Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Echinococcosis medical therapy
Introduction
Overview
Overview
Both cystic echinococcosis and alveolar echinococcosis are complicated to treat, sometimes requiring extensive surgery and/or prolonged drug therapy. There are 3 options for the treatment of cystic echinococcosis: anti-infective drug treatment, percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique and surgery.[1]
Medical Therapy
Medical Therapy
Cystic echinococcosis stage 1 of less than 5 cm
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 1 of more than 5 cm
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and Puncture, Aspiration, Injection, Re-aspiration (PAIR)
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 2 of any size
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and either modified catheterization or surgery
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
Cystic echinococcosis stage 3 of any size
- Preferred regimen: Albendazole 10 to 15 mg/kg per day q12 and either modified catheterization or surgery
- Alternative regimen: Puncture, Aspiration, Injection, Re-aspiration (PAIR)
World Health Organization classification of cystic echinococcosis and treatment stratified by cyst stage [2][3]
Abbreviations: PAIR: puncture, aspiration, injection, reaspiration, CE: cystic echinococcus.
| WHO stage | Description | Stage | Size | Preferred treatment | Alternate treatment |
|---|---|---|---|---|---|
| CE1 | Unilocular unechoic cystic lesion with double line sign | Active | <5 cm | Albendazole alone | PAIR |
| >5 cm | Albendazole + PAIR | PAIR | |||
| CE2 | Multiseptated, “rosette-like” “honeycomb” cyst | Active | Any | Albendazole + either modified catheterization or surgery | Modified catheterization |
| CE3a | Cyst with detached membranes (water-lily sign) | Transitional | <5 cm | Albendazole alone | PAIR |
| >5 cm | Albendazole + PAIR | PAIR | |||
| CE3b | Cyst with daughter cysts in solid matrix | Transitional | Any | Albendazole + either modified catheterization or surgery | Modified catheterization |
| CE4 | Cyst with heterogenous hypoechoic/hyperechoic contents; no daughter cysts | Inactive | Any | Observation | – |
| CE5 | Solid plus calcified wall | Inactive | Any | Observation | – |
References
References
- ↑ Mihmanli M, Idiz UO, Kaya C, Demir U, Bostanci O, Omeroglu S, Bozkurt E (2016). “Current status of diagnosis and treatment of hepatic echinococcosis”. World J Hepatol. 8 (28): 1169–1181. doi:10.4254/wjh.v8.i28.1169. PMC 5055586. PMID 27729953.
- ↑ Junghanss T, da Silva AM, Horton J, Chiodini PL, Brunetti E (2008). “Clinical management of cystic echinococcosis: state of the art, problems, and perspectives”. Am. J. Trop. Med. Hyg. 79 (3): 301–11. PMID 18784219.
- ↑ Brunetti E, Kern P, Vuitton DA (2010). “Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans”. Acta Trop. 114 (1): 1–16. doi:10.1016/j.actatropica.2009.11.001. PMID 19931502.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Mahshid Mir, M.D. [2]Â ; Cafer Zorkun, M.D., Ph.D. [3]