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TM: Cestodes (ii) (E granulosus (Dx (imaging (CT/MRI (equally efficacious,…
TM: Cestodes (ii)
E granulosus
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worldwide, more frequent in rural sheep raising areas
life cycle
- eggs ingested by sheep, cattle, rodents, man
- embryo develops - hyatid cyst in liver/other organs
contains daughter cyst, brood capsules + scolices inside endocyst
comprised of endocyst + pericyst (outer, composed of host-derived fibrous tissue)
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cyst rupture - inflamm, anaphylaxis, acute abdo, infection
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- Scolices becomes adult worms in intestine
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clinical features
often asymptomatic, esp if cysts are <5cm in diameter
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also muscles (5%), bones (3%), kidneys (2%), brain (1%), spleen (1%)
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E multilocularis
invasive solid lesions of firm consistence, multiloculated (lots of blebs)
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occurs in N hemisphere - central europe - austria, alps
primary hosts = mainly foxes (also dogs, cats, coyotes, wolves)
intermediate host = small rodents, rarely humans
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tx
albendazole 400mg BO x 4 wks, followed by 2wks rest, for 3-12 cycles
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30% cure, 50% improvement, 20% no change
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Echinococcus spp
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intermediate hosts = sheep, cattle, goats
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Neurocysticerosis
symptoms
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psych disturbances: changes in personality, mental status (mostly in adults)
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