# Echinococcosis (Hydatid Disease) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Echinococcus Granulosus - StatPearls (NCBI Bookshelf NBK539751) - https://www.ncbi.nlm.nih.gov/books/NBK539751/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD07.10 - condition scope only, no dose · Egyptian National Drug Formulary - Antimicrobial 2023 (albendazole monograph, p26) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Antimicrobial 2023 (albendazole monograph, p26) ## Treatment metadata - Albendazole — 400 mg — oral.solid - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text ECHINOCOCCOSIS (HYDATID DISEASE) Sources: Echinococcus Granulosus - StatPearls (NCBI Bookshelf NBK539751) - https://www.ncbi.nlm.nih.gov/books/NBK539751/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD07.10 - condition scope only, no dose · Egyptian National Drug Formulary - Antimicrobial 2023 (albendazole monograph, p26) Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (8) - It can stay silent for months or years, and some carry cysts for years unaware [cyst] - A growing cyst brings symptoms slowly, by pressing on the tissue around it [cyst] - Anything sudden points to rupture rather than to growth - Rupture can set off an allergic reaction with hives, swollen mucous membranes and flushing, and it can kill [urticaria] - In the liver: abdominal pain, reduced appetite and a swollen abdomen [abdominal distension · abdominal pain · poor appetite] - In the lung: a long-running cough, chest pain and breathlessness [breathlessness · chest pain · cough] - Infection is often caught in childhood but shows late, because the cysts grow so slowly [cyst] - Cysts in brain or eye are the exception and usually declare themselves in childhood [cyst] SIGNS - what you find (5) - An enlarged liver, a mass you can feel, and a distended abdomen [abdominal distension · hepatomegaly] - The liver holds more than 65 in 100 of these and the lungs 25 - Bone, spleen, nervous system and heart can also be involved - Usually there is a single cyst, but 20 to 40 in 100 have more than one organ involved [cyst] - A leaking cyst spills its contents into the peritoneum and seeds fresh cysts there [cyst] TESTS (12) - Start with exposure history, including living in or coming from an area where it is common - Ask particularly about contact with dogs and with cattle - Liver tests do not track severity and are abnormal in only about 4 patients in 10 - Alkaline phosphatase is the enzyme that rises; transaminases and bilirubin usually stay normal - The blood count may show raised eosinophils - ELISA screens for antibody and an immunoblot confirms it, but many patients mount no response at all - Ultrasound is the first choice for liver and abdomen, and for follow-up, though it depends on the operator - Ultrasound appearances run from a simple cyst with a double line, through a many-chambered rosette - Then a detached membrane giving the water lily sign, or daughter cysts within solid material - Finally a mixed-density mass without daughter cysts, then a solid walled cyst - The first two appearances mean live disease, the third a cyst in transition, the last two inactive disease - Plain films show ring-like calcification in up to 30 of every 100, at any stage IF NOT THIS - what else fits (6) - It can copy a great many conditions, depending on where the cyst sits - Liver abscess, or a simple liver cyst - Budd-Chiari syndrome - Biliary colic, or biliary cirrhosis - Tuberculosis - Primary liver cancer Source StatPearls "Echinococcus Granulosus" - disease-level clinical article Status traced to the source above Rx: Antiparasitic | Main treatment ANTIPARASITIC 1. ALBENDAZOLE [1st line] Adult 10-15 mg/kg/day in two divided doses, each dose capped at 400 mg x 1 to 6 months, decided by the cyst stage and the response Peds 5-7.5 mg/kg/dose [child max 400 mg] (Hydatid disease in children and adolescents: 5-7.5 mg/kg per dose twice daily for 1 to 6 months, each dose capped at 400 mg. The grid above is per dose, not per day - twice this amount is given in 24 hours.) 3kg -> 15-22.5 mg/dose 4kg -> 20-30 mg/dose 5kg -> 25-37.5 mg/dose 6kg -> 30-45 mg/dose 7kg -> 35-52.5 mg/dose 8kg -> 40-60 mg/dose 9kg -> 45-67.5 mg/dose 10kg -> 50-75 mg/dose 11kg -> 55-82.5 mg/dose 12kg -> 60-90 mg/dose 13kg -> 65-97.5 mg/dose 14kg -> 70-105 mg/dose 15kg -> 75-112.5 mg/dose 16kg -> 80-120 mg/dose 17kg -> 85-127.5 mg/dose 18kg -> 90-135 mg/dose 19kg -> 95-142.5 mg/dose 20kg -> 100-150 mg/dose 21kg -> 105-157.5 mg/dose 22kg -> 110-165 mg/dose 23kg -> 115-172.5 mg/dose 24kg -> 120-180 mg/dose 25kg -> 125-187.5 mg/dose 26kg -> 130-195 mg/dose 27kg -> 135-202.5 mg/dose 28kg -> 140-210 mg/dose 29kg -> 145-217.5 mg/dose 30kg -> 150-225 mg/dose 31kg -> 155-232.5 mg/dose 32kg -> 160-240 mg/dose 33kg -> 165-247.5 mg/dose 34kg -> 170-255 mg/dose 35kg -> 175-262.5 mg/dose 36kg -> 180-270 mg/dose 37kg -> 185-277.5 mg/dose 38kg -> 190-285 mg/dose 39kg -> 195-292.5 mg/dose 40kg -> 200-300 mg/dose 41kg -> 205-307.5 mg/dose 42kg -> 210-315 mg/dose 43kg -> 215-322.5 mg/dose 44kg -> 220-330 mg/dose 45kg -> 225-337.5 mg/dose 46kg -> 230-345 mg/dose 47kg -> 235-352.5 mg/dose 48kg -> 240-360 mg/dose 49kg -> 245-367.5 mg/dose 50kg -> 250-375 mg/dose Choice Alternatives. Albendazole is the drug of choice in the cited article; mebendazole at 40-50 mg/kg/day is the alternative and is the less-used of the two. Source Egyptian National Drug Formulary - Antimicrobial 2023 (albendazole monograph, p26) Why The cited article names albendazole as the drug of choice for hydatid disease at 10-15 mg/kg/day, with mebendazole 40-50 mg/kg/day as the other option. The formulary's albendazole monograph names cystic hydatid disease of the liver, lung and peritoneum caused by the larval form of the dog tapeworm as an indication and gives the weight- based rule below, so the drug, the indication and the dose all come from named documents. Drug treatment alone is for cysts the article calls CE1 and CE3a under 5 cm in liver or lung, for disease in two or more organs, and for a patient who cannot have surgery; it is also given around surgery or a percutaneous procedure to stop the cyst coming back. Caution DO NOT GIVE IT TO SHRINK A CYST THAT MIGHT BURST. The cited article says benzimidazole treatment is contraindicated in cysts vulnerable to rupture, and in early pregnancy. THIS IS NOT A DECISION TO MAKE ALONE. Which cyst is treated with a drug, which with surgery and which with the PAIR needle procedure depends on the ultrasound stage. Anaphylaxis is a real risk if a cyst is punctured or leaks, and the article says the operator must be equipped to deal with it. Monitor while on treatment: the cited article asks for white cell count, liver transaminases and ultrasound every 3 to 6 months at first, then yearly once stable. Do not give to anyone with a known allergy to albendazole or another benzimidazole. Mebendazole 40-50 mg/kg/day is the alternative the article gives if albendazole cannot be used. Egypt ALBENDAZOLE 400 MG 6 TABS PHARMA CURE P... 46.00 EGP (7.67/unit) ANTIZOLE 100MG/5ML SUSP. 30ML ALEXANDRIA 19.00 EGP -> ? strength differs, ? different route - not oral solid ALZENTAL 20MG/ML SUSP. 20ML EIPICO 21.00 EGP -> ? strength differs, ? different route - not oral solid MAIN TREATMENT 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Hydatid cyst disease from contact with dogs and livestock, seen in Egypt's rural farming communities. Diagnosis and treatment (surgery and/or albendazole) requires imaging and specialist care; GP recognises the possibility and refers. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Hydatid cyst disease from contact with dogs and livestock, seen in Egypt's rural farming communities. Diagnosis and treatment (surgery and/or albendazole) requires imaging and specialist care; GP recognises the possibility and refers. Caution The drug rows above are what the treating service gives. They are here so that the referral is an informed one and so the GP can recognise the regimen the patient comes back on - not as permission to start it without the referral. RED FLAG - Sudden severe pain or an allergic reaction suggesting cyst rupture, jaundice, or coughing blood from a lung cyst: refer urgently. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)