ECHINOCOCCUS
Echinococcosis
is a tissue infection of humans caused by larvae of Echinococcus granu-losus and
E. multilocularis. The former is a more common cause of human disease.
Echinococcus granulosus
PARASITOLOGY
The adult E.
granulosus inhabits the small bowel of dogs, wolves, and other canines,
where it survives for a scant 12 months. The scolex, like that of the genus Taenia, pos-sesses four sucking discs
and a double row of hooklets. The entire strobila, however, mea-sures only 5 mm
in length and contains but three proglottids; one immature, one mature, and one
gravid. The latter segment splits either before or after passage in the stool,
releas-ing eggs that appear identical to those of T. saginata and T. solium.
A number of mammals may serve as intermediates, including sheep, goats, camels,
deer, caribou, moose, and, most important, humans. When one of these hosts
ingests eggs, they hatch. The embryos penetrate the intestinal mucosa and are
carried by the portal blood to the liver. Here, many are filtered out in the
hepatic sinusoids. The rest traverse the liver and are carried to the lung,
where most lodge. A few pass through the pulmonary capillaries, enter the
systemic circulation, and are carried to the brain, heart, bones, kidneys, and
other tissues. Many of the larvae are phagocytosed and destroyed. The survivors
form a cyst wall composed of an external laminated cuticle and an internal
germinal membrane. The cyst fills with fluid and slowly expands, reaching a
diameter of 1 cm over 5 to 6 months. Secondary or daughter cysts form within
the original hydatid. Within each of these daughter cysts, new protoscol-ices
are produced from the germinal lining. Some break free, dropping to the bottom
of the cyst to form hydatid sand. When hydatid-containing tissues of the
intermediate host are ingested by a canine, thousands of scolices are released
in the intestine to develop into adult worms.
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