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Pediatric Echinococcosis Workup

  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
 
Updated: Jul 18, 2015
 

Laboratory Studies

Ultrasonography, chest radiography, CT scans, or MRI are imaging modalities that can detect findings suggestive of echinococcosis, especially in those patients with reported epidemiological risk factors. Serologic tests are then used to help confirm the diagnosis. If radiologic studies and epidemiology suggest echinococcosis, consider further evaluation when serology test results are negative.

The Centers for Disease Control and Prevention in Atlanta, Georgia provides the following types of serologic testing for humans:[10]

  • Indirect hemagglutination
  • Indirect fluorescent antibody
  • Enzyme immunoassay/enzyme-linked immunosorbent assay

Test sensitivities range from 60-95%. Liver cysts are more likely to yield positive serologic test results than pulmonary cysts. Positive test results are less likely with calcified or dead cysts and more likely with ruptured cysts.

False-positive serologic test results may occur in patients with other parasitic infections (e.g. cysticercosis) and in patients diagnosed with cancer or with immune dysfunction.

Antigen testing may be helpful if antibody test results are negative, although this modality is not available in the United States.

Stool evaluation for ova and parasites is generally not useful for diagnosis, but a loop-mediated isothermal amplification method (LAMP) for E. granulosus coprodetection in canines has been described.[11]

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Imaging Studies

Ultrasonography is the imaging study of choice to diagnosis CE and AE. It is a noninvasive diagnostic tool and can ascertain hydatid cyst size. Ultrasonography may reveal irregular, heterogeneous, hypoechoic lesions, and calcified cysts. Ultrasonographic positive findings are then complemented or confirmed with computed tomography (CT) and/or magnetic resonance imaging (MRI). Liver cysts are commonly located in the hepatic right lobe and can be difficult to differentiate from abscesses or neoplasms. Liver cysts may be single or multiple.

Chest radiography may reveal cysts in the pulmonary fields, ranging from 1-20 cm in size. Pulmonary cysts do not calcify and they do not produce daughter cysts. Approximately one-third of patients with a positive finding on chest radiography, have definable hepatic cysts.

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Contributor Information and Disclosures
Author

Germaine L Defendi, MD, MS, FAAP Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Germaine L Defendi, MD, MS, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Michael D Nissen, MBBS FRACP, FRCPA, Associate Professor in Biomolecular, Biomedical Science & Health, Griffith University; Director of Infectious Diseases and Unit Head of Queensland Paediatric Infectious Laboratory, Sir Albert Sakzewski Viral Research Centre, Royal Children's Hospital

Michael D Nissen, MBBS is a member of the following medical societies: American Academy of Pediatrics, Royal College of Pathologists of Australasia, Royal Australasian College of Physicians, American Society for Microbiology, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

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Diagram of the Echinococcus life cycle, provided by the Centers for Disease Control and Prevention.
 
 
 
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