People are usually infected when they accidentally consume soil, water, or food that has been contaminated by Echinococcus eggs passed in dog stool.
Cysts form in the liver, lungs, or another organ and cause various symptoms, including pain.
Doctors do imaging tests (such as ultrasonography or computed tomography) to check for cysts, blood tests to check for antibodies to the tapeworm, and analysis of fluid from the cyst to confirm the diagnosis.
Treatment usually involves removing cysts or draining them, injecting a salt solution to kill the parasite and then removing it, and giving the drug albendazole.
(See also Overview of Parasitic Infections Overview of Parasitic Infections A parasite is an organism that lives on or inside another organism (the host) and benefits (for example, by getting nutrients) from the host at the host's expense. Although this definition actually... read more and Tapeworm Infection Tapeworm Infection Tapeworm infection of the intestine occurs mainly when people eat raw or undercooked contaminated pork, beef, or freshwater fish or, for the dwarf tapeworm, contaminated food or water. Adult... read more .)
Adult tapeworm Tapeworm Infection Tapeworm infection of the intestine occurs mainly when people eat raw or undercooked contaminated pork, beef, or freshwater fish or, for the dwarf tapeworm, contaminated food or water. Adult... read more species called Echinococcus granulosus and Echinococcus multilocularis live in the intestine of dogs or other canines (such as foxes or coyotes). These tapeworms sometimes infect people, causing cysts in the liver or other organs.
Echinococcus granulosus is common in the sheep-raising areas of the Mediterranean, Middle East, Australia, New Zealand, South Africa, and South America. It also occurs rarely in some parts of North America.
Echinococcus multilocularis occurs mainly in Central Europe, Alaska, Canada, and Siberia. It also occurs rarely in Wyoming, the Dakotas, and the upper Midwest.
Dogs, particularly herd dogs, become infected when they consume cysts of the tapeworms in tissues of infected animals (such as sheep, goats, cattle, or pigs). The cysts (called hydatid cysts) develop into adult tapeworms in the dog's intestine. Infected dogs pass tapeworm eggs in their stool. Sheep, cattle, goats, or pigs consume tapeworm eggs in soil contaminated with dog stool. Inside these animals, the eggs hatch and develop into cysts in the animal's internal organs.
People (often shepherds) are infected when they accidentally consume soil, water, or food that has been contaminated by Echinococcus eggs passed in dog stool.
Echinococcus eggs remain alive in soil for up to a year. Eggs may also be present on the fur of infected animals. After people touch an infected animal, they may pick up eggs, transfer the eggs from their hands to their mouth or to food, and thus become infected.
The eggs hatch in the intestine and release spheres that contain tapeworm larvae (called oncospheres). The spheres penetrate the wall of the intestine and travel through the bloodstream to various organs, such as the liver and lungs. In these organs, the spheres develop into cysts, which enlarge gradually and which, in people, can cause symptoms. The resulting infection is called echinococcosis.
Echinococcosis symptoms include the following:
Abdominal pain and yellowing of the skin and whites of the eyes (jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia. (See also Overview... read more ) if cysts form in the liver
Chest pain and coughing up blood or the contents of cysts if cysts form in the lungs
Cysts in the liver or other tissues can be seen using ultrasonography Ultrasonography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more , computed tomography (CT) Computed Tomography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more , or magnetic resonance imaging (MRI) Magnetic Resonance Imaging Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, radionuclide scanning, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more . Echinococcosis cysts in the lungs can be seen on chest x-rays Chest Imaging Chest imaging studies include X-rays Computed tomography (CT) CT angiography Magnetic resonance imaging (MRI) read more and are sometimes discovered when a routine x-ray is taken.
Blood tests for antibodies to Echinococcus may also be helpful. Antibodies Antibodies One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more are proteins produced by the immune system Overview of the Immune System The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more to help defend the body against attack, including that by parasites.
Doctors can often surgically remove the Echinococcus granulosus cyst or drain the cyst with a needle. To drain the cyst, they use ultrasonography to guide placement of the needle. They then remove cyst fluid, inject a salt solution into the cyst to kill the parasites, and drain the solution out. Masses due to Echinococcus multilocularis are removed surgically.
Albendazole is an oral prescription drug used to treat a variety of parasitic worm infections. Albendazole is given before and during procedures, such as surgery or drainage of a cyst with a needle, to prevent the infection from spreading if the cyst's contents spill during the procedure. Albendazole is usually continued for 1 to 6 months after the procedure. It reduces the likelihood that a cyst will come back or spread. Albendazole alone can kill some cysts. It is also used to suppress the growth of cysts that cannot be removed surgically or drained.
Occasionally, when the infection is severe, liver transplantation Liver Transplantation Liver transplantation is the surgical removal of a healthy liver or sometimes a part of a liver from a living person and then its transfer into a person whose liver no longer functions. (See... read more is done.