5.2.5.5 Multilocular echinococcosis

Multilocular (alveolar) echinococcosis, infestation of Echinococcus multilocularis, is endemic in Hokkaido, the northernmost island of Japan. This zoonotic parasitosis showing liver involvement is mainly mediated by ingestion of eggs excreted from red foxes [70]. The liver infested by E. multilocularis was surgically removed from a female patient aged 30's living in Hokkaido. The multilocular hydatid cyst wall was collapsed and embedded in the fibrous tissue. No protoscolex was seen in the lesion. The patient's serum diluted at 1:200 was reactive with the collapsed cyst wall component, while the intact hydatid cyst wall revealed negativity (Figure 43) [23].
