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Hydatid echinococcosis - Treatment and prevention
Last reviewed: 08.07.2025
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The regimen and diet are determined by the nature of the complications.
Chemotherapeutic treatment of hydatid echinococcosis is performed in cases of cyst rupture, when there is a risk of seeding when the integrity of the cyst is violated during surgery, as well as in cases of multiple small cysts (no more than 3-5 cm) of the liver, lungs and other organs, in which surgical intervention is technically difficult. Anti-relapse treatment of hydatid echinococcosis is recommended after surgery, when another localization of a small parasite cannot be ruled out.
Antiparasitic treatment of hydatid echinococcosis is carried out with albendazole orally after meals at 10 mg / kg (no more than 800 mg per day) in two doses, a course of 28 days, intervals between courses of at least 2 weeks. The duration of treatment for clinically expressed forms of invasion (the presence of cysts) is 12-18 months. Treatment of hydatid echinococcosis is carried out with normal laboratory parameters (clinical and biochemical blood tests), during the treatment, a control blood test is carried out every 5-7 days. The use of high doses of albendazole for a long time in itself becomes the cause of complications due to the toxic effect of the drug: leukopenia, agranulocytosis, alopecia, fever, toxic hepatitis are noted. One of the important indicators indicating the undesirable effect of albendazole and the threat of developing serious complications is an increase in aminotransferase activity. If the leukocyte count drops below 3.0x10 9 /l and aminotransferase activity increases 5-6 times, treatment should be suspended until the indicators return to normal or improve significantly. In case of progressive leukopenia and hyperfermentemia, the drug should be discontinued. During chemotherapy, suppuration and spontaneous cyst ruptures are possible due to the inhibition of vital activity or death of the parasite. In these cases, antibacterial therapy is administered, and surgical treatment is performed if indicated.
Treatment of hydatid echinococcosis is assessed using instrumental monitoring and monitoring the dynamics of the titer of specific antibodies.
The main treatment for hydatid echinococcosis is surgical methods. It is important to carefully weigh the benefits and risks, as well as the indications and contraindications for choosing treatment approaches: surgical removal of cysts, antiparasitic drug therapy, or a combination of both. In the case of large, superficially located (risk of rupture), infected cysts or cysts connected to the bile duct system, surgical intervention is urgent or urgently delayed, it is performed after comprehensive preoperative preparation. An indication for surgical treatment of hydatid echinococcosis is also considered to be the effect of the volumetric process on vital organs, such as cysts of the lungs, brain, kidneys, bones and other organs. In case of multiple lesions, surgical treatment is carried out in stages.
Contraindications - hard-to-reach, dying, decarbed or multiple small cysts. General surgical, anesthetic and therapeutic contraindications are taken into account. Indications for surgery in small children and people with multiple cysts should be very well-founded. Obstructive jaundice in liver echinococcosis is resolved only by surgery.
Forecast
After radical removal of echinococcal cysts, the prognosis is favorable; if surgical treatment of hydatid echinococcosis is impossible, the prognosis is unfavorable.
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Clinical examination
After surgical treatment of hydatid echinococcosis, examination is performed 1-2 times a year, including clinical, biochemical blood tests, serological reactions and instrumental examination (ultrasound, CT, MRI). Convalescents are removed from the register no earlier than after 5 years in the absence of signs of relapse and persistent negative results of serological reactions.
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Prevention of hydatid echinococcosis
Hydatid echinococcosis can be prevented by maintaining personal hygiene. Particular vigilance is necessary when keeping dogs in the house and caring for animals. Planned deworming of dogs is carried out. In places unfavorable for echinococcosis, planned medical examination of risk groups is necessary.