Cases reported "Echinococcosis"

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1/7. Echinococcal synovitis of the knee joint.

    Bone lesions are present in 1% to 2% of cases of hydatid disease. Hydatid synovitis can usually be identified due to secondary extension from the adjacent bone, or infrequently after hematogenous spread. We present an extremely rare case of hydatid synovitis without bony involvement. A 74-year-old man with diagnosed hydatid disease was admitted to our department because of left knee swelling. Neither physical examination nor laboratory studies revealed any remarkable findings. Radiographic evaluation of the knee joint was noncontributory. The patient underwent an arthroscopically assisted synovectomy, and the biopsy revealed an echinococcus contamination. No complications occurred during the postoperative period.
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2/7. Hydatid cyst of the uterus.

    BACKGROUND: Hydatidosis is a common zoonosis that affects a large number of humans and animals, especially in poorly developed countries. The infesting parasite has four forms named echinococcus granulosis, E. multilocularis, E. vogeli and E. oligarthrus (very rare in humans). The most frequently involved organs are liver followed by the lung. The involvement of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We report a case of hydatid cyst in the uterus. CASE: A 70-year-old female with a history of hydatid cysts of the liver, was admitted to hospital after complaining of low abdominal pains. On physical and gynecological examinations, no pathological finding was detected. However, the uterus was significantly large for a postmenopausal patient. Transvaginal sonography (TS) revealed a cystic mass in the uterus with a size of 7 x 6 cm. After further examinations a subtotal hysterectomy was performed. Microscopic examination showed scolices of echinococcus granulosis. CONCLUSION: Hydatid cysts in the genital tract are rare and the occurrence in the uterus is an extreme rarity. Differentiation between hydatid cyst and malignant disease of the related organ is difficult. To avoid misdiagnosis, a careful examination of pelvic masses should be carried out in endemic areas for detection of hydatid cysts.
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keywords = physical
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3/7. Primary subcutaneous cyst hydatic disease in proximal thigh: an unusual localisation: a case report.

    BACKGROUND: Musculoskeletal hydatidosis is very rare and represents 1%-5.4% of all cases of echinococcosis. On clinical basis, infection mimics a soft-tissue tumor, and the preoperative radiological diagnosis is very important to avoid biopsy. CASE PRESENTATION: We report an unusual case of primary subcutaneous hydatidosis in proximity to vastus lateralis muscle. It was diagnosed according to the computed tomography appearance, clinical and pathological findings. A 43 year old female patient was admitted with a history of pain at proximal thigh for the last 30 days. On physical examination, a mass which was 4 x 5 cm in diameter, painful and erythematous, was palpated over greater trochanter. Sedimentation rate was 40 mm in the first hour. CT (Computed tomography) scan demonstrated, a soft tissue mass with central cystic component in the subcutaneous tissue near vastus lateralis muscle.Histopathological examination of the specimen revealed a pericystic structure, which consisted of connective tissue and scattered hyaline cells showing a necrotic basophilic structure that resembled a cuticular membrane. Treatment with high dose albendazole was conducted for 4 weeks. CONCLUSIONS: This case illustrates that echinococcal disease should be considered in the differential diagnosis of every cystic mass in every anatomic location, especially when they occur in areas where the disease is endemic.
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4/7. Hydatid cyst of the craniocervical junction: case report.

    OBJECTIVE AND IMPORTANCE: Although rare in developed countries, hydatid disease is a serious parasitic infection in endemic areas. Spinal disease most commonly involves the thoracic region, and involvement of the upper cervical spine is extremely rare. In this report, a case of hydatid disease involving the craniocervical junction is presented, along with a review of the literature. CLINICAL PRESENTATION: A 44-year-old man presented with the complaint of neck pain. The results of his physical and neurological examinations were within normal ranges, except for pain exacerbated by neck motion and spasm of the cervical musculature. magnetic resonance imaging demonstrated a cystic lesion involving the odontoid process and body of C1 and C2, with thin and regular cyst walls and cyst contents similar in intensity to that of cerebrospinal fluid. The results of serological tests performed with the suspected diagnosis of hydatid disease were positive. INTERVENTION: The patient initially underwent surgery to provide stabilization of the craniocervical junction, using autogenous bone graft and sublaminar wiring from the occiput to C3 via a posterior approach. The cyst was approached via a transoral route, using a U-shaped pharyngeal incision. There were no neurological deficits after surgery. Postoperative magnetic resonance imaging scans confirmed complete excision of the cyst, and the patient was discharged on the 12th postoperative day. He received six cycles of albendazole treatment, each consisting of 28 days with an intervening drug-free period of 2 weeks. magnetic resonance imaging scans performed 1 year after surgery revealed the patient was still disease-free. CONCLUSION: Hydatid disease should be considered in the differential diagnosis of spinal cord compression, especially in endemic areas. Although the chance of obtaining a cure is unlikely, radical surgery coupled with antihelminthic therapy seems to provide long-lasting relief.
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5/7. A rare case: spontaneous cutaneous fistula of infected splenic hydatid cyst.

    Hydatid disease is caused by the larval stage of the genus echinococcus. Live hydatid cysts can rupture into physiologic channels, free body cavities or adjacent organs. Although hydatid disease can develop anywhere in the human body, the liver is the most frequently involved organ, followed by the lungs. cysts of the spleen are unusual. There are only five case reports of spontaneous cutaneous fistulization of liver hydatid cysts in the literature. But there isn't any report about cutaneous fistula caused by splenic hydatid cyst. We report a first case of spontaneous cutaneous fistula of infected splenic hydatid cyst. A 43-year-old man was admitted to our Emergency Service with abdominal pain and fluid drainage from the abdominal wall. He has been suffering from a reddish swelling on the abdominal wall skin for four months. After a white membrane had been protruded out from his abdominal wall, he was admitted to our Emergency Service. On physical examination, a white membrane was seen to protrude out from the 2 cm x 1 cm skin defect on the left superolateral site of the umblicus. Large, complex, cystic and solid mass of 9.5 cm-diameter was located in the spleen on ultrasonographic examination. At operation, partial cystectomy and drainage was performed. After the operation, he was given a dosage of 10 mg/kg per day of albendazole, divided into three doses. He was discharged on the postoperative 10(th) d. It should be kept in mind that splenic hydatid cysts can cause such a rare complication.
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6/7. Hydatid disease of the heart.

    A 27-year-old physical education teacher, from a rural sheep farming area of south africa, was referred following an isolated episode of collapse. Transthoracic echocardiography and MRI showed a cystic lesion under the septal leaflet of the tricuspid valve attached to the right ventricular wall. A provisional diagnosis of hydatid cyst was made. Hydatid serology was negative and there was no evidence of hydatidosis elsewhere. Preoperatively, the patient was treated with praziquantel and albendazole. Surgery was performed using cardiopulmonary bypass. Cyst was excised without any spillage. The patient was weaned off bypass without any support and made an uneventful recovery. Cytology and microbiology of the specimen confirmed hydatid pathology. This case describes excision of a right ventricular hydatid with techniques used to avoid spillage. It also describes an up-to-date antihelminthic therapy used in the management of hydatid cysts.
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keywords = physical
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7/7. Unilocular hydatid cyst of the kidney in a child: a diagnostic challenge.

    A case of an unilocular renal hydatid cyst in a 10-year-old French girl without any notion of travelling in a foreign country is reported. In children affected by renal echinococcosis, clinical symptoms and physical examination are nonspecific. Among the diagnostic procedures, the role of echography in the assessment of the diagnosis is pointed out.
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