Pulmonary hydatidosis Dr.mohammadzadeh Thorasic surgeon

اكينوكوكوس گرانولوزوس اكينوكوكوس مولتي لوكولاريس اكينوكوك يعني خار هيداتيس يعني يك قطره اب

كرم بالغ : در روده كوچك سگ شغال و روباه زندگي مي كند. طول ان 2/5 الي 9 ميليمتر است و بدن از 3 تا 4 بند تشكيل شده است Echinococcus granulosus

مرحله لاروي كرم به شكل كيسه اي چند جداره وپر از مايع است كه در جدار داخلي ان جوانه هاي كيسه اي شكل ايجاد مي شود

طبقات مختلف كيست يك حفره اي : 1)لايه پري سيست 2)لايه مطبق 3)لايه زاينده داخلي 4)مايع هيداتيد 5)كيسه هاي زايا 6)كيست هاي دختر 7)اسكولكس ها

A section of a hydatid cyst The cyst consists of a thick outer layer (*), several thinner internal layers, and many protoscolices. The protoscolices are often called "hydatid sand."

Hydatid cyst (Hydatid disease) Mother cyst (left) daughter cyst (right)

Higher magnification of the protoscolices

protoscolex. Note the "hooks" that will form the hooks associated with the adult worm's armed rostellum. Protoscolices with double row hooklets

Hydatid cyst Hydatid cyst showing a row of brood capsules attached to the germinal layer.

Egg An egg of Echinococcus granulosus(upper). These eggs are virtually indistinguishable from other closely related species of tapeworms such as Taenia.Taenia

Echinococcus granulosus in the small intestine of a dog (the small, white objects) Although these tapeworms are quite small, a single dog can be infected with many of them.

Clinical Features of unruptured cysts 1)پنهاني بودن علائم 2)خلط خوني 3)درد سينه 4)تنگي نفس 5)سرفه 6)برجستگي جدار سينه

Hydatid cyst in lung. This patient had a single large cyst in the left lung.

An intact hydatid cyst

An intact hydatid cyst

Clinical Features of ruptured cyst i.Quiescent type ii.Abscess type iii.Progressive type

A patient with bilateral hydatid cyst

Water lily sign

Allergic reactions and sometimes anaphylactic shock may occur if the cyst ruptures. Ruptures of the cyst may also lead to the escape of protoscolices into the surrounding tissues, these can then develop into further cysts.

Differential Diagnosis of hydatid cyst

A Very huge hydatid cyst

Diagnosis Microscopy Fluid aspirated from a hydatid cyst will shows multiple protoscolices (size approximately 100 µ m), each of which has typical hooklets. The protoscolices are normally invaginated (left), and evaginated (middle, then right) when put in saline.

Antibody Detection Indirect hemagglutination (IHA) indirect fluorescent antibody (IFA) tests, and enzyme immunoassays (EIA) are sensitive tests for detecting antibodies in serum of patients.

Treatment Surgery is the most common form of treatment for echinococcosis. The drug of choice for treatment is albendazole.