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Echinococcosis, alveolar
Diagnostic Methods
Diagnostic methodsPros and cons
Parasitological diagnosis 
Humans can serve as intermediate host for the fox tapeworm E. multilocularis, which excludes a parasitological diagnosis in stool samples.
With microscopy protoscolices can be detected in cyst fluids from surgical specimens.
Imaging technique (ultrasonography, computed tomography and magnetic resonance imaging) are diagnostically helpful
 
Molecular diagnosis 
PCR detects parasite nucleic acids in needle biopsies or in stool samples of foxes or dogs (final hosts) with excellent sensitivity and specificity
  • Demand on reagents and equipment
  • Excellent epidemiological tool
Antigen detection 
Several home-made tests detect copro-antigens in the faeces of definitive hosts by ELISA and specific monoclonal antibodies. One test kit is commercially available. 
Antibody detection 
Serology is an important diagnostic element for detecting alveolar echinococcosis. Various test formats (IFA, ELISAs, Western blots) have been developed to detect specific antibodies with a high sensitivity.
Using an affinity-purified or recombinant antigen (e.g. Em18), a differential diagnosis between the two species seems possible.
  • Antibody tests are excellent for screening
  • Moderate specificity if crude antigens are used