Echinococcus is an infection caused by the Echinococcus granulosus or Echinococcus multilocularis worm.

Echinococcus is common in:

• Africa
• Central Asia
• Southern South America
• The Mediterranean
• The Middle East

In the United States, the disease is very rare. However, it has been reported in California, Arizona, New Mexico, and Utah.

Humans become infected when they swallow eggs in contaminated food. The infection is carried to the liver, where cysts form. Cysts can also form in the:

• Brain
• Bones
• Kidney
• Lungs
• Skeletal muscles
• Spleen

Risk factors include being exposed to:

• Cattle
• Deer
• Feces of dogs, wolves, or coyotes
• Pigs
• Sheep

A liver cyst may produce no symptoms for 10 - 20 years until it is large enough to be felt by physical examination.

Symptoms include:

• Pain in the upper right part of the abdomen
• Bloody sputum
• Chest pain
• Cough
• Fever
• Severe skin itching

A physical examination may show signs of:

• Abdominal pain
• Problems with the skin and other organs
• Shock

The following tests may be done to find the cysts:

• Abdominal CT scan or ultrasound
• Abdominal X-ray
• Blood test
• Chest x-ray
• Liver function tests
• Thoracic CT scan or ultrasound

Most often, echinococcosis is found accidentally when an imaging test is done for another reason.

Many patients can be treated with albendazole or mebendazole. These medications are often used for up to 3 months. Another drug, praziquantel, may be helpful combined with albendazole or mebendazole.

The cysts may be removed with surgery, if possible. This can be a complicated surgery.

If the cysts respond to oral medication, the likely outcome is good.

The cysts may break open (rupture) and cause severe illness, including:

• Fever
• Low blood pressure
• Shock

The cysts may also spread throughout the body.

Call your health care provider if you develop symptoms of this disorder.

In areas where the disease is known to occur, health education and routinely removing tapeworms from dogs can help prevent the disease.

Craig PS, McManus DP, Lightowlers MW, Chabalgoity JA, Garcia HH, Gavidia CM, et al. Prevention and control of cystic echinococcosis. Lancet Infect Dis. 2007;7:385-394.