How does infection occur?
The adult worm lives in the intestines of dogs, wolves and jackals. With their feces, eggs fall into the soil, grass, vegetables and animal fur. A person swallows eggs with unwashed greens, berries, unboiled water, or putting them into his mouth with his hands after playing with a dog. In the intestine, an embryo emerges from the egg, which penetrates the blood and settles in the organs: most often in the liver, in second place - the lungs. The disease is not transmitted from person to person.
- Unwashed vegetables, greens, berries
- Raw water from ditches and springs
- Contact with dogs, especially herding dogs
- Farm work and slaughter
- Failure to comply with hand hygiene after soil and animals
Symptoms
While the cyst is small, it does not interfere with breathing and does not manifest itself in any way; this period lasts for years. Complaints appear when the formation compresses the bronchus or lung tissue. Then a persistent dry cough, heaviness and pain in the chest on the affected side, and shortness of breath on exertion occur. When the cyst suppurates, the temperature rises and the sputum becomes purulent. The rupture of a cyst gives a dramatic picture: a coughing attack with abundant clear fluid, suffocation and an allergic reaction up to shock.
- Prolonged dry cough
- Pain and heaviness in the chest
- Shortness of breath on exertion
- Sometimes hemoptysis
- Fever during suppuration
- Urticaria and suffocation upon rupture
Diagnostics
Most often, a cyst is first seen on fluorography or a general x-ray of the chest as a round, uniform shadow with clear contours. To clarify the size, number and location of cysts, computed tomography is required. Since echinococcus often affects the liver, an additional ultrasound of the abdominal cavity is performed. An increase in eosinophils can be detected in the blood, and serological tests detect antibodies to the parasite, although a negative result does not exclude the diagnosis. If a cyst is suspected of having echinococcus, puncture is not performed.
- Chest X-ray in two projections
- Computed tomography of the lungs
- Ultrasound of the liver and abdominal cavity
- Complete blood count with eosinophil assessment
- Serological tests for echinococcus
- Examination by a thoracic surgeon
Treatment
The main method is surgery: the cyst is removed entirely, taking care not to damage the membrane so that the contents do not enter the pleural cavity and bronchi. The volume of intervention depends on the size and location of the formation - from enucleation of the cyst to resection of part of the lung. Before and after surgery, a course of antiparasitic drugs is prescribed to reduce the risk of relapse; The regimen and duration are determined by the doctor. Small cysts are sometimes observed, but self-treatment with tablets alone is rarely used and according to strict indications.
- Surgical removal of the cyst
- Resection of a section of the lung for large and multiple cysts
- Antiparasitic therapy before and after surgery
- Simultaneous treatment of liver cysts if present
- Observation and control images over several years
Prevention
Infection is preventable by simple rules. The main thing is hand and food hygiene, as well as a responsible attitude towards dogs: they need to be regularly treated for helminths and not fed with raw livestock entrails. Particular attention is required in rural areas and during home slaughter of animals, when organs with cysts can end up in dogs. If echinococcosis is detected in a family, the rest of the family members should also undergo examination, since they usually have a common source of infection.
- Wash vegetables, herbs and berries thoroughly
- Drink only boiled or bottled water
- Wash your hands after handling the dog and working with the soil
- Deworm your pet dogs regularly
- Do not feed raw animal organs to dogs
- Examination of family members of the sick person
