Use of CT and ultrasound imaging and serology in the diagnosis of abdominal hydatid cysts in an area of high endemicity

During a 12 month period a total of 1513 patients were scanned by either CT or US, for various abdominal disorders. One hundred and twenty four [8.2%] of these were specifically referred for clinically suspected abdominal hydatid disease. Hydatid cysts were diagnosed by CT in 83.3% of cases, and by US in 78.6% cases. Serological and skin tests, using indirect haemagglutination and counter immunoelectrophoresis tests and the Casoni test, were positive in 68.1% of cases. Both CT and US accurately defined single and multiple cysts, predominantly in the liver, according to their size, location and morphological form. CT images were subjectively more precise. Surgical and histological confirmation in 48 cases provided the basis of comparing the relative sensitivity of the three diagnostic approaches: 100.0% for CT. 89.5% for US and 85.4% for serology, in 41 proven hydatid cases. The differences are not statistically significant. Owing to the very small number [7] of cases in which surgical confirmation of non-hydatid lesions was available, the relative specificity of the 3 methods could not be determined. There was, however, no significant difference between the diagnostic accuracy of CT [88.9%], US [81.0%] and serology [85.4%]

Death following a series of anaphylactic crises in a case of multiple pulmonary hydatidosis treated with mebendazole

A young girls presented as a case of mediastinal and sub-cutaneous emphysema. Records showed that she had had 2 previous thoracotomies and a lower lobectomy to remove multiple hydatid cysts. X-rays showed cystic shadows along the right base of mediastinum and the right cardiophrenic angle. She had repeated attacks of anaphylaxis and each time responded to hydrocortisone, aminophylline, and antihistaminics. During one of her stable periods, she was started on mebendazole in 3 divided daily doses of 600, 900 and 1200 mg for the first 3 successive days, and thereafter on 1200 mg daily. She continued to have recurrent anaphylaxis which was attributed to her sensitization to hydatid fluid antigen from a slow leaking hydatid cyst [S]. Her IgE levels, CFT and IHA titres were depressed. Thirty days after the start of mebendazole treatment, she had the final attack of acute respiratory distress with restlessness and sweating. Despite the use of hydrocortisone and aminophylline, she went into an anaphylactic shock and all efforts to resuscitate her failed

relationship between abortion and infection with toxoplasma gondii and listeria monocytogenes

A group of 41 women with a previous history of abortions was examined for toxoplasmosis by the IHA and IFAT tests. Cervical swabs and blood samples were cultured for listeriosis. Twelve multigravidae with no previous history of abortions acted as controls. The were five [12.2] abortions/stillbirths in the test group, and none in the control group. All five, however, were negative for listeriosis and two of the five were also negative for toxoplasmosis by both the serological tests. While seropsitivity for toxoplasmosis was significantly [x2 test at 5% level] higher in the test group with IFAT, there was no statistically significant difference between the two groups using the IHA test. There was no apparent correlation between abortions/stillbirths and the number of previous abortions in the test group. A causal relationship between abortions/stillbirths and seropositivity for toxoplasmosis and culture positivity for listeriosis is not established