CLINICAL-EPIDEMIOLOGICAL CHARACTERISTIC OF ECHINOCOCCOSIS IN ZAPOROZHYE REGION

Abstract

Relevance of an echinococcosis is caused by case rate body height, late diagnostics, augmentation of number of the complicated forms, growing number of patients with atypical localizations of echinococcosis cysts.

The aim of this work: to analyze clinical-epidemiological features of echinococcosis in Zaporozhye region.

During 2005-2012 years 36 cases of echinococcosis in the Zaporozhye region are analyzed. For confirmation of the diagnosis were used instrumental (ultrasonic research, computer tomography), serological (identification of antibodies to echinococcus), histological (after cyst excision) methods. The obtained data were processed by a method of variation statistics.

Results of the conducted research showed that among the adult patients (86,1%) aged from 21 till 79 years are prevailed. Women are prevailed: 75 against 25% of men. Among the patients the most part had risk to become infected by an echinococcosis: owners of animals which didn’t passed dehelmintization. 33,3% of patients had no epidemic factor.

Localization of echinococcus cysts mainly became perceptible in a liver (77,8 %) and lungs (11,0 %). In isolated cases echinococcus cysts were localized only in kidneys (2,8 %), abdominal cavity (2,8 %). In 5,6% cases multiple lesions took place. At localization of echinococcus cyst in a liver and abdominal organs (32 patients) clinical signs of invasion persisted within several weeks, months or 2-3 years constantly amplifying. Main symptoms were: pain in combination with asthenia and dyspepsia disorders. In 9% of cases echinococcosis of the liver was diagnosed "casually". Instrumental methods were main in identification of echinococcus cysts of liver and abdominal organs. At 45,5% of patients despite existence of clinical implications of disease and existence of echinococcus cysts according to the ultrasonic research no specific antibodies were detected.

Echinococcosis in the lungs was diagnosed in 4 patients. Clinical-radiological data in 3 cases demanded carrying out differential diagnostics with pneumonia and pulmonary tuberculosis.

Special difficulties in diagnostics of echinococcosis arose in the case of the multiple localization in the organs. In 2 patients multiple localizations of echinococcosis was diagnosed with difficulties and only finally n autopsy.

Treatment of patients with echinococcosis included surgical excision of the cysts (85,3 %). Only conservative therapy by albendazol was used in 3 patients because of failure of the surgical treatment, or impossibility of surgical treatment because of the multiple lesion of liver. Echinococcosis recurrence after treatment was registered in 13,9% of cases.

During 2005-2012 in Zaporozhye region quantity of the echinococcosis diagnosed patients became perceptible. The majority of patients (66,7 %) had epidemiological risk of infection (58,4 %). Most often localization of Echinococcus granulosus cysts were registered in a liver (77,8 %) and lungs (11,0%). Difficulties in clinical diagnostics were caused by a polymorphism of symptomatology and low level (54,5 %) of identifications of specific antibodies by enzyme immunoassay method. Echinococcosis recurrence after treatment was achieved in 13,9 % of cases.

Key words: echinococcosis, clinical manifestations, diagnosis.