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PAIR Albendazole Cover — SCE Infectious Diseases MCQ

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ModerateParasitologyPAIR Albendazole CoverSCE Infectious Diseases

A 45-year-old man with known Echinococcus granulosus hydatid cyst in the liver (10 cm, CE1 classification — active, unilocular) is planned for PAIR (Puncture-Aspiration-Injection-Reaspiration). What must he receive before and after the procedure?

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Correct answer: D — Albendazole 400 mg BD starting at least 4 days before PAIR and continuing for 1–3 months after — to reduce viability of protoscolices and prevent secondary echinococcosis from any spillage

PAIR for hepatic hydatid cysts requires peri-procedural antihelmintic cover with Albendazole to: (1) reduce protoscolex viability before puncture, (2) prevent secondary echinococcosis from any inadvertent peritoneal spillage, and (3) continue treatment post-procedure to manage residual disease. Albendazole 400 mg BD should start ≥4 days before PAIR (some recommend ≥1 month) and continue for 1–3 months post-procedure. During PAIR, hypertonic saline (15–20%) or 95% ethanol is injected as a scolicidal agent. Anaphylaxis kit must be available during the procedure.

Reference: WHO 2022 – Echinococcosis; NICE CKS 2024 – Hydatid disease