Echinococcus in the lungs symptoms. Pulmonary echinococcosis: causes, symptoms and treatment

Infectious diseases are quite common, lung echinococcosis is no exception. Most often it is found in countries with a hot climate, for example, in South America, Africa, some parts of the USA, Australia, southern parts of Europe, as well as in countries with developed cattle breeding, where meat is the basis of all dishes - Uzbekistan, Tajikistan, Kazakhstan, Kyrgyzstan, as well as some regions of Russia, the Caucasus and Tatarstan.

Causes of infection with pulmonary echinococcosis

Echinococcosis of the lung is characterized by two signs: physical compression and the sensitive effect of foreign echinococcus genes on the body. Cysts can develop one at a time or en masse. They grow slowly, over several years, and if detected late, they can reach a diameter of 40 cm. Growing cysts compress the tissues of the affected organ, which can lead to its atrophy. Pulmonary echinococcosis is often accompanied by allergic reactions such as eosinophilia, urticaria, and in severe cases, anaphylaxis.

In medicine, there are three periods of development of this disease:

1. I period - often asymptomatic latent, it may be invisible for many years from the moment of helminthic invasion. At this stage, the disease is usually discovered incidentally on x-rays.
2. II period - the period of manifestation of symptoms. Patients feel dull pain in the chest, accompanied by a cough. Such symptoms appear when the hydatid cyst has already grown sufficiently.
3. The third period is the period of development of complications. If the disease was not detected earlier, during this period of development, patients have suppuration of the cyst, characterized by fevers, chills, and pain. And there is also a potential danger of a cyst breaking through and getting its contents into the bronchi, pleura, abdominal cavity and bile ducts.

A specialist, conducting an examination by palpation, if the cysts have already reached a large diameter and are located in the upper parts of the lungs, can detect protrusion or swelling of the chest wall and upper limbs in a patient with echinococcosis. With echinococcosis, the patient's breathing changes, becomes weakened and is accompanied by moist rales. It may not be heard at all if the cysts have reached large sizes. However, the main way to diagnose and confirm that a person has pulmonary echinococcosis is an X-ray examination, ultrasound, CT, and MRI. Therefore, regular preventive fluorography plays an important role.

Treatment of echinococcosis

Surgical treatment

It is carried out using several methods:

We present our own observation of pulmonary echinococcosis in a child. A 5-year-old boy wanders with his parents in the tundra. Parents contacted a health worker in one of the villages of the Nenets Autonomous Okrug with complaints of fever up to 39 degrees and cough for 5 days. When admitted to a district hospital: moist cough, in the lungs, weakening of breathing on the right in the corner of the scapula, lateral sections along the anterior surface at the level of 2-6 ribs, moist, single, variable-sized wheezing, no shortness of breath was noted. Hemodynamics are stable. Active, selective appetite. Over time, the weakening of breathing persisted, and the wheezing was intermittent. Sputum microscopy - 2-5 l. in the field of view, CD was not detected. Sputum culture (against the background antibacterial therapy) negative. X-ray in the projection of the middle lobe of the right lung shows a rounded shading of the lung tissue with a diameter of 7 cm. In the blood test, erythrocytes 3.68 x 1012/l, HB 117 g/l, leukocytes 7.8 x 109/l, eosinophils 0%, band neutrophils 6%, segm. 48%, lymphocytes 42%, monocytes 2%, ESR 38mm/hour. With antibacterial therapy (cefazolin, macropen), the temperature returned to normal. Radiologically, the rounded shading became more clearly defined. There was a discrepancy between the clinic and the X-ray picture. Tuberculosis was excluded. An echinococcal cyst of the right lung is suspected. The child was sent to the Arkhangelsk Regional Children's Clinical Hospital, where the diagnosis of pulmonary echinococcosis was confirmed and surgical treatment: right thoracotomy and echinococcectomy.

RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols Ministry of Health of the Republic of Kazakhstan - 2015

Invasion of another site and multiple echinococcosis caused by echinococcus multilocularis (B67.6), Invasion of another site and multiple echinococcosis caused by echinococcus granulosus (B67.3), Invasion of the lung caused by echinococcus granulosus (B67.1), Invasion of the liver caused by echinococcus granulosus (B67.0), Invasion of the liver due to echinococcus multilocularis (D67.5), Invasion due to echinococcus granulosus, unspecified (B67.4), Invasion due to echinococcus multilocularis, unspecified (B67.7), Echinococcosis of other organs and unspecified ( B67.9), Liver echinococcosis, unspecified (B67.8)

Infectious diseases in children, Pediatrics, Pediatric surgery

general information

Short description

Recommended
Expert advice
RSE on REM "Republican Center
health development"
Ministry of Health
and social development
Republic of Kazakhstan
dated November 27, 2015
Protocol No. 17

Echinococcosis- larval or cystic stage of development of the tapeworm belonging to the species Echinococcus granulosus in the tissue of the liver and lungs.

Protocol code:

ICD code(s):
B 67.0 Liver invasion caused by Echinococcus granulosus
B 67.1 Invasion of the lung caused by Echinococcus granulosus
B 67.3 Invasion of other sites and multiple echinococcosis due to Echinococcus granulosus
B 67.4 Infestation caused by Echinococcus granulosus, unspecified
D 67.5 Liver invasion caused by Echinococcus multilocularis
B 67.6 Invasion of other localization and multiple echinococcosis caused by Echinococcus multilocularis
B 67.7 Infestation due to Echinococcus multilocularis, unspecified
B 67.8 Echinococcosis of the liver, unspecified
B 67.9 Echinococcosis of other organs and unspecified

Abbreviations used in the protocol:
ALT - alanine aminotransferase
AST - aspartate aminotransferase
IV - intravenously
IM - intramuscular
ELISA - enzyme immunoassay
Gastrointestinal tract - gastrointestinal tract
CT - computed tomography
MRI - magnetic resonance imaging
CBC - complete blood count
OAM - general urine analysis
RPHA - direct hemagglutination reaction
ESR - erythrocyte sedimentation rate
CVS - cardiovascular system
FFP -- fresh frozen plasma
Ultrasound - ultrasonography
EC - echinococcosis
ECG - electrocardiogram
EchoCG - electrocardiography
½ - one second part
¼ - one fourth part
Ig G - immunoglobulin G

Date of development/revision of the protocol: 2015.

Protocol users: local pediatricians, ambulance doctors medical care, doctors general practice, surgeons.

Note: The following grades of recommendation and levels of evidence are used in this protocol:
Level I- Evidence from at least one properly designed randomized controlled trial or meta-analysis
Level II- Evidence obtained from at least one well-designed clinical trial without adequate randomization, from an analytical cohort or case-control study (preferably from a single center), or from dramatic results obtained in uncontrolled studies.
Level III- Evidence obtained from the opinions of reputable researchers based on clinical experience.
Class A- Recommendations that have been approved by consensus of at least 75% percent of the multi-sector expert group.
Class B- Recommendations that were somewhat controversial and did not meet with agreement.
Class C- Recommendations that caused real disagreement among group members.

Classification

Clinical classification:

Classification of liver echinococcosis (Ordabekov S.O.):
By origin:
primary
recurrent
· residual
By the number of echinococcal cysts:
single.
· multiple
combined
· widespread
According to the clinical course:
· uncomplicated
· complicated
By stages:
· asymptomatic
with symptoms
stage of complications
According to the nature of the complications:
necrosis
· calcification
complete calcification
· partial calcification
Suppuration:
perforation
sepsis
amyloidosis
· bleeding
Perforation:
· traumatic
spontaneous
Compression of neighboring organs:
· gastrointestinal tract
· urinary organs
large vessels
bile ducts
Other complications (Pulatova A.T. 1983):
· small - echinococcal cysts with a volume of up to 5-10 ml;
· small - 110-100 ml;
medium - 100-500 ml;
· more - 500-1500 ml;
· giant echinococcal cysts with a volume of more than 1500 ml.

Classification of pulmonary echinococcosis(Pulatova A.T.):
Depending on location:
isolated damage to both lungs
Damage to both lungs and another organ
Damage to one lung and other organs
According to the clinical course:
· early stage
· clinical manifestations
stage of complications
Types of complications:
suppuration of echinococcal cyst
breakthrough into the pleural cavity
· breakthrough into the bronchus and pleural cavity
rupture through the diaphragm into the abdominal cavity
Depending on the size of the cysts:
small - up to 5 cm in diameter
medium - with a diameter of 5 to 10 cm
· large - from 10 to 15 cm
· giant - over 15cm

Clinical picture

Symptoms, course

Diagnostic criteria:

Complaints and anamnesis:
· in an uncomplicated course, it is asymptomatic, there may be pain of varying intensity in the right hypochondrium, in the chest area, cough, a feeling of heaviness in the epigastrium, right hypochondrium, low-grade fever, abdominal enlargement, palpable tumor formation, icterus of the skin and sclera, an allergic reaction.
· in complicated cases: pain of varying intensity in the abdominal area, in the chest area, cough with sputum, shortness of breath, tachycardia, hyperthermia, allergic reaction; if an echinococcal cyst ruptures, anaphylactic shock, hydrothorax with displacement of the mediastinal organs in the opposite direction can be observed.

Physical examination:
· with uncomplicated liver echinococcosis, it is possible to determine a palpable tumor-like formation in the upper parts abdominal cavity;
· when a cyst ruptures into the abdominal cavity, symptoms of peritoneal irritation are noted against the background of severe pain syndrome;
· when an hydatid cyst suppurates, there is an increase in body temperature, changes characteristic of a local purulent process, and symptoms of intoxication;
· with uncomplicated pulmonary echinococcosis, dullness of percussion sound on the affected side may be observed. During ascultation, breathing may weaken;
· when a cyst ruptures in bronchial tree there may be suffocation, cough with sputum and chitinous particles, moist rales of various sizes, an allergic reaction;
· when a cyst breaks into the pleural cavity, symptoms of intrathoracic tension, displacement of mediastinal organs, tachycardia, shortness of breath, symptoms of respiratory failure (hydrothorax, pneumothorax) are noted;
· when an hydatid cyst suppurates, a temperature reaction, symptoms of intoxication and respiratory failure (pyopneumothorax) are observed.

Diagnostics

List of basic and additional diagnostic measures:

The main (mandatory) diagnostic examinations carried out at the outpatient level:
· General analysis blood;
· General urine analysis;
Blood biochemistry (urea, creatinine, total protein, AST, ALT, total bilirubin, direct and indirect bilirubin, glucose), blood electrolytes (potassium, sodium, chlorine, calcium);
· Ultrasound of the abdominal organs/pleural cavities;
· plain radiography of the chest in two projections;
· RPGA for echinococcal antibodies;
· ELISA for echinococcal antibodies;
· ECG.

Additional diagnostic examinations performed at the outpatient level:
Echocardiography.

The minimum list of examinations that must be carried out when referring to planned hospitalization ( inpatient care): according to the internal regulations of the hospital, taking into account the current order of the authorized body in the field of healthcare.

Basic (mandatory) diagnostic examinations carried out at the hospital level during emergency hospitalization and after a period of more than 10 days from the date of testing in accordance with the order of the Ministry of Defense:
· blood coagulogram;
· histological examination biological material.

Additional diagnostic examinations carried out at the hospital level during emergency hospitalization and after more than 10 days have passed from the date of testing in accordance with the order of the Ministry of Defense:
CT / MRI of the abdominal organs - with liver echinococcosis allows you to evaluate the relationship with the biliary tract, the exact size and external contours, segmental localization of the echinococcal cyst, to obtain a detailed image of its structure;
CT / MRI of the chest organs - with pulmonary echinococcus allows you to evaluate the relationship with the lung structures, the exact size and external contours, segmental localization of the echinococcal cyst, to obtain a detailed image of its structure;
· diagnostic laparoscopy of the abdominal cavity;
endoscopic thoracoscopy - in case of breakthrough inflammatory process tracheobronchial tree and pleural layers;
· endoscopic bronchoscopy - when an echinococcal cyst breaks into the bronchus.

Diagnostic measures carried out at the emergency stage emergency care:
· collection of complaints;
· taking anamnesis;
· physical examination;
· thermometry.

Instrumental studies:
· Ultrasound of the abdominal organs - echinococcal cyst has the form of single-chamber single or multiple liquid echo-negative formations with a smooth surface, devoid of internal structures. Echinococcal cysts are visualized in a certain segment of the liver, as round-shaped echo-negative formations with multiple daughter cysts;
· during an X-ray examination of patients with liver echinococcosis, the following data can be obtained to help recognize liver echinococcosis: high standing of the diaphragm, limitation of its mobility, increase in the size and shape of the liver, calcification in the liver area;
· during diagnostic laparoscopy of the abdominal organs - the presence of fluid in the abdominal cavity with particles of the chitinous membrane and a picture of peritonitis are noted;
CT/MRI of the abdominal organs - the presence of an echinococcal cyst, size, location in the liver segment,
· Ultrasound of the chest cavity - detection of echinococcal cysts in the lungs;
· plain radiography of the chest - homogeneous, round shadows with clear contours. In complicated forms of pulmonary echinococcosis, a positive symptom of a “floating film”, a picture of a lung abscess, pneumothorax, hydropnemothorax with a displacement of the mediastinal organs in the opposite direction;
· endoscopic bronchoscopy: when an echinococcal cyst breaks into the bronchus, a chitinous membrane with a picture of endobronchitis may be detected;
· CT/MRI of the chest - the presence of an echinococcal cyst in the lungs;
· endoscopic thoracoscopy - when an echinococcal cyst breaks into the pleural cavity.

Indications for consultation with specialists:
· consultation with a pediatrician to exclude concomitant somatic pathology;
· consultation with a gastroenterologist to exclude gastrointestinal pathologies;
· consultation with an endocrinologist to exclude endocrinological pathology;
· consultation with a cardiologist to exclude CVS pathology;
· consultation with a phthisiatrician if a specific process is suspected;
· consultation with an oncologist if an oncological process is suspected.

Laboratory diagnostics

Laboratory research:
· UAC - moderate leukocytosis, eosinophilia, increased ESR; in complicated forms - hyperleukocytosis, neurophilia with a shift to the left, eosinophilia;
· RPGA - increased titer of antiechinococcal antibodies;
· ELISA - increasing the titer of Ig G class antibodies to echinococcal antigens.

Differential Diagnosis

Differential diagnosis:

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Treatment

Treatment goals:

removal of the chitinous shell, sanitation of the cavity.

Treatment tactics:

Surgical intervention:

Surgical intervention provided in an inpatient setting:

Surgical treatment for liver echinococcosis:
· laparotomic/laparoscopic endovideosurgical removal of the chitinous membrane, sanitation of the cavity.
Indications for surgery:
· verified diagnosis of hydatid cyst of the liver measuring more than 3 cm in diameter.

Surgical treatment for pulmonary echinococcosis:
· thoracotomy/thoracoscopy, endovideosurgical removal of the chitinous membrane, sanitation of the cavity;
Indications for surgery for pulmonary echinococcosis:
· presence of echinococcal cysts in the lungs;
· danger of rupture of a large hydatid cyst over 10 cm in diameter, rupture of the hydatid cyst into the bronchial tree, pleural cavity, suppuration.

Contraindications There are absolute and relative:
Absolute contraindications:
· serious condition of the patient due to severe somatic, congenital pathology of cardio-vascular system;
· violation of the blood coagulation system.
Relative contraindications:
· catarrhal phenomena, viral and bacterial infections;
· protein-energy deficiency of 2-3 degrees;
· anemia;
· digestive disorders;
diseases respiratory organs, their catarrhal states; unsatisfactory condition of the skin (pyoderma, recent phenomena of exudative diathesis, infectious diseases in the acute period).

Non-drug treatment: No.

Other types of treatment:

Other types of services provided at the stationary level:
· Exercise therapy;
· breathing exercises.

Indicators of treatment effectiveness:
· clinically - healing of a postoperative wound, absence of pain, temperature reaction;
· laboratory - absence of leukocytosis, eosinophilia in the blood, normalization of RPHA, ELISA;
Ultrasound of the abdominal organs - the absence of an echinococcal cyst and a residual cavity in the liver;
· X-ray - absence of pronounced infiltration of lung tissue.

Drugs ( active ingredients) used in the treatment

Hospitalization

Indications for hospitalization indicating the type of hospitalization:

Indications for emergency hospitalization:
For liver echinococcosis:
· breakthrough of echinococcal cysts into the abdominal cavity and biliary tract;
· suppuration of the cyst.
With echinococcosis of the lungs:
· identifying the picture of complications: breakthrough of echinococcal cysts into the bronchial tree, pleural cavity, suppuration of the cyst.

Indications for planned hospitalization:
· detection of echinococcal cysts in the liver and lungs.

Prevention

Preventive actions
· when the diagnosis of echinococcosis is confirmed, an emergency notification is submitted to the SES;
· V postoperative period exercise therapy and early activation of the patient are prescribed;
· Observe the rules of personal hygiene when keeping dogs and pets in the house. Routine deworming of dogs, culling and destruction of infested carcasses of domestic animals.

Sources and literature

1. Minutes of meetings of the Expert Council of the RCHR of the Ministry of Health of the Republic of Kazakhstan, 2015
   1. List of used literature: 1) Pulatov A. T. // Echinococcosis in childhood . - M. Medicine, 2004. – P. 224. 2) Ordabekov S.O., Akshulakov S.K., Kulakeev O.K.//Human echinococcosis: textbook. - Almaty: Evero, 2009. – P. 512. 3) Sattar A, Khan AM, Anjum S, Naqvi A. // Role of ultrasound guided fine needle aspiration cytology in diagnosis of space occupying lesions of the liver. /J Ayub Med Coll Abbottabad. 2014 Jul-Sep; 26(3):334-6. 4) Vuitton D.A., Millon L., Gottstein B., Giraudoux P// Proceedings of the International Symposium/ Innovation for the Management of Echinococcosis Besançon, March 27–29, 2014./Parasite. 2014; 21: 28. Published online 2014 Jun 25. 5) Ren B, Wang J, Liu W. Comparative study between diffusion weighted imaging and histopathological features in hepatic alveolar echinococcosis. Chin J Radiol 2012;46(1):57–61. 6) Pulatov A.T., Petlakh V.I., Bryantsev A.V. and others // Breakthrough of an echinococcal liver cyst into the pleural cavity // Pediatric surgery. 2002. - No. 1. - P. 41-44. 7) Shamsiev A.M., Shamsiev A.Zh., Gaffarov U.B. “Long-term results of treatment of echinococcosis of the liver and lungs in children” Pediatric surgery, No. 5, 2008. Pages 46-48. 8) Dzhenalaev D.B.//Endovideosurgery in the treatment of echinococcosis of the liver and lungs in children.//Pediatrics and pediatric surgery. – 2009. No. 1. – P. 48-50. 9) Chetverikov S.G., Akhmad Z.M.// The problem of residual cavity and local recurrences in surgical treatment of hepatic echinococcosis./Klin Khir. 2014 Jun ;(6):31-3. 10) Tenguria R.K., Naik M.I.//Evaluation of human cystic echinococcosis before and after surgery and chemotherapy by demonstration of antibodies in serum./Ann Parasitol. 2014;60(4):297-303. 11) Vikas D. G., Sanjay S., Shelly R., Sumeet P.// Single-stage management of large pulmonary and hepatic hydatid cysts in pediatric age group: Report of two cases./ Lung India. 2014 Jul-Sep; 31(3): 267–269. 12) Skuhala T., Trkulja V., Runje M., Vukelic D., Desnica B//. Albendazolesulphoxide concentrations in plasma and hydatid cyst and prediction of parasitological and clinical outcomes in patients with liver hydatidosis caused by Echinococcus granulosus./Croat Med J. 2014 Apr;55(2):146-55. 13) Bedioui H., Bouslama K., Maghrebi H., Farah J., Ayari H., Hsairi H., Kacem M., Jouini M., Bensafta Z.// Predictive factors of morbidity after surgical treatment of hepatic hydatid cyst ./Pan Afr Med J. 2012;13:29. Epub 2012 Oct 12. 14) Grozavu C., Ilias M., Pantile D. // Multivisceral echinococcosis: concept, diagnosis, management. /Chirurgia (Bucur). 2014 Nov-Dec; 109(6):758-68. 15) Nugmanov N. N., Dzhanzakov B.B., Utetleuov A.M., Yesenaliev G.K.//Surgical treatment of pulmonary echinococcus in children./Bulletin of KazNMU. – 2012. – P. 23-25.

Information

List of protocol developers with qualification information:
1) Dzhenalaev Bulat Kanapyanovich - Doctor of Medical Sciences, Professor, RSE at the Western Kazakhstan State University medical University them. Marata Ospanova”, head of the department of pediatric surgery.
2) Karabekov Agabek Karabekovich - Doctor of Medical Sciences, Professor, RSE at the South Kazakhstan State Pharmaceutical Academy, Head of the Department of Pediatric Surgery.
3) Botabaeva Aigul Saparbekovna - Candidate of Medical Sciences, acting as Associate Professor of the Department of Pediatric Surgery of JSC Astana Medical University.
4) Kalieva Sholpan Sabataevna - candidate of medical sciences, associate professor of the RSE at the Karaganda State Medical University, head of the department clinical pharmacology and evidence-based medicine.

Disclosure of no conflict of interest: No.

Reviewer: Mardenov Amanzhol Bakievich - Doctor of Medical Sciences, Professor of the Department of Pediatric Surgery. RSE on REM "Karaganda State Medical University".

Indication of the conditions for reviewing the protocol: Review of the protocol 3 years after its publication and from the date of its entry into force or if new methods with a level of evidence are available.

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And also in domestic animals:

• cats;
• sheep;
• horses;
• goats;
• cows.

Only larvae can live in the human body without further development, but they are located in an oncosphere with two shells, in which capsules mature, growing and increasing the cyst in size.

Helminth larvae enter a child’s body due to lack of basic hygiene. The entrance gate is always oral cavity baby. Children tend to bite their nails, put various objects in their mouths that they might pick up on the street, and also eat unwashed fruits, berries and vegetables. You cannot drink water from natural reservoirs; even tap water is best boiled.

Children become infected through contact with pets. Once in the esophagus and digestive organs, the larvae of echinococcus spread throughout the body, forming capsules, which, in turn, can remain in any organ and gradually grow. Their number depends on how many oncospheres have entered the body.

How does echinococcosis occur?

The oncosphere grows over a long period of time, forming vesicles filled with toxins; this formation is called an hydatid cyst. As the cysts grow, they begin to put pressure on internal organs If the lungs are affected, fibrous tissue for cysts is the most favorable environment for reproduction.

The most dangerous thing is that if the cyst grows rapidly, it can burst and release toxic fluid into the child’s body. In this case, severe intoxication occurs, and the baby risks dying.

There are four stages of echinococcosis:

• I – asymptomatic, lasts a long time from the moment the infection occurred.
• II – the first signs of helminthic infestation, very weakly expressed, almost invisible.
• III – vivid symptoms, if you consult a doctor, you can start timely treatment.
• IV – complications of the affected organs develop, and death is possible.

Symptoms

In children, the symptoms of the disease differ from adults and develop faster. Parents should contact the clinic at the first sign of infection. Symptoms depend on the organ affected. In children, the liver and lungs are usually affected.

Complexity timely diagnosis is that echinococcosis in children passes latently for a long time, nothing bothers the child. He has no pain, his body temperature is within normal limits. The disease is very insidious, symptoms appear on last stage when the cyst can only be removed surgically.

The following are considered alarming symptoms and reasons to consult a doctor:

The longer the disease lasts, the brighter the symptoms become, at the last stage of lung echinococcosis, when coughing, the patient experiences severe pain, and the sputum takes on a putrid odor and contains blood. Signs resemble a course oncological diseases lungs.

In children, in effect anatomical structure as the cyst grows, the chest can become deformed and bulge forward, causing pain to the child and making it difficult to breathe. Such symptoms are characteristic of the last stage of the disease, which is life-threatening. The cyst may burst at any moment if it is not treated ambulance, the patient may die.

Echinococcosis of the lungs is more often diagnosed with fluorography, which allows you to start treating the disease on early development and limit medicines. If the treatment has not been carried out, and the cyst continues to grow, there is a risk of its rupture, at which the temperature may rise sharply, the patient will feel a sharp, severe pain in chest. In the worst case, if a large cyst ruptures, anaphylactic shock may occur.

Pulmonary echinococcosis on fluorography

Gradually increasing in size, the cyst can provoke pneumonia or pleurisy, which is also fraught with serious consequences. Echinococcus in children causes complications in a more severe form than in adults. Symptoms and treatment depend entirely on the location of the cysts and the stage of the disease. To detect infestation in a timely manner, it is necessary to conduct annual checks on the child.

Diagnostics

Diagnosis of echinococcosis includes laboratory and instrumental studies. When the first symptoms appear, the doctor prescribes a blood test, which can not only detect the invasion, but also determine its extent. A number of other studies are also being conducted:

• an immunological test for the presence of a specific protein in the blood, which confirms infection with echinococci;
• laboratory blood test for the presence of antibodies;
• microscopic examination of sputum, which may contain particles of the cystic membrane;
• if necessary, perform bronchoscopy;
• other blood tests determine the extent of organ damage;
• Ultrasound of the liver (done to confirm or rule out liver invasion);
• X-ray of the chest (the image determines the damage to the lungs and the size of the cyst);
• computed tomography of the respiratory system;
• laparoscopy of the abdominal organs (performed after ultrasound confirmation of the disease).

If the disease is detected at an early stage, which is rare, it can be cured with drug therapy; pulmonary echinococcosis does not go away on its own.

Treatment

Typically, surgical removal of cysts is used for treatment. Drug treatment gives results very rarely, only at the very early stage of echinococcosis. For this purpose, anthelmintic drugs are used - Nemozol or Vermox.

The dosage and treatment regimen should be determined by a doctor. Taking these medications slows down the growth of the cyst, but they have a number of contraindications, which include pregnancy and lactation.

At operative method Treatment involves removing the cyst, as well as adjacent affected tissue, especially the lungs. Oncospheres are more often localized in the lower lobes of the lungs; if the cysts are large or have many cysts, lung resection is performed.

If removing the cyst is impossible or it could rupture at any time, surgeons use another method to remove it. The membrane of the cyst is carefully pierced with a long needle and the contents are sucked out with a special instrument.

After this, the cyst is treated and sutured. If doctors do not recognize a ruptured cyst in time, its contents can poison the entire body and infect any internal organ.

It is not recommended to treat pulmonary echinococcosis using traditional medicine; home remedies can only be used for the purpose of prevention and healing of the body. For this it is recommended:

• drink a decoction of tansy or wormwood;
• prepare infusions with the addition of ginger and lemon;
• Eat a mixture made from garlic, honey and lemon, a tablespoon a day;
• eat black peppercorns.

Before you take folk remedies It is necessary to consult a doctor; the child may be allergic to herbs or honey.

Complications caused by echinococcosis

The disease can have a number of serious consequences, and they can also develop due to improper treatment or late diagnosis. Such complications include:

Parents should monitor the child’s well-being and promptly show him to the doctor. Even if the patient has been cured, he is observed for another 4 years, and laboratory blood tests are regularly performed. If during the entire observation period a blood test does not reveal the presence of antibodies, the patient can be considered cured.

Preventive measures

In a family with children, much attention should be paid to the prevention of helminthic infestation, primarily these measures include:

• hand hygiene and compliance general rules hygiene;
• When preparing food, it is necessary to follow the rules of heat treatment of meat;
• kitchen utensils after raw meat must be carefully processed;
• it is necessary to ensure that the child does not come into contact with stray cats and dogs;
• if animals live in the house, measures should be taken to eliminate worms;
• it is necessary to inform the child about possible consequences non-compliance with hygiene measures;
• It is better to drink boiled water, and pour boiling water over berries, vegetables and fruits.

A disease such as echinococcosis is much easier to prevent. It is not always possible to start timely treatment, especially in young children. Moreover, it is extremely rare to cure a child with medication.

Pulmonary echinococcosis is the second most common form of infection after liver echinococcosis. The disease is caused by bovine tapeworm, due to the peculiarities of its development in the human body, the disease lasts a long time, and in severe cases can cause death. If echinococcus is detected early, treatment will be effective.

Causes of infection

Echinococcus penetrates the respiratory organs from the intestines. In rare cases, dust containing worm eggs may be inhaled. Routes of infection:

She penetrates blood vessel and enters the portal vein.

Through the bloodstream, the hydatid larva can invade the liver, respiratory system, heart, brain, or muscles of an infected person or pet.

There is further development of the oncosphere and the formation of finna.

The vesicular stage of development of echinococci proceeds as follows:

• after infection, a single-chamber bubble (cyst) is formed in the tissues, surrounded by a dense membrane;
• Secondary and tertiary bubbles containing heads with suckers (scolex) are formed inside it.

The life activity of Finns (echinococcus) continues for several decades.

As echinococcosis develops, the cyst constantly increases in size, squeezing the tissue, and sometimes breaks into the adjacent cavity.

The number of cysts depends on how many eggs enter the human body.

Echinococcosis. Symptoms, treatment, prevention.

Echinococcosis - a disease of dirty hands

The diameter of the cyst in an advanced state reaches 10 cm.

What symptoms occur with pulmonary echinococcosis?

Doctors distinguish 3 stages of the disease, distinguished by specific symptoms:

1. Latent, which begins from the moment the larva of echinococcus penetrates the lung tissue, continues until the appearance of clinical symptoms infection. At this time, nothing bothers the patient, but sometimes there is increased fatigue or malaise, similar to a cold.
2. The period of clinical symptoms begins several years after infection. By this time, the diameter of the cyst reaches 3-4 cm. The patient gradually develops dull pain in the chest and develops shortness of breath. A clear sign lung damage - cough. At the beginning of the clinical stage, it is persistent and dry, but over time the discharge of sputum with traces of blood increases. With further development of the disease, bronchospasm, dysphagia, atelectasis and other complications may occur. Side symptoms with echinococcosis, skin is considered allergic reactions(itching, rash).
3. Signs of the terminal phase appear depending on the development of the complication - suppuration, breakthrough or cyst growth. The symptoms of a purulent process in the lung coincide with the manifestations of an abscess (cough, pain, fever, etc.). When a cyst breaks into the bronchus, an acute attack of coughing occurs with copious discharge of liquid sputum mixed with pus and blood, as well as the contents of the bladder and its membranes. A cyst rupture into the pleural cavity can be fatal due to the development of pyopneumothorax and anaphylactic shock. Dangerous conditions can also be caused by a cyst breaking into the pericardium.

Functional diagnostic methods

If, when interviewing a patient who has presented with symptoms of pulmonary diseases, it becomes clear that he belongs to a risk group for echinococcosis (villagers, hunters, tanners, etc.), then doctors make a diagnosis taking into account the possibility of infection with echinococci. For research use:

• radiography with differentiation of echinococcosis and carcinoma, tuberculosis, hemangioma or lung abscess;
• at computed tomography and ultrasound determines a cyst with an internal cavity;
• serological tests (PCR, ELISA, RNGA) detect antibodies to the pathogen;
• the blood test shows signs of eosinophilia, leukocytosis, increased ESR;
• A microscopic examination of sputum is carried out if a cyst breakthrough is suspected: scolex of echinococci, membranes of blisters, etc. are found in the discharge.

When big size Echinococcosis cysts are also detected during physical examination: percussion sound is dull, when listening to the lungs, moist rales or bronchial breathing are detected.

A protrusion of part of the chest may appear on the affected side.

How to treat the disease?

The patient is treated using complex methods.

Only a specialist can prescribe and carry it out. For cysts up to 3 cm, chemotherapy is indicated.

The treatment process must be carried out under the supervision of a physician, since it is associated with the use of potent and toxic drugs (Albendazole, Escazole, Vermox, etc.).

Surgery

At surgical intervention different methods are used:

1. Enucleation or echinococcectomy for small sizes of echinococcus. During the operation, the integrity of the cyst is not violated, and it is removed with all its contents. After removal of the cyst, the cavities in the lungs are sutured, and the patient is prescribed restorative treatment.
2. Large formations are removed by piercing the membrane of the bladder and sucking out its contents with a special device. After this, glycerin or a salt solution is introduced into the shell to destroy the remains of echinococcus larvae. The ruptured cyst is disinfected with tampons. After antiseptic treatment, the membranes of the bladder are removed and the cavity is sutured.
3. In difficult cases, resection of the lung tissue is used, i.e., part of the organ affected by echinococci is removed.

Traditional methods

Triad powder (tansy, wormwood and cloves in a ratio of 4:1:2) is a proven means of combating echinococcus. You can prepare the powder according to another recipe from equal parts of tansy, wormwood and celandine grass. A mixture of herbal ingredients is recommended to use 1.75 g 3 times a day. Treatment is carried out in long courses (1-2 months).

To combat and prevent infection with echinococci ethnoscience uses dried ginger root. The spice needs to be crushed and added 1 tsp. powder in 50 ml of milk. Take the product once a day, on an empty stomach.

With constant intake over several years, the active ingredients of ginger accumulate in the tissues, preventing possible infection, or destroy the larvae in the intestines.

Preventive measures

On the territory of livestock enterprises and private farmsteads, they are fighting stray dogs, and pets are periodically dewormed. Personal hygiene is also important: washing hands after working with animals and communicating with dogs and cats, boiling water from open reservoirs.

The fight against flies in livestock buildings and in housing is also a mandatory measure for the prevention of infection with echinococci.