[Echinococcosis. Rational diagnosis and therapy].

The most dangerous of the parasitoses seen in Middle Europeans, are cystic and alveolar echinococcosis which, here in Germany, varies considerably in frequency. Cystic echinococcosis is found throughout the entire world; the disease is seen mostly in "guest workers". Alveolar echinococcosis may be observed sporadically in all the Alpine countries, in Bavaria, and also in Baden-Württemberg. As a result of slow growth, the onset of the symptomatology is considerably delayed. Dangerous complications are jaundice, stenosis of the pylorus of the stomach, incidents resulting from portal hypertension, infections of the cysts, and perforation of the lesion into the neighbouring organs or into the free abdominal cavity. The complement-binding reaction, indirect haemagglutination and the indirect enzyme immuno test, together, achieve a sensitivity of up to 97%. Static scintigraphy of liver and spleen, ultrasonography, laparoscopy, X-ray survey, angiography, and, in particular, computerized tomography, are further diagnostic procedures. If at all possible, treatment should be surgical. The only conservative measure worth trying is the administration of mebendazole (Vermox).