Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

Hydatid Cyst Disease 737

tests

Basic Blood Tests

■Serum alkaline phosphatase, rarely hyperbilirubinemia; CT/US can

be diagnostic

Specific Diagnostic Tests

■IHA: 75–94% sensitivity; specificity lower, requiring PCR

differential diagnosis

■Amebic abscess, pygenic abscess

management

What to Do First

■History, physical exam, imaging

General Measures

■Admit to hospital if ill or unstable

specific therapy

Treatment Options

■Drug therapy: albendazole, mebendazole, or praziquantel employed

first to minimize risk of dissemination

■Surgery: radical cystpericystectomy+/−cyst evacuation & local

instillation of scolicidal agents; treatment of choice

■Recent reports of successful radiologic cyst aspiration & scolicide

instillation; avoid diagnostic cyst aspiration in suspected cases of

hydatid cyst disease

follow-up

n/a

complications and prognosis

Complications

■Allergic reaction, incl anaphylaxis, dissemination, & cholangitis

Prognosis

■May remain asymptomatic for life; cyst infection/rupture increases

mortality