[Current principles for diagnosis and treatment of hydatid disease]

Hydatid disease is a parasitic disease caused by one of two species of Echinococcus: Echinococcus granulosus (cystic hydatid disease) or Echinococcus multilocularis (alveolar hydatid disease). Widely accepted criteria of diagnosis of hydatid disease are based on the result of ultrasonography suggesting the presence of hydatid cyst and positive results of serologic tests. The serologic tests should begin with a screening test (ELISA or haemagglutination), and then should be verified using a western-blot method in order to detect the reaction with 8 kDa fraction of Echinococcus antigen. Further differentiation of the infecting species may be accomplished with the aid of Em2 plus or Em-18 ELISA tests which detect antibodies specific for E. multilocularis. The final diagnosis is based on the histologic examination of hydatid lesion or detected protoscolex of tapeworm in cystic liquid. Treatment of cystic hydatid disease consist of surgical therapy, percutaneous drainage (PAIR), chemotherapy and long-term observation. Treatment of alveolar hydatid disease is based on radical surgical resection of parasitic lesion and many years of chemotherapy. In case of chronic liver failure the transplantation is necessary.