Editing Echinococcosis (section)

==Diagnosis==
[[File:Polycystic echinococcosis affecting the left side of the liver.jpg|thumbnail|right|Computed tomography (A) and magnetic resonance (B) images of the liver of a 72-year-old man from French Guiana with polycystic echinococcosis affecting the left side of the liver. White arrows indicate the multicystic liver lesion.]]
[[File:İndirekt Hemaglütinasyon Deneyi.jpg|thumb|Indirect hemagglutination assay for human echinococcosis. Different serum samples diluted from the left to the right. Seropositivity was suspected in Sample 179]]

===Classification===
The most common form found in humans is cystic echinococcosis (also known as unilocular echinococcosis), which is caused by ''[[Echinococcus granulosus sensu lato]]''. The second most common form is [[alveolar hydatid disease|alveolar echinococcosis]] (also known as alveolar colloid of the liver, alveolar hydatid disease, alveolococcosis, multilocular echinococcosis, "small fox tapeworm"), which is caused by ''[[Echinococcus multilocularis]]'' and the third is polycystic echinococcosis (also known as human polycystic hydatid disease, neotropical echinococcosis), which is caused by ''[[Echinococcus vogeli]]'' and very rarely, ''[[Echinococcus oligarthrus]]''. Alveolar and polycystic echinococcosis are rarely diagnosed in humans and are not as widespread as cystic echinococcosis, but polycystic echinococcosis is relatively new on the medical scene and is often left out of conversations dealing with echinococcosis, and alveolar echinococcosis is a serious disease that has a significantly high fatality rate, and may have the potential to become an emerging disease in many countries.<ref>{{cite journal |last1=Baumann |first1=Sven |last2=Shi |first2=Rong |last3=Liu |first3=Wenya |last4=Bao |first4=Haihua |last5=Schmidberger |first5=Julian |last6=Kratzer |first6=Wolfgang |last7=Li |first7=Weixia |last8=Barth |first8=Thomas F. E. |last9=Baumann |first9=Sven |last10=Bloehdorn |first10=Johannes |last11=Fischer |first11=Iris |last12=Graeter |first12=Tilmann |last13=Graf |first13=Natalja |last14=Gruener |first14=Beate |last15=Henne-Bruns |first15=Doris |last16=Hillenbrand |first16=Andreas |last17=Kaltenbach |first17=Tanja |last18=Kern |first18=Peter |last19=Kern |first19=Petra |last20=Klein |first20=Katharina |last21=Kratzer |first21=Wolfgang |last22=Ehteshami |first22=Niloofar |last23=Schlingeloff |first23=Patrycja |last24=Schmidberger |first24=Julian |last25=Shi |first25=Rong |last26=Staehelin |first26=Yael |last27=Theis |first27=Frauke |last28=Verbitskiy |first28=Daniil |last29=Zarour |first29=Ghaith |title=Worldwide literature on epidemiology of human alveolar echinococcosis: a systematic review of research published in the twenty-first century |journal=Infection |date=October 2019 |volume=47 |issue=5 |pages=703–727 |doi=10.1007/s15010-019-01325-2 |pmid=31147846 |pmc=8505309 }}</ref>

===Cystic===
A formal diagnosis of any type of echinococcosis requires a combination of tools that involve imaging techniques, histopathology, or nucleic acid detection and serology. For cystic echinococcosis diagnosis, imaging is the main method—while serology tests (such as indirect hemagglutination, ELISA (enzyme-linked immunosorbent assay), immunoblots, or latex agglutination) that use antigens specific for ''E. granulosus'' verify the imaging results. The imaging technique of choice for cystic echinococcosis is ultrasonography, since it is not only able to visualize the cysts in the body's organs,<ref name="BrunettiEnrico">{{cite journal |vauthors=Brunetti E, Kern P, Vuitton DA |title=Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans |journal=Acta Trop. |volume=114 |issue=1 |pages=1–16 |date=April 2010 |pmid=19931502 |doi=10.1016/j.actatropica.2009.11.001 |doi-access=free }}</ref> but it is also inexpensive, non-invasive and gives instant results.<ref>{{cite journal |vauthors=Macpherson CN, Milner R |title=Performance characteristics and quality control of community-based ultrasound surveys for cystic and alveolar echinococcosis |journal=Acta Trop. |volume=85 |issue=2 |pages=203–9 |date=February 2003 |pmid=12606098 |doi=10.1016/s0001-706x(02)00224-3}}</ref> In addition to ultrasonography, both MRI and CT scans can and are often used although an MRI is often preferred to CT scans when diagnosing cystic echinococcosis since it gives better visualization of liquid areas within the tissue.<ref name="BrunettiEnrico" /><ref>{{Cite journal |last=Rizi |first=Farid Rajaee |title=Hydatid cyst {{!}} Radiology Case {{!}} Radiopaedia.org |url=https://radiopaedia.org/cases/hydatid-cyst-26?lang=us |access-date=2022-09-13 |website=Radiopaedia |language=en-US |doi=10.53347/rid-152545|doi-access=free }}</ref>

===Alveolar===
As with cystic echinococcosis, ultrasonography is the imaging technique of choice for alveolar echinococcosis and is usually complemented by CT scans since CT scans can detect the largest number of lesions and calcifications that are characteristic of alveolar echinococcosis. MRIs are also used in combination with ultrasonography though CT scans are preferred. Like cystic echinococcosis, imaging is the major method used for the diagnosis of alveolar echinococcosis while the same types of serologic tests (except now specific for ''E. multilocularis'' antigens) are used to verify the imaging results. It is also important to note that serologic tests are more valuable for the diagnosis of alveolar echinococcosis than for cystic echinococcosis since they tend to be more reliable for alveolar echinococcosis since more antigens specific for ''E. multilocularis'' are available.<ref name=Eckert04 /> In addition to imaging and serology, identification of ''E. multilocularis'' infection via PCR or a histological examination of a tissue biopsy from the person is another way to diagnose alveolar echinococcosis.<ref name="BrunettiEnrico" />

===Polycystic===
Similar to the diagnosis of alveolar echinococcosis and cystic echinococcosis, the diagnosis of polycystic echinococcosis uses imaging techniques, in particular ultrasonography and CT scans, to detect polycystic structures within the person's body. However, imaging is not the preferred method of diagnosis since the method that is currently considered the standard is the isolation of protoscoleces during surgery or after the person's death, and the identification of definitive features of ''E. oligarthrus'' and ''E. vogeli'' in these isolated protoscoleces. This is the main way that PE is diagnosed, but some current studies show that PCR may identify ''E. oligarthrus'' and ''E. vogeli'' in people's tissues.<ref>{{cite journal |vauthors=Knapp J, Chirica M, Simonnet C, etal |title=''Echinococcus vogeli'' infection in a hunter, French Guiana |journal=Emerging Infect. Dis. |volume=15 |issue=12 |pages=2029–31 |date=December 2009 |pmid=19961693 |pmc=3044547 |doi=10.3201/eid1512.090940 }}</ref> The only drawback of using PCR to diagnose polycystic echinococcosis is that there aren't many genetic sequences that can be used for PCR that are specific only ''E. oligarthrus'' or ''E. vogeli''.<ref name=Eckert04 />