leave random cavities in which bleeding can also occur. Then there is also the risk of bacterial superinfections, which can even lead to sepsis.

If the lungs are infected, lung cysts can burst, which lead to bleeding and occur together with a strong cough and difficulty breathing. When the central nervous system and especially the brain are affected, various, often irreversible, neurological disorders occur. In some cases, the parasite cannot be completely eliminated with the help of drug and surgical treatment. In the context of a very dangerous complication, anaphylactic shock, in very rare cases a massive reaction of the immune system even allows spontaneous healing.

When should you go to the doctor?

The disease is characterized by a gradual and steady increase in various health impairments. These show up individually for each patient and should be presented to a doctor as soon as they are consciously noticed by the person concerned. General dysfunctions, a feeling of illness and an inner weakness indicate the presence of a health disorder. If there is a feeling of tightness in the organism, if the person concerned complains of pressure sensitivity or if a sensory disorder appears, the observations must be examined by a doctor. Irregularities in digestion, changes in the appearance of the skin as well as a decreasing general resilience of the organism are indications that should be followed up. A doctor's visit is necessary so that the complaints can be clarified.

A medical examination is required in the event of pain, noise development during digestion or irregular breathing. Consult a doctor if there are abnormalities in the heart rhythm, changes in blood pressure, restrictions in mobility and a decrease in physical performance.

Headaches, restlessness and fatigue should also be assessed. Sleep disturbances and fatigue are other health irregularities that indicate the presence of an illness. Once symptoms persist, they should be presented to a doctor. If there are changes in the habitual behavior, if there are mood swings or internal irritation, these irregularities should also be investigated.

Treatment & Therapy

Cystic echinococcosis is treated when it causes symptoms. However, drug therapy is usually used even for cysts that do not trigger any symptoms. The active ingredient albendazole is preferably used here. In addition to treatment with various drugs, there is also the option of performing surgical interventions.

The goal of such procedures is to remove cysts in the liver. Once removed, the area is cleaned with a solution of table salt. A sterilizing mixture may also be injected. The drug albendazole is also used in such cases.

prevention

Cystic echinococcosis can be prevented by avoiding the infestation of the organism with the larvae of the dog tapeworm. This can be achieved primarily through compliance with hygienic standards.

Aftercare

In most cases of echinococcosis, direct follow-up measures are significantly limited. Sometimes they are not even available to the person affected, so that with this disease a doctor should be consulted very early on so that there are no other complications and complaints. The sooner a doctor is consulted, the better the further course of the disease will usually be.

Those affected by echinococcosis are mostly dependent on taking various drugs. Regular intake and the correct dosage should always be observed in order to counteract the symptoms correctly and permanently. Regular checks and examinations by a doctor are also very important.

This allows further damage to be detected. If echinococcosis is to be treated by surgery, those affected are advised to take it easy and rest after the operation. Stressful activities or strenuous movements should be avoided. The disease itself usually does not reduce the life expectancy of the person affected if it is treated correctly. However, the further course also depends very much on the time of diagnosis of the disease.

You can do that yourself

It has usually been a long time before this diagnosis is made and the patient is already receiving medical treatment. Depending on what the doctor advises, the patient will be given medication or even have to undergo surgery. As with all operations, good compliance is important so that there are no unnecessary pre- or post-operative complications. This includes, among other things, informing the attending physicians and surgeons about all medication taken and all known pre-existing conditions in order to minimize the risk of anesthesia.

To support the recovery process, patients should ensure that they are in good general condition before and after the procedure. Anyone who refrains from consumption poisons such as nicotine or alcohol and instead eats well, avoids stress, keeps regular bedtime and pays attention to regular exercise, activates and supports his body's own immune system and can thus make a decisive contribution to quickly recovering from cystic echinococcosis.

In particular, exercise in the fresh air, preferably in the country or in the forest, activates the cardiovascular system and thus the immune system. Especially when patients have complained in advance of a drop in performance, headaches, fatigue and sleep disorders, daily, long walks in the forest are a good way to regain your strength.