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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 69

Concerning Hydatid disease:
False a. Surgical removal of cysts should not be attempted
True b. It is caused by dog tapeworm

False c. It is usually accompanied by eosinophilia
True d. It is treated with albendazole
False e. It is best diagnosed by microscopy of fluid obtained from ultrasound guided aspiration of the suspected cyst

Hydatid disease is usually caused by Echinococcus granulosus (dog tapeworm). Alveolar hydatid disease is caused by Echinococcus multilocularis and is found in Eastern Europe and in China.
The adult tapeworm's definitive host is the dog. An infected dog usually has many adult worms in its gut. Each worm has three proglottids. The eggs emerge from the proglottids either before or after the latter are expelled from the dog. Accidental ingestion of such eggs by humans leads to cyst formation, usually in the liver.
Eosinophilia occurs in only 15% of cases.
Albendazole is often used in the treatment of hydatid disease but results in resolution of cysts in only 25% of cases. Surgery is often needed.
Cysts found on ultrasound scan may be confused with liver abscesses, carcinomatous metastases, hepatoma or polycystic disease. Aspiration of hydatid cysts may lead to anaphylaxis and in general should be avoided.

Copyright: Rob Skelly 2006