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Echinococcus granulosus

Echinococcus granulosus. Echinococcus granulosus. Hydatid disease Cosmopolitan Mediterranean countries Russian federation China North and East Africa Australia South America North America: Deep South and Far West. Echinococcus granulosus.

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Echinococcus granulosus

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  1. Echinococcus granulosus

  2. Echinococcus granulosus • Hydatid disease • Cosmopolitan • Mediterranean countries • Russian federation • China • North and East Africa • Australia • South America • North America: Deep South and Far West

  3. Echinococcus granulosus • ADULT MORPHOLOGY - small tapeworm - 3-6 mm long • consists of scolex, neck, immature proglottid, mature proglottid, and gravid proglottid

  4. Carnivore Humans Herbivore

  5. 10-30 scolices per brood capsule

  6. Pathogenesis • Hydatid cyst • Slow growth • Asymptomatic for years • Up to 20 years (unless in nervous system) • Pathology depends on • Location • Size • How many

  7. Pathogenesis • Crowds host tissues • Destroys tissues-replaces with cyst • Grows continuously • 15 quarts of fluid • Millions of scolices • Rupture of the cyst fatal • Anaphylactic shock hydatid fluid (death) • In most herbivores, cysts do not keep growing

  8. Unilocular hydatid cyst in the lung Note pressure effects exerted by cyst that crowds and destroys lung tissue

  9. Hydatid Cyst

  10. Diagnosis • Physical imaging • MRI • CT scan • Ultrasound • X-ray • Serodiagnosis

  11. Hydatid Cyst of Echinococcus granulosus

  12. Treatment • Surgery • Preoperative chemotherapy-albendazole • Protoscolicidal compounds • Ethanol • Saline • Formalin • Recurrence • 50% • Undetected cysts • Inadequate removal • Mebendazole • 48% of cysts

  13. Epidemiology • How do people get infected? • How do eggs get into environment? • How do we ingest them?

  14. Epidemiology • Human-Dog • Herbivores: Sheep, goats, camels, rabbit • Sheep raising areas • Offal

  15. Epidemiology • Human-Dog contact

  16. Epidemiology • Human-wildlife contact

  17. Echinococcus granulosus

  18. Complex • Echinococcus granulosus comprises multiple species • Life cycle patterns • Host specificity • Development Rate • Antigenicity • Transmission dynamics • Chemotheraputic drug response • Pathology

  19. Control • Sheep vaccine successful

  20. Echinococcus multilocularis

  21. Life Cycle of Echinococcus multilocularis • 1. Adult tapeworm occurs in intestine of foxes. • Dogs, cats, and coyotes can also serve as definitive hosts. • Adult is small - 1-2 mm long

  22. Echinococcus multilocularis Alveolar hydatid cyst in a mouse - cyst metastasizes from the liver to fill the body cavity

  23. Alveolar Hydatid Cyst

  24. Echinococcus multilocularis • Liver • Cyst multilocular hydatid • External budding • Extend processes throughout tissues • Cirrhosis of liver • Thinner membrane • Metastasis • Advanced cases

  25. Echinococcus multilocularis • Not easily operable • timing • Chemotherapy • Praziquantel can increase growth • Mebendazole and albendazole given throughout the life of the patient. • retards growth • Not easily treatable

  26. Echinococcus multilocularis • Fox tapeworm • Europe, Asia, Americas, New Zealand

  27. Echinococcus multilocularis This species has recently been reported in the upper Midwest (North and South Dakota, Minnesota, Iowa, Nebraska, southern Wisconsin, and Indiana). Recently identified in Illinois, Ohio and Missouri.

  28. Epidemiology • Increasing in Europe • Up to 1980’s only in France, Switzerland, Germany, and Austria • Spreading throughout Europe.

  29. Epidemiology • Increase in fox infection • Increase in human infection • Still rare • Switzerland and Germany • Antirabies vaccines • Increased fox abundance • Movement of foxes • Encroachment on urban areas • Contact with domestic dogs

  30. Hymenolepis

  31. Hymenolepis • Hymenolepis diminuta • Rare in humans • 90 cm • Model tapeworm • Hymenolepis nana • “Dwarf tapeworm” 40 mm long • Common in humans • 97.3% children in Moscow • 1% children in SE US Cysticercoid

  32. Hymenolepis nana D A 1 B 2 3 4 C

  33. Pathogenesis and Treatment • Similar to Adult species of Taenia • Praziquantel

  34. Dipylidium caninum

  35. Dipylidiumcaninum • Most common tapeworm of dogs • Cats, humans • 2 sets of reproductive organs

  36. Gravid proglottids shed Dog eats flea Infective stage?

  37. Diagnostics

  38. Pathogenesis and Treatment • Similar to Adult species of Taenia • Praziquantel

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