How to Diagnose Echinococcosis

Echinococcosis is an infection by tapeworms in the Echinococcus genus. It is a general term that covers three specific diseases: cystic echinococcosis, alveolar hydatid echinococcosis and polycystic echinococcosis. These tapeworms have a more complex life cycle than other parasites that involves a definitive host and an intermediate host. Humans are accidental hosts and do not typically play a part in the life cycle. The following steps will show how to diagnose echinococcosis.

Difficulty: Challenging

Instructions

1. Expect echinococcosis to be asymptomatic for many years. Many cases are only discovered incidentally during imaging for an unrelated reason.

2. Observe common secondary symptoms caused by compression of adjacent structures. The patient may experience abdominal pain, obstruction of the bile duct or a palpable mass. Less common symptoms are determined by the location of the lesion. For example, some cases of echinococcosis may have pulmonary involvement and may cause respiratory symptoms.

3. Use imaging to suggest a diagnosis of echinococcosis, especially when accompanied by epidemiological risk factors. Computed Tomography (CT), radiography, ultrasound and Magnetic Resonance Imaging all may be used effectively.

4. Confirm a diagnosis of echinococcosis with serologic testing. There are three assays that can be used: enzyme-linked immunosorbent assay, indirect fluorescent antibody and indirect hemagglutination. The sensitivity ranges from 60 to 95 percent depending on the location and type of cyst. Liver cysts are easier to detect than pulmonary cysts and ruptured cysts are more likely to show positive results than dead or calcified ones.

5. Perform antigen testing if echinococcosis is suspected but the antibody results are negative. This test is not available in the United States.

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