Where can I donate blood for echinococcosis alveococcosis. Alveococcosis: signs, causes and treatment regimen in humans

Alveococcosis (lat. Alveococcosis) is a rare zoonotic helminthiasis from the group that is characterized by a severe course and causes tumor-like damage to the liver with metastases to other organs (mainly to the lungs and brain). In most cases, the disease ends in death years later, it develops slowly, and delayed treatment can usually only slow down the process.

Synonyms: multichamber or alveolar echinococcosis.

According to the ICD-10, the disease has the code B67.5 (liver alveococcosis), B67.6 (damage to other organs), B 67.7 (localization not specified).

Pathogen

On the left photo (A) is an adult alveococcus that lives in the intestines of foxes and other canines, reaching a length of up to 6 mm. But the disease alveococcosis is caused by its larval stage, which forms around itself vesicles (cysts), which resemble balls up to 20 mm in diameter (photo B). Their number is constantly growing and they grow together.

The adult worm, as a rule, does not exceed 4 mm in length. It belongs to the type of flatworms, the class of cestodes (tapeworms), the order (Cyclophyllidea). However, unlike such well-known relatives from the same order, like chains, it has only up to 5 segments, not thousands.

Life cycle of alveococcus (Echinococcus multilocularis)

Alveococcosis in humans is much less common than single-chamber (cystic) echinococcosis, caused by the larvae of several other worm species from the genus Echinococcus (most often Echinococcus granulosus). The reason is that dogs often act as carriers of the causative agent of echinococcosis, and foxes and other wild canines are more often carriers of alveococcosis. With single-chamber (cystic) echinococcosis, a cyst is formed from the larva, which grows in size and can reach up to several kilograms. But it can be surgically removed, which is much more difficult to do with a huge number of small formations fused with the tissues of the organ, as in alveococcosis.

Ways of infection

Man acts as an intermediate host. To sexually mature individuals, helminths grow in the body of wild (foxes, wolves, coyotes and others) and domestic animals (cats and dogs). They are the final hosts.

People become infected by swallowing helminth eggs, which occurs as a result of non-compliance with the rules of hygiene - contact with animal hair, and then eating without first washing their hands. Increased risk in hunters, menagerie workers. You can get infected when cutting fox carcasses, rarely when caring for pets.

Also, infection occurs when eating herbs and berries contaminated with the feces of sick wild animals. Sometimes eggs can get into the human body even when dust is inhaled.

People are not able to infect each other with alveococcosis, since inside them the pathogen does not become mature and cannot produce eggs.

In addition to wild animals, domestic dogs can also act as carriers and therefore spreaders of eggs, although this is rare due to the fact that they do not often eat intermediate hosts such as rodents. A dog is much more likely to contract single-chamber echinococcosis.

Epidemiology

Alveococcosis occurs on all continents except Antarctica. Although alveococcus is very common among animals (up to 50% of foxes are infected in some regions), humans are rarely infected.

The highest incidence is recorded in the Northern Hemisphere, where a cold-temperate climate prevails. Cases of alveococcosis are more often recorded in Central Europe (Germany, France, Switzerland, Austria), northern and central parts of Asia, China, North America, including Canada.

Over the past decades, there has been an expansion of areas where alveococcosis occurs. Back in the 1980s, many of the eastern European countries did not have cases or they were very rare, and in the early 2000s, the statistics in them changed dramatically. This is caused primarily by fox migration. It is expected that there will be changes in the future. The increase in infections is not hindered by the increasing level of development of the countries of Central Europe or the United States, as they have only become more frequent in recent decades. Nevertheless, alveococcosis remains a relatively rare disease - with 1982 to 2000 a total of 559 cases were reported throughout Europe.

In the Russian Federation, the disease occurs in most of the territory, but mainly in the Republic of Sakha, Khabarovsk, Krasnoyarsk, Altai Territory. Also, cases of infection were recorded in the Kirov region.

Pathogenesis

Helminth eggs enter the human intestine. Oncospheres (the first stage of the larva) are introduced into the wall of the small intestine. With blood flow, they reach the right lobe of the liver within three to four hours, where they settle in at least 90% of cases compared to other organs (according to some sources, always initially only in the liver). In the future, it is possible to damage any other organs due to metastasis, in which the infection from the liver spreads through the blood (hematogenous route) and the lymphatic system.

Alveococcosis in humans can be asymptomatic for many years. After that, the first general symptoms appear, such as headache, nausea, vomiting, abdominal pain, rarely jaundice. There is also an important more specific sign - hepatomegaly (enlarged liver).

The clinical picture is similar to cancer. Without treatment for ten years, more than 90% of alveococcosis leads to death. The incubation period is 5-15 years.

The development of alveococcosis occurs in several stages:

• early;
• height;
• stage of severe manifestations;
• terminal.

Each of them is accompanied by characteristic features.

Alveococcosis of the liver

In most cases, at an early stage of the development of the disease, they are completely absent. Even after many years of the course of alveococcosis, only non-specific signs appear: lethargy, discomfort in the abdomen, loss of appetite. At this stage of the disease, the larvocysts are already quite large.

At the peak stage, the disease begins to progress. There is pain in the right hypochondrium, epigastric region, digestion is disturbed, belching appears, stool disorder, weakness.

At the stage of severe manifestations, obstructive jaundice develops. Feces become light, and urine, on the contrary, dark. The mucous membrane of the oral cavity acquires a yellowish tint. As the disease progresses, the limbs, face, and torso acquire the same color. Patients complain of itching that occurs on the back, arms and legs.

If the nodes grow into large veins, portal hypertension may appear. In this regard, swelling of the lower extremities, varicose veins are observed and there is a risk of bleeding.

The terminal stage of the disease is accompanied by irreversible processes. Weight decreases sharply, immunodeficiency occurs, complications appear. As a rule, the patient dies.

Alveococcosis of the lungs

Basically, the lungs are affected secondarily as a result of the formation of metastases. They grow through the diaphragm from the liver. Alveococcosis of the lungs is accompanied by chest pains, cough with purulent contents or sputum with blood impurities. Pleural empyema (purulent lesion) often develops. In children, echinococcosis, including alveolar echinococcosis, usually develops faster in the lungs than in the liver, which is most likely due to certain physiological features that facilitate the growth of nodes.

Alveococcosis of the kidneys

This type of disease is quite rare. As in the case of the lungs, kidney damage is secondary. In this case, signs similar to necrosis appear.

Complications

Possible complications include a variety of lesions of the liver tissue (purulent, necrotic, fibrosis), the spread of larvae in the patient's body and damage to other organs. Most often, there is inflammation of the biliary tract (cholangitis), jaundice (due to impaired outflow of bile from the liver), gallstones appear (cholelithiasis), sepsis, thrombosis of the inferior vena cava, glomerulonephritis (inflammation of the kidneys), chronic and acute liver failure, increased venous pressure And so on. As the disease progresses, one or more complications may occur.

Diagnostics

At the initial stage of the disease, serological tests are used, which make it possible to establish a diagnosis before the first symptoms appear. In this case, they are more effective than with single-chamber echinococcosis. They include antibody analysis, enzyme immunoassay (ELISA), immunochromatographic analysis (IHA).

Visualization methods play an important role. It is possible to determine the presence of nodes and tissue damage on ultrasound, supplemented by methods of computer (preferably) or magnetic resonance imaging.

Diagnostics also includes laboratory methods of research, such as a general blood and urine test. When viewed under a microscope, a sputum smear can determine the causative agent of the disease. Differential diagnosis is based on the exclusion of single-chamber echinococcosis, cirrhosis and polycystic liver disease, cancers.

A biopsy of the node may be done to detect the pathogen. But at the same time, it is worth initially excluding single-chamber echinococcosis, in which this procedure exposes the patient to a high risk of the contents of the cyst entering the abdominal cavity due to its size and puncture.

Treatment

Therapy is usually carried out in a hospital setting. Early diagnosis and timely treatment can lead to a complete recovery after surgical removal, but there is a high risk of incomplete disposal of formations and further growth.

Even with proper treatment and after a successful surgical intervention, the recurrence of the disease is not ruled out. Patients should undergo examinations at least 2 times a year and take long-term courses of anthelmintic drugs to avoid the recurrence of alveococcosis.

Prevention

The rarity of the disease and the long incubation period complicate individual and community prevention efforts. First of all, you must follow the rules of personal hygiene. Do not eat with dirty hands after contact with the hair of a wild animal. Do not eat unwashed berries and herbs. If a person's professional activity involves the possibility of contaminated dust entering the respiratory tract, it is necessary to use personal protective equipment (masks). Individuals at risk should be screened regularly.

According to the recommendations of the International Epizootic Bureau (OIE), for the effective destruction of eggs, treatment at a temperature of 85 ° C or 70 ° C is required, but already within 12 hours. She also gives recommendations for processing at low temperatures, but they are not applicable in everyday life - (-80 ° C) in within 48 hours or -70 °C inwithin 4 days. But it can be assumed from this that freezing at a temperature of -24 ° C for a longer period can also kill eggs. Chemical disinfection is considered unreliable.

Alveococcosis (Alveococcosis; Echinococcus multilo-cularis) is a helminthiasis that mainly affects the liver. Its causative agent has infiltrating growth, which causes metastases to various organs.

Alveococcosis is caused by the larvae of the tapeworm alveococcus (Echinococcus multilocularis). The source of invasion are cats and dogs, as well as foxes and arctic foxes. Mature eggs are excreted in the faeces of these animals, contaminating their fur, environmental objects and soil. Human infection with alveococcosis occurs through contact with animals, as well as the consumption of contaminated berries, vegetables and water.

Epidemiology

Alveococcosis is ubiquitous, more common in Central Europe, North America, and Asian countries.

Human infection occurs through contact with dogs and cats, with the skins of arctic foxes, foxes, wolves, etc. The final hosts (dogs, cats, wolves, arctic foxes, foxes) become infected by eating intermediate hosts (rodents) infested with alveococcus larvae.

Sprouting, and not moving away the affected tissue, alveococcal nodes cause circulatory disorders of the organ, degeneration and atrophy of tissues. In addition to the mechanical effect, alveococcus larvae also have a toxic and allergenic effect on the human body due to the entry into the blood of metabolic products and their decay.

Clinic, symptoms, course of alveococcosis

The disease develops gradually, imperceptibly for the patient, slowly (for years and decades) and remains asymptomatic for a long time. Only the accidental discovery of an enlarged liver by the patient himself or by the doctor forces him to look for the cause of this first symptom. Often, patients turn to a specialist themselves, having found a tumor-like formation in the abdomen. With a further increase in the liver, the patient notes heaviness and pressure in the right hypochondrium, then dull and aching pain. After a few years, the palpable liver becomes bumpy and very dense. Jaundice may develop. In other cases, there is weakness, nausea, loss of appetite, dull, less often acute abdominal pain, progressive weight loss. On examination, subicteric sclera is often found, sometimes severe jaundice. The liver, as a rule, is enlarged, "wooden" density, sometimes tuberous. Hyperproteinemia, hypergammaglobulinemia, hypalbuminemia are noted. Metastases to the lungs, brain, lymph nodes, heart, adrenal glands, kidneys, etc. are possible. Even metastases to the eye are possible.

Often the spleen is enlarged. Sometimes ascites joins. In the presence of decay in the center of the nodes in advanced cases, there is a rise in temperature, loss of strength, sweating. Leukocytosis, eosinophilia appear, ESR accelerates.

The formation of large necrosis and cavities in the nodes or germination in the inferior vena cava can lead to profuse bleeding.

Diagnosis of alveococcosis

The diagnosis of alveococcosis is established on the basis of the clinical picture (nonspecific damage to various organs), in the presence of an epidemiological history (contact with infected animals), with the obligatory consideration of instrumental data from X-ray examination and radioisotope examination, ultrasound examination (ultrasound), computed and magnetic resonance imaging.

In laboratory conditions, the disease is confirmed using the following specific methods:

• microscopic examination of sputum - detection of the causative agent of alveococcosis
• immunological research methods: reactions of enzyme-labeled antibodies with alveococcal diagnosticum, latex agglutination, indirect hemagglutination (RIHA), enzyme immunoassay (ELISA)

Nonspecific methods of laboratory diagnosis of alveococcosis include a complete blood count and a biochemical blood test. Differential diagnosis of alveococcosis is carried out with echinococcosis and polycystic liver disease, as well as cirrhosis and hemangioma.

Treatment

It is possible to perform a radical operation for liver alveococcosis only in 15-20% of patients. Most patients arrive at the surgical departments too late.

Early recognition makes it possible to completely remove the lesion.

Alveococcosis- This is a helminthiasis that is caused by one of the representatives of the type of flatworms, namely Alveococcus multilocularis. The human liver is primarily affected, then the alveococcus can also go to other organs (for example, the lungs, spleen, brain, heart, muscles, bones).

The most common cause of the disease: non-compliance with the simplest rules of personal hygiene. In particular, you can become infected with the improper maintenance of animals (for example, dogs), when cutting carcasses or skins of infected animals. Less commonly, helminth ingestion is possible by the oral route, that is, by eating fruits, vegetables, wild berries and herbs contaminated with animal feces.

Symptoms of alveococcosis

Symptoms of alveococcosis in the early stages: aching pain in the liver of a periodic nature, nausea with vomiting, indigestion, upset stool, general fatigue, malaise. In the late stage, the symptoms are complicated by obstructive jaundice, chills, fever, liver abscesses, and purulent cholangitis. When metastasizing to other organs - the corresponding symptoms of a violation of their functioning.

It is important to diagnose and treat alveococcosis as soon as possible in order to prevent the development of serious complications when the helminth spreads throughout the body. For accurate and timely diagnosis in our clinic, all the main methods are used: blood, feces, X-ray and ultrasound methods, organ tomography.

Treatment of alveococcosis

The treatment of alveococcosis is complex, including surgery and specific drug therapy, but the qualified specialists of our clinic know how to get rid of this helminth in the shortest possible time and restore your health.

Shchelkovskaya

Alveococcosis has a high prevalence on the planet. The frequency of occurrence of this helminthiasis in endemic areas reaches up to 8-10 cases per 100 thousand population. Attention is drawn to the severity and multiorganism of the lesion, the difficulty of drug treatment, as well as the lethality of the disease.

Alveococcosis, causative agent

Geographic distribution of alveococcosis

In the world there are natural foci of alveococcosis, where the causative agent of helminthiasis circulates, which are provided by the presence of certain wild sources of infection (animals). In the world, these are the countries of Central Europe, Central and South America, Northern Canada, Alaska, Central Asia, Transcaucasia; in Russia, these are the Far East, Western Siberia, the Kirov region and others. In northern countries, lemmings, white foxes support the circulation of the causative agent of alveococcosis, in southern countries - mice, voles, muskrats, foxes and others.

Causes of alveococcus

Alveococcosis, node on the cut

Sources of infection with alveococcosis

intermediate host- man, mouse-like rodents (voles, ground squirrels, gerbils, muskrats, beavers, nutrias), which are a biological dead end. A person with alveococcosis is not a source of infection.

Alveococcosis, sources of invasion

Susceptibility to alveococcosis is universal, but due to certain moments of infection, people of young and middle age (30-50 years) get sick.

The development cycle of alveococcosis in humans(intermediate host): through the mouth (orally), oncospheres (eggs) enter the human small intestine, are released from the outer shell, followed by the introduction into the intestinal mucosa. Here they penetrate into the blood and lymphatic vessels, then into the portal vein and with the blood flow reach the liver. Most oncospheres are retained in the liver, where larvocysts are formed. In rare cases, oncospheres overcome the liver barrier and reach other organs (lungs, spleen, heart, brain, and others).

The process of formation of a multilithic cyst is long. The larvocyst in humans is formed over several years. Its growth occurs by external or exogenous formation of vesicles or cysts, which gradually replace the tissue of the affected organ. With such growth, the entire architectonics of the organ is significantly disrupted - the vessels are affected, the function of the cells, and blood circulation are disrupted. In general, the process of larvocyst germination in the organ tissue can be compared with the formation of a tumor. Separate vesicles with blood flow are brought into other organs, forming metastases (secondary foci).

Alveococcus, larvocyst in the liver

The pathological effect of alveococcus on the human body

What is the focus of alveococcosis(alveococcus node, alveococcus cyst) - a conglomerate of vesicles with foci of the inflammatory-necrotic process ranging in size from 0.5 to 35 cm in diameter. Bubbles are formed exogenously and, due to the absence of a dense capsule, actively spread into healthy liver tissue. The process resembles the growth of a malignant tumor. Surrounded by vesicles, connective tissue grows - fibrosis is formed. It is possible to attach a secondary infection with the risk of abscess formation, germination in the bile ducts and the development of cholangitis. In the foreseeable future, the process may go far with the formation of biliary cirrhosis of the liver.
Often a protracted process is incompatible with the life of the patient.

Immunity in alveococcosis is similar to that in echinococcosis - unstable, but repeated invasions of alveococcus are not described.

Symptoms of alveococcosis

For a long time (years), the disease is asymptomatic, patients do not complain. The patient's condition is satisfactory. Suspicion arises during an objective examination of the patient - an enlarged liver is revealed, dense, bumpy to the touch.

The manifest (clinically expressed) stage of alveococcosis develops several years after the invasion and the beginning of the development of the larvocyst. Allocate an early stage, the stage of the height of the disease, the stage of severe manifestations, the terminal stage.

Early stage characterized by the appearance of the first signs of impaired liver function: the patient is disturbed by periodic aching pain in the liver (right hypochondrium), a feeling of heaviness, some loss of appetite, weakness. When examining a patient at this stage, it is possible to palpate an alveococcal dense node, however, with its central location, this is difficult to do. Laboratory at an early stage, the nature of the proteinogram changes: the total amount of protein in the blood serum increases, the amount of gamma globulins increases, and the ESR increases.

heat stage characterized by the progression of the disease: pain in the liver becomes almost constant, pain in the epigastric region, signs of indigestion - a feeling of heaviness after eating, belching, stool disorders, patients complain of loss of appetite, weakness. On examination, the liver is still enlarged in size, but more pronounced, along with inflamed areas of tissue of a densely elastic consistency, dense multiple nodes are felt - the so-called "stony density of the liver". Laboratory - a moderately pronounced increase in the number of eosinophils up to 15%, an increase in ESR, more pronounced dysproteinemia: total protein increases significantly (up to 110 g / l at a rate of 65-85 g / l), a decrease in albumin, a pronounced increase in gamma globulins (up to 60% at a rate of 12-19%), C-reactive protein is increased in the biochemical blood test, thymol test is increased (a sign of mesenchymal inflammation of the liver).

IN stage of severe manifestations we see the development of one or another severe manifestation of organ damage by alveococcus. Most often, this is the development of obstructive jaundice: the patient's stool brightens up to a grayish-white color, at the same time the urine becomes dark, the sclera and mucous membrane of the oral cavity begin to turn yellow, then the skin of the face, limbs, torso. Jaundice with a mechanical obstruction is intense, congestive, sometimes with a slight greenish tint. Also, patients are concerned about itchy skin on the limbs, back. Laboratory - an increase in the amount of bilirubin due to the direct fraction, an increase in the amount of bile pigments in the urine.

Sometimes alveococcal nodes grow into large vessels (portal veins, inferior vena cava), in which there are signs of portal hypertension - ascites (fluid in the abdominal cavity), swelling of the legs, varicose veins of the esophagus, the risk of bleeding.

With a far advanced process, secondary metastatic foci are formed in other organs and tissues. Most often it is the lungs, brain, heart, kidneys, bones. Half of the patients will be disturbed by damage to the kidney tissue with the development of glomerulonephritis (damage to the glomerular apparatus of the kidneys) - there may be pain in the projection of the kidneys, a change in the color of urine, and urination disorders. The cause of kidney damage is associated either with metastasis of the process, or with mechanical compression of the kidney tissue from the outside. In the analysis of urine, protein (proteinuria), erythrocytes (erythrocyturia), leukocytes (leukocyturia), pus (pyuria).

Terminal stage of alveococcosis runs very hard. Violations of the function of the affected organs become irreversible, patients lose weight dramatically, immunodeficiency is pronounced, and complications develop.

Complications of alveococcosis:

In some cases, inside the nodes, the tissue can disintegrate with the formation of a cavity with purulent contents - liver abscess, purulent cholangitis; if there is a breakthrough of the cavity, then the patient's pain increases, the temperature rises;
- inflammation of the tissue around the affected liver can occur - parihepatitis,
- germination of the node into the gallbladder, ligaments, omentum, and through the diaphragm - into the lungs, pericardium, heart, kidneys;
- systemic amyloidosis with kidney damage can lead to chronic renal failure.

Diagnosis of alveococcosis

The preliminary diagnosis is clinical and epidemiological. A careful collection of epidemiological history for the previous few years before the disease will largely clarify the picture. The region of residence, the patient's lifestyle, the likelihood of infection when visiting forests, hunting, contact with animals, the degree of occupational risk of invasion, and others are of great importance. Clinical data make it possible to suspect alveococcosis only a few years after infection.

The final diagnosis is carried out in a complex manner using laboratory methods, specific laboratory tests, and instrumental methods.

1) laboratory methods - complete blood count (eosinophilia, increase in ESR), proteinogram (increase in total protein, decrease in albumin, increase in gamma globulins), biochemistry (increase in bilirubin due to direct fraction, increase in thymol test, alkaline phosphatase), urinalysis ( possible proteinuria, hematuria, leukocyturia) and others;
2) serological tests for antibodies to alveococcus (RNHA, ELISA, latex agglutination reaction);
3) instrumental research methods (ultrasound, MRI, CT, radiography);

Alveococcosis, node on CT

4) targeted biopsy of the node during laparoscopy (performed only with 100% exclusion of echinococcosis in order to avoid a fatal outcome for the patient);
5) microscopic examination of sputum in order to detect alveococcus;

Differential diagnosis is carried out with echinococcosis, liver cirrhosis, malignant and benign neoplasms, polycystic liver disease, hemangioma, tuberculosis.

Treatment of alveococcosis

Therapeutic measures are similar to those for echinococcosis.
When making a diagnosis, hospitalization is required.

Patients are monitored for life. Once every 6 months, ultrasound control (or other instrumental examination) is carried out in order to cause a possible relapse, blood tests, biochemical analyzes are monitored, and all necessary studies are carried out.

Prevention of alveococcosis

1) Compliance with the rules of personal hygiene, as well as the rules of visiting nature with the possibility of processing hands before eating.
2) Deratization measures to prevent the spread of rodents with alveococcosis.
3) Preventive deworming every six months of pets (dogs, cats).

Infectious disease specialist Bykova N.I.

Alveococcosis is a disease, helminthiasis in humans from the cestodosis group, caused by alveococcus (Alvaeococcus multilocularis). The worm takes over the stomach of a wild fox. The disease is a natural focal zoonosis. Most of all goes to the liver. The multi-chamber bladder is capable of growth, as is the larva of Echinococcus.

According to the structure of the ICD 10, alveococcosis covers the interval B67.5-B67.7.

History of alveococcosis

The symptoms of tapeworm damage were known to the ancients. Treatment was with herbs. The role of the worm as the cause of damage to the body was obvious. The Talmud discusses the life cycle of the worm in the intestines of sacrificial animals. Hippocrates (IV century BC) described a liver eaten alive, replaced by a worm bladder. After the rupture of the membrane, the death of the patient occurred. The helminth affected the lungs.

The ancient Greeks saw that it was capable of causing worms in livestock. Galen took over. In 1782, Johann Goiz described the similarity of the alveococcus head with tapeworms. The notes remain the property of the author.

In 1801 Carl Rudolphi named the genus Echinococcus a worm. It was the tapeworm that showed that worms needed an intermediate host. For example, the sheep solitaire uses a sheep. In 1852, Ludwig von Buhl (Munich) described an unusual tumor that included numerous vesicles filled with a gel-like substance. The doctor named the find - alveolar colloid.

In 1853-1854, the first description of the helminth appeared. The role of the fox tapeworm in relation to human disease was pointed out by Rudolph Leuckart in 1863, but the scientific world ignored the warning. On February 17, 1863, Bernhard Naunin removed a large cyst from a patient's liver and infected a dog.

In 1875, Fritz Mohren expressed the opinion that echinococcosis and alveolar colloid are caused by various pathogens. The scientific world has rejected this assumption. Instead, the multi-chambered object observed in alveococcosis was recognized as a mutation, an ugly form of canine tapeworm. The debate went on until 1955, when researchers Robert Rausch and Everett Schiller in Alaska received evidence from foxes for the statements of the German scientist.

In parallel, Hans Vogel did the same work in Germany. In 1959, Abuladze singled out multilocular echinococcosis as a separate type of disease, giving the pathogen its current name (Alvaeococcus multilocularis).

Epidemiology of alveococcosis

A sick beast throws out eggs, segments. Infection with alveococcosis occurs by the fecal-oral route. Eggs are attached to the wool, or fall into the soil. The development of the epidemic can be avoided if people are taught to wash their hands. Skinning hunters are at risk. The invasive danger of food and water is not so great. It is required to comply with reasonable requirements, avoid unwashed berries, herbs.

Alveococcus is not indifferent to:

• Berry pickers.
• Fur farm workers.
• Furriers.
• Hunters.

Etiology of alveococcosis

The disease is caused by the larvae of the tapeworm-alveococcus. A small tapeworm reaches a length of 4.5 mm. An adult worm infects the intestines of dogs, cats, foxes, arctic foxes. The scolex is supplied with 4 suckers and 28-32 chitinous hooks. Strobil includes 2-5 segments. The last segment is a hermaphrodite, contains 350-400 eggs.

The developed oncosphere is equipped with 6 hooks that allow it to stay in the body of the final host. A mature detached segment is completely independent, crawls out of the anus to disperse the eggs.

Pathogenesis of alveococcosis

The tumor grows into the liver, nearby organs (gall bladder, lungs). Tenidiasis does not have such a destructive mechanism against the host. The formation definitely resembles a tumor with the ability to metastasize. Around the bubble there is a tendency for the deposition of mineral salts. Hepatocytes atrophy, but due to the growth of connective tissue mass, the total volume of the organ is increased.

Clinical manifestations of alveococcosis

Localization of the pathogen is not limited to the liver. Blockage of the bile ducts provokes the development of jaundice, cirrhosis of the liver develops. Metastases are given to:

1. brain;
2. lungs.

Necrotic tissues fester. The consequences (without the intervention of specialists) are incompatible with life. The immune response is impaired, loses effectiveness. The initial stage is asymptomatic. The latent stage is followed by general toxic manifestations, allergic reactions.

Early stage

Constant aching pain and a feeling of heaviness in the stomach become an integral part of life. On palpation, hepatomegaly is detected, or a dense tumor is palpated under the right rib. Doctors note a symptom of Lyubimov's iron liver. Gradually, the right half of the chest increases: the alveococcus runs out of free space, and it begins to squeeze the surrounding organs.

The intercostal spaces disappear, being pushed out by the underlying tissues. The process is similar to liver cancer. Eosinophilia is observed - 15-17%.

late stage

The patient is weakened, there is no appetite, nausea and pressing pain are constantly pursued, body weight is rapidly decreasing, obstructive jaundice develops. It irritates the skin, portal hypertension causes swelling of the lower extremities. Increased vascular pressure in the intestinal area, turns into bloody vomiting.

The collapse of the nodes is accompanied by reinvasion: the pain intensifies against the background of fever, migraines.

Complications of alveococcosis

Metastasis to:

1. Kidneys.
2. Lungs.
3. Abdominal cavity.
4. Bronchi.
5. Brain.

Secondarily affected organs give a vivid picture of dysfunction.

Diagnosis of alveococcosis

Serological analysis reveals an increase in ESR, anemia, eosinophilia. These signs are not always observed, so the final conclusion is made according to the results of radiography.

When the cyst ruptures, scolexes penetrate the liver, lungs, clog sputum, urine, feces. Doctors examine the micropreparation under a microscope, staining samples according to Ziehl-Neelsen. Informative methods are:

1. Tomography.
2. Nuclear magnetic resonance.

Professional x-rays of internal organs help clarify the diagnosis. A serological blood test (for antibodies) is ineffective. False negative results are observed in the presence of an obvious clinical picture. An exception is liver damage: a study of RNGA gives a 90% correct solution. The intradermal Cazzoni test shows 50% positive responses when there is no invasion.

Diagnosis by biopsy is contraindicated. Puncture of the cyst allows the alveococcus to spread. Urine samples are useful, there are:

• Erythrocyturia.
• Leukocyturia.
• Piuria.

Treatment of alveococcosis

Treatment is operative. At lectures, students of medical universities are shown a macropreparation of internal organs affected by the disease. After that, many will deprive their pets of their favorite food - mice.