ICD-10: B67.61

Echinococcus multilocularis infection, classified under ICD-10 code B67.61, refers to a parasitic disease caused by the larval stage of the Echinococcus multilocularis tapeworm. This infection primarily affects the liver but can also involve multiple organs, leading to significant health complications.

Clinical Description

Etiology

Echinococcus multilocularis is a cestode (tapeworm) that primarily infects canids, such as foxes and domestic dogs, which serve as definitive hosts. Humans become accidental intermediate hosts through the ingestion of eggs shed in the feces of infected animals. The larvae develop into cysts, primarily in the liver, but can also spread to other organs, including the lungs and brain, leading to a condition known as alveolar echinococcosis (AE) [1].

Pathophysiology

Once ingested, the eggs hatch in the intestines, releasing oncospheres that penetrate the intestinal wall and migrate to the liver. Here, they develop into multilocular cysts that can invade surrounding tissues, mimicking malignant tumors. The growth of these cysts can lead to liver dysfunction, portal hypertension, and other systemic complications due to the mass effect and potential for metastasis to other organs [2].

Symptoms

The clinical presentation of Echinococcus multilocularis infection can vary widely, often depending on the extent of the disease. Common symptoms include:
- Abdominal pain, particularly in the upper right quadrant
- Jaundice due to bile duct obstruction
- Weight loss and anorexia
- Nausea and vomiting
- Fever in advanced cases

In cases where the infection spreads to other sites, symptoms may include respiratory distress if the lungs are involved or neurological symptoms if the central nervous system is affected [3].

Diagnosis

Diagnosis of Echinococcus multilocularis infection typically involves a combination of clinical evaluation, imaging studies, and serological tests. Imaging techniques such as ultrasound, CT scans, or MRI are crucial for visualizing the cystic lesions in the liver and other organs. Serological tests can help confirm the diagnosis by detecting specific antibodies against Echinococcus multilocularis [4].

Treatment

The treatment of Echinococcus multilocularis infection is complex and often requires a multidisciplinary approach. Surgical intervention may be necessary to remove cysts, especially if they are causing significant symptoms or complications. However, complete surgical excision can be challenging due to the infiltrative nature of the disease. In cases where surgery is not feasible, antiparasitic medications such as albendazole or mebendazole are used to manage the infection and prevent further growth of the cysts [5].

Prognosis

The prognosis for patients with Echinococcus multilocularis infection varies significantly based on the stage of the disease at diagnosis and the effectiveness of treatment. Early detection and intervention are critical for improving outcomes, as untreated infections can lead to severe complications and can be fatal in some cases [6].

Conclusion

Echinococcus multilocularis infection is a serious parasitic disease that can affect multiple sites in the body, primarily the liver. Understanding its clinical presentation, diagnostic methods, and treatment options is essential for healthcare providers to manage this condition effectively. Given the potential for severe complications, awareness and early intervention are key to improving patient outcomes.

References

1. ICD-10-CM TABULAR LIST of DISEASES and INJURIES.
2. ICD-10 International statistical classification of diseases.
3. Human echinococcosis incidence in Canada, 2000–2020.
4. HELMINTHIASES Includes Flukes, Tapeworms, Filarial.
5. ICD-10-AM Disease Code List.
6. CodeMap® ICD-10 (CM) Report.

Echinococcus multilocularis infection, classified under ICD-10 code B67.61, is a parasitic disease caused by the larval stage of the Echinococcus multilocularis tapeworm. This infection primarily affects the liver but can also involve multiple sites in the body, leading to a range of clinical presentations, signs, symptoms, and patient characteristics.

Clinical Presentation

General Overview

Echinococcus multilocularis infection is often asymptomatic in its early stages, which can lead to delayed diagnosis. When symptoms do occur, they may vary significantly depending on the extent of the infection and the organs involved. The disease is endemic in certain regions, particularly in parts of Europe, Asia, and North America, where the lifecycle of the parasite is maintained through interactions between definitive hosts (such as foxes and dogs) and intermediate hosts (such as rodents) [1].

Signs and Symptoms

The clinical manifestations of Echinococcus multilocularis infection can include:

• Abdominal Pain: Patients may experience persistent or intermittent abdominal pain, often localized to the right upper quadrant due to liver involvement [1].
• Jaundice: As the infection progresses, it can lead to bile duct obstruction, resulting in jaundice, characterized by yellowing of the skin and eyes [1].
• Weight Loss: Unintentional weight loss is common as the disease progresses, often due to decreased appetite and malabsorption [1].
• Fatigue and Weakness: General malaise and fatigue are frequently reported, contributing to a decline in the patient's overall health status [1].
• Fever: Some patients may present with low-grade fever, particularly if there is secondary infection or inflammation [1].
• Hepatomegaly: Enlargement of the liver may be noted during physical examination, which can be a direct result of the cystic lesions formed by the parasite [1].

Complications

In advanced cases, the infection can lead to severe complications, including:

• Cyst Rupture: Rupture of the cysts can lead to anaphylactic reactions or secondary infections, which can be life-threatening [1].
• Metastatic Spread: Although rare, the infection can metastasize to other organs, leading to further complications and a more complex clinical picture [1].

Patient Characteristics

Demographics

• Geographic Distribution: The infection is more prevalent in rural areas where there is close contact with definitive hosts, particularly in regions of North America, Europe, and Asia [1].
• Age and Gender: While the infection can affect individuals of any age, it is often diagnosed in adults. There is no significant gender predisposition noted in the literature [1].

Risk Factors

• Exposure to Infected Animals: Individuals who work with or have close contact with dogs or foxes are at higher risk of infection [1].
• Consumption of Contaminated Food or Water: Ingestion of food or water contaminated with Echinococcus eggs, particularly in areas where the parasite is endemic, increases the risk of infection [1].
• Immunocompromised Status: Patients with weakened immune systems may be more susceptible to severe manifestations of the disease [1].

Conclusion

Echinococcus multilocularis infection, represented by ICD-10 code B67.61, presents a complex clinical picture that can vary widely among patients. Early recognition of symptoms and understanding of patient characteristics are crucial for timely diagnosis and management. Given the potential for severe complications, awareness of risk factors and preventive measures is essential, particularly in endemic regions. Further research and public health initiatives are needed to address the challenges posed by this parasitic infection and to improve patient outcomes.

[1] Expert consensus for the diagnosis and treatment of cystic echinococcosis.

The ICD-10 code B67.61 refers specifically to "Echinococcus multilocularis infection, multiple sites." This condition is associated with a parasitic infection caused by the Echinococcus multilocularis tapeworm, which primarily affects the liver and can lead to serious health complications. Below are alternative names and related terms associated with this condition:

Alternative Names

1. Alveolar Echinococcosis: This is the most common alternative name for infections caused by Echinococcus multilocularis. It highlights the characteristic cystic lesions that form in the liver and other organs.
2. Multilocular Echinococcosis: This term emphasizes the multilocular nature of the cysts formed by the parasite.
3. Echinococcosis multilocularis: A direct reference to the species and the type of infection, often used in medical literature.

Related Terms

1. Echinococcus Infection: A broader term that encompasses infections caused by various species of Echinococcus, including Echinococcus granulosus and Echinococcus multilocularis.
2. Cystic Echinococcosis: While primarily associated with Echinococcus granulosus, this term is sometimes used in discussions about echinococcal infections in general.
3. Hydatid Disease: This term is often used to describe infections caused by Echinococcus species, although it is more commonly associated with Echinococcus granulosus.
4. Echinococcal Cyst: Refers to the cysts formed in the body due to the infection, which can be multilocular in the case of Echinococcus multilocularis.

Clinical Context

Echinococcus multilocularis infection is particularly prevalent in certain geographic regions, including parts of Europe, Asia, and North America, where the lifecycle of the parasite can be maintained through interactions between definitive hosts (like foxes) and intermediate hosts (such as rodents) [1][2]. The infection can lead to severe complications, including liver failure, if not diagnosed and treated promptly.

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and discussing this condition, as well as for researchers studying its epidemiology and treatment options.

Echinococcus multilocularis infection, classified under ICD-10 code B67.61, is a parasitic disease caused by the larval stage of the Echinococcus multilocularis tapeworm. This infection primarily affects the liver but can also involve other organs, leading to significant health complications. The diagnosis of this infection involves several criteria and methods, which are outlined below.

Diagnostic Criteria for Echinococcus multilocularis Infection

1. Clinical Presentation

• Symptoms: Patients may present with nonspecific symptoms such as abdominal pain, weight loss, jaundice, and hepatomegaly. In advanced cases, symptoms may include ascites and portal hypertension due to liver involvement[6].
• History of Exposure: A detailed patient history is crucial, particularly regarding exposure to areas where Echinococcus multilocularis is endemic, such as certain regions in North America, Europe, and Asia. Contact with infected animals, particularly foxes and domestic dogs, is also significant[8].

2. Imaging Studies

• Ultrasound: This is often the first imaging modality used to detect liver lesions. It can reveal cystic structures that are characteristic of echinococcal infection[6].
• Computed Tomography (CT) and Magnetic Resonance Imaging (MRI): These imaging techniques provide more detailed views of the liver and can help differentiate between Echinococcus multilocularis and other liver lesions. CT scans typically show multilocular cystic lesions with a characteristic "honeycomb" appearance[6][8].

3. Serological Tests

• Antibody Detection: Serological tests can be performed to detect specific antibodies against Echinococcus multilocularis. Enzyme-linked immunosorbent assays (ELISA) are commonly used for this purpose. A positive serology can support the diagnosis, especially in asymptomatic patients[6][8].

4. Histopathological Examination

• Tissue Biopsy: In some cases, a biopsy of the affected tissue may be necessary to confirm the diagnosis. Histological examination can reveal the presence of the parasite and its characteristic structures[6].

5. Molecular Techniques

• PCR Testing: Polymerase chain reaction (PCR) can be utilized to detect Echinococcus multilocularis DNA in tissue samples or body fluids, providing a highly specific and sensitive diagnostic method[6].

Conclusion

The diagnosis of Echinococcus multilocularis infection (ICD-10 code B67.61) relies on a combination of clinical evaluation, imaging studies, serological tests, and, when necessary, histopathological examination. Given the potential for severe complications, early diagnosis and treatment are critical. If you suspect exposure or symptoms consistent with this infection, it is essential to seek medical attention for appropriate testing and management.

Echinococcus multilocularis infection, classified under ICD-10 code B67.61, is a parasitic disease caused by the larval stage of the Echinococcus multilocularis tapeworm. This infection primarily affects the liver but can also involve other organs, leading to significant health complications. The treatment of this condition is complex and typically involves a combination of medical and surgical approaches.

Overview of Echinococcus multilocularis Infection

Echinococcus multilocularis is primarily transmitted through the fecal-oral route, often via contact with infected canines or contaminated food and water sources. The infection can lead to the development of alveolar echinococcosis, which is characterized by the formation of cyst-like lesions in the liver and potentially other organs. This condition can mimic liver cancer and may result in severe complications, including portal hypertension and liver failure if left untreated[1][2].

Standard Treatment Approaches

1. Medical Management

The first line of treatment for Echinococcus multilocularis infection typically involves antiparasitic medications. The most commonly used drugs include:

• Albendazole: This is the primary medication used to treat echinococcosis. It works by inhibiting the growth and reproduction of the parasite. Treatment usually lasts for several months to years, depending on the severity of the infection and the response to therapy[3][4].

• Mebendazole: An alternative to albendazole, mebendazole may also be used, although it is less commonly prescribed for this specific infection. It functions similarly by disrupting the parasite's metabolism[5].

2. Surgical Intervention

In cases where the infection has led to significant complications or where there are large cysts, surgical intervention may be necessary. Surgical options include:

• Cyst Resection: This involves the surgical removal of the infected tissue or cysts. It is often considered when the lesions are localized and accessible, and when the patient is in good overall health[6].

• Liver Transplantation: In severe cases where the liver is extensively damaged, transplantation may be the only viable option. This is typically reserved for patients with advanced disease who do not respond to medical therapy[7].

3. Follow-Up and Monitoring

Patients undergoing treatment for Echinococcus multilocularis infection require regular follow-up to monitor the effectiveness of the treatment and to check for any recurrence of the disease. Imaging studies, such as ultrasound or MRI, are often employed to assess the status of the lesions[8].

4. Supportive Care

Supportive care is also crucial, especially in managing symptoms and complications associated with the infection. This may include:

• Nutritional Support: Ensuring adequate nutrition is vital, particularly if the liver function is compromised.
• Management of Complications: Addressing issues such as portal hypertension or liver dysfunction may require additional medical interventions[9].

Conclusion

The treatment of Echinococcus multilocularis infection (ICD-10 code B67.61) is multifaceted, involving both medical and surgical strategies tailored to the individual patient's condition. Early diagnosis and intervention are critical to improving outcomes and preventing severe complications. Regular monitoring and supportive care play essential roles in the management of this serious parasitic infection. If you suspect exposure or symptoms related to this infection, it is crucial to seek medical attention promptly.

For further information or specific case management, consulting with a healthcare professional specializing in infectious diseases is recommended.