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Pulmonary hydatidosis Dr.mohammadzadeh Thorasic surgeon اكينوكوكوس گرانولوزوس اكينوكوكوس مولتي لوكوالريس اكينوكوك يعني خار هيداتيس يعني يك قطره اب Echinococcus granulosus كرم بالغ : در روده كوچك سگ شغال و روباه زندگي مي كند. طول ان 2/5الي 9ميليمتر است و بدن از 3تا 4بند تشكيل شده است • مرحله الروي كرم به شكل كيسه اي چند جداره وپر از مايع است كه در جدار داخلي ان جوانه هاي كيسه اي شكل ايجاد مي شود مرحله الروي كرم به شكل كيسه اي چند جداره وپر از مايع است كه در جدار داخلي ان جوانه هاي كيسه اي شكل ايجاد مي شود • طبقات مختلف كيست يك حفره اي : (1اليه پري سيست (2اليه مطبق (3اليه زاينده داخلي (4مايع هيداتيد (5كيسه هاي زايا (6كيست هاي دختر (7اسكولكس ها A section of a hydatid cyst The cyst consists of a thick outer layer (*), several thinner internal layers, and many protoscolices. The protoscolices are often called "hydatid sand." Hydatid cyst (Hydatid disease) Mother cyst (left) daughter cyst (right) Higher magnification of the protoscolices protoscolex. Note the "hooks" that will form the hooks associated with the adult worm's armed rostellum. Protoscolices with double row hooklets Hydatid cyst Hydatid cyst showing a row of brood capsules attached to the germinal layer. Egg An egg of Echinococcus granulosus(upper). These eggs are virtually indistinguishable from other closely related species of tapeworms such as Taenia. Echinococcus granulosus in the small intestine of a dog (the small, white objects) Although these tapeworms are quite small, a single dog can be infected with many of them. (1 (2 (3 (4 (5 (6 پنهاني بودن عالئم خلط خوني درد سينه تنگي نفس سرفه برجستگي جدار سينه Clinical Features of unruptured cysts Hydatid cyst in lung. This patient had a single large cyst in the left lung. An intact hydatid cyst An intact hydatid cyst Clinical Features of ruptured cyst i. Quiescent type ii. Abscess type iii. Progressive type A patient with bilateral hydatid cyst Water lily sign Allergic reactions and sometimes anaphylactic shock may occur if the cyst ruptures. Ruptures of the cyst may also lead to the escape of protoscolices into the surrounding tissues, these can then develop into further cysts. Differential Diagnosis of hydatid cyst A Very huge hydatid cyst Diagnosis Microscopy Fluid aspirated from a hydatid cyst will shows multiple protoscolices (size approximately 100 µm), each of which has typical hooklets. The protoscolices are normally invaginated (left), and evaginated (middle, then right) when put in saline. Antibody Detection Indirect hemagglutination (IHA) indirect fluorescent antibody (IFA) tests, and enzyme immunoassays (EIA) are sensitive tests for detecting antibodies in serum of patients. Treatment Surgery is the most common form of treatment for echinococcosis . The drug of choice for treatment is albendazole .