Echinococcosis (Hydatid Cyst Disease) Management

Definition

Echinococcosis is a parasitic infection caused by Echinococcus granulosus, a canine tapeworm transmitted through dogs, sheep, and horses. Human infection occurs through ingestion of contaminated food or water.

The disease leads to the formation of visceral hydatid cysts, most commonly affecting:

• Liver

• Lungs

Many infected individuals remain asymptomatic for prolonged periods.

Clinical presentation

• Upper abdominal discomfort

• Upper abdominal pain

• Poor appetite

• Upper abdominal mass

• Hepatomegaly (enlarged liver)

• Cough

• Features of acute hypersensitivity reaction following cyst rupture

Complicated disease

• Portal hypertension

• Biliary obstruction

• Budd–Chiari syndrome

Pharmacological treatment

Albendazole

• Dose: 400 mg

• Route: Oral (PO)

• Frequency: Every 12 hours

• Duration: 3 months

OR

Mebendazole

• Dose: 500 mg

• Route: Oral (PO)

• Frequency: Every 12 hours

• Duration: 3 months

Referral

Refer symptomatic or complicated cases to higher-level centres with appropriate expertise and facilities for further evaluation and management.

Possible complications

• Hydatid cyst rupture

• Acute hypersensitivity reactions

• Anaphylaxis

• Portal hypertension

• Biliary obstruction

• Budd–Chiari syndrome

• Liver dysfunction

• Pulmonary complications

Common sites of Hydatid Cyst Formation

• Liver (most common)

• Lungs

• Spleen

• Kidneys

• Brain

• Bone