Medicine

July 26th, 2020

Hepatic Echinococcosis

Clinicals - History

Introduction

Hepatic echinococcosis is a widely endemic zoonosis most commonly caused by Echinococcus granulosus, a cestode found in the small intestines of canids. Livestock and humans are intermediate hosts that can develop cystic echinococcosis (CE) after ingesting worm eggs.

Right upper quadrant pain

Hepatic CE can lead to right upper quadrant (RUQ) pain. This is due to capsular distension caused by the mass effect of cyst growth.

Right upper quadrant mass

Some patients with hepatic CE may present with a palpable RUQ mass depending on the size and location of the cysts.

Jaundice

Patients with hepatic CE may present with jaundice due to compression of the bile ducts resulting in hyperbilirubinemia.

Cholestatic pruritus

Patients with hepatic CE can present with intense itching. This occurs when bile obstruction leads to direct hyperbilirubinemia and consequent accumulation of pruritogens in the systemic circulation.

Pulmonary symptoms

Patients with CE may present with pulmonary symptoms, such as pleuritic chest pain, dyspnea, hemoptysis, and chronic cough. This happens when cysts develop in the lungs, exerting pressure on nearby structures and creating a local inflammatory response.

Asymptomatic

Patients with CE are often asymptomatic for many years.

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