Echinococcosis. Treatment in Israel

Pulmonary echinococcosis is a complex disease, difficult to detect in the early stages due to the absence of symptoms in patients.

What is pulmonary echinococcosis?

Echinococcosis is a disease from the group of helminthiases, in which echinococcal cysts form in the lungs (and other organs). The causative agent is the larva of a tapeworm from the family of cestodes. Humans are intermediate hosts, while the definitive hosts are animals from the canine family, often dogs, less frequently wolves.

How does infection occur?

The larva of the helminth first gets onto the fur of the animal, onto grass, clothing, and human hands during contact with the animal. Then it enters the gastrointestinal tract from the hands and food. In the human stomach, under the influence of gastric juice, the larval shell ruptures, and the small larva of the helminth, freed from its shell, penetrates into the intestinal wall of the small intestine using hooks, and then enters the bloodstream (usually into the veins). With the bloodstream, the larva reaches the lung, where it gets trapped, is covered with a chitinous shell, and begins to grow.

The growth of the formed cyst is very slow, so the person feels almost nothing. People who constantly come into contact with animals are more susceptible to the disease: zoo workers, fur farm workers, slaughterhouse workers, shepherds, etc. The disease is particularly common in countries in Asia, Australia, Africa, Ukraine, Mongolia, etc. The disease often flares up during the berry-picking season when a person eats unwashed berries or collects herbs. The main and most important rule of prevention is to wash hands, not to drink raw water from natural sources, and not to eat dirty berries.

Symptoms

Latent stage. In the early stages, the disease is detected accidentally during examination for some other reason. The person does not notice any symptoms and does not suspect the disease.

Symptomatic stage. In later stages, when the cyst becomes large and compresses lung tissue, new young cysts may appear, and when daughter cysts begin to grow around the cyst, the patient may experience a persistent dry cough, chest pain, and hemoptysis.

Complication stage. The most severe stage, echinococcal cysts become infected, rupture of the shell is possible, and the contents spill into the pleural cavity. Against the background of complications, anaphylactic shock develops, accompanied by pain syndrome. Without emergency assistance, the outcome is fatal.

Treatment of pulmonary echinococcosis at the "Top Ichilov" clinic

Treatment is unequivocally surgical. The echinococcal cyst is removed. If it is in other organs, during cyst excision it is necessary to open it, aspirate the contents, and only then remove it; however, in the lung, it is possible to perform the operation without opening the cyst shell. This is facilitated by mechanical ventilation during anesthesia. With the help of a mechanical ventilator, it is possible to increase the pressure in the lung and allow the surgeon to remove the cyst. The cyst is excised along with healthy tissue of the organ. After the operation, histological examination is mandatory.

Diagnosis of pulmonary echinococcosis at the "Top Ichilov" clinic

1. Examination by a specialist. During the examination, changes in the intercostal space can sometimes be determined, percussion in the area of the lesion gives a dull sound, and auscultation reveals wheezing, bronchial or amphoric breathing. Together with the medical history, the doctor may suspect the presence of pulmonary echinococcosis.
2. X-ray examination. Small round homogeneous shadows are visible in the lung on the images.
3. Kasoni test. An anaphylactic test, echinococcal antigen is injected intradermally into the patient, the test is read after 3 hours, but the reaction may appear as early as 30 minutes. At the injection site, hyperemia, swelling, and severe itching are observed. Symptoms may last for two days.