LIVER INFECTION-Alveolar Echinococcus


Alveolar echinococcus

 Clinical features

Early symptoms are usually non-specific and vague. The most common initial presentation is mild right upper quadrant pain. Tender hepatomegaly or a mass may be present. As the disease progresses, jaundice, ascites and hepatic insufficiency occur. In the early stages, a high index of suspicion in endemic areas is required. Differential diagnosis includes hepatoma, tuberculosis, hemangioma or focal nodular hyperplasia.

 

alveolar echinococcus LIVER INFECTION-Alveolar Echinococcus

Alveolar echinococcus


Investigation

Radiological investigations such as ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) may provide additional information. Serology may be non-conclusive in the early stage of the disease; however, it may subsequently confirm the underlying process. Occasionally, laparoscopy and biopsy may be required. Even at operation, the accuracy of diagnosis is only 50%.

 

Treatment

The only known definitive cure for E. alveolaris is liver resection. Transplantation has been performed on selected cases but long-term outcome is uncertain. Albendazole, although unable to eliminate the parasite, may slow progression of the disease and should be administered on an indefinite basis in conjunction with surgery