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Clinical manifestations and diagnosis of echinococcosis

Pedro L Moro, MD, MPH
Section Editor
Peter F Weller, MD, MACP
Deputy Editor
Elinor L Baron, MD, DTMH


Echinococcal disease is caused by infection with the metacestode stage of the tapeworm Echinococcus, which belongs to the family Taeniidae. Four species of Echinococcus produce infection in humans; E. granulosus and E. multilocularis are the most common, causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. The two other species, E. vogeli and E. oligarthrus, cause polycystic echinococcosis but have only rarely been associated with human infection.

The clinical manifestations and diagnosis of cystic and alveolar echinococcal infection will be reviewed here. The epidemiology, treatment, and prevention of echinococcosis are discussed separately. (See "Epidemiology and control of echinococcosis" and "Treatment of echinococcosis".)


The Echinococcus species have different geographic distributions and involve different hosts. E. granulosus and E. multilocularis also differ in their clinical presentation. (See "Epidemiology and control of echinococcosis".)

Echinococcus granulosus — The initial phase of primary infection is always asymptomatic. Many infections are acquired in childhood but do not cause clinical manifestations until adulthood. Latent periods of more than 50 years before symptoms arise have been reported. While approximately 50 percent of detected cases occur in asymptomatic patients, many more cases remain undiagnosed or are found incidentally at autopsy.

The clinical presentation of E. granulosus infection depends upon the site of the cysts and their size. Small and/or calcified cysts may remain asymptomatic indefinitely. However, symptoms due to mass effect within organs, obstruction of blood or lymphatic flow, or complications such as rupture or secondary bacterial infections can result.

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Literature review current through: Dec 2017. | This topic last updated: Nov 21, 2017.
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