Hydatid cyst involving the mandible ramus

ABSTRACT Parasitic infections rarely involve the oral and maxillofacial regions and pose a diagnostic challenge when they do. Hydatid cysts are parasitic cysts caused by Echinococcus granulosus. Intraosseous involvement is observed in 3% of cases, of which only 2-6% are in the maxillofacial region. A scientific literature search revealed only seven cases involving the mandible. We report a rare case in a 16-year-old female patient who presented with facial asymmetry and well-defined radiolucency of the ramus. Our findings will help in understanding the diagnostic issues caused by non-specific presentation and difficulties in suspecting such a rare diagnosis as echinococcosis of the oral or maxillofacial region. A thorough systemic investigation is essential as 20-30% of these cases show multiorgan involvement.

Giant Hydatid Cyst of Lungs

Introduction: Hydatid disease in humans is caused by zoonotic parasites, after accidental ingestion of food contaminated by ova of Echinococcus granulosus. Giant hydatid cyst of the lung is most commonly seen in children, but it is rare in human adults. The lung is the second most common organ affected by hydatid diseases after the liver in humans. History and radiological findings are usually helpful in diagnosing hydatid cysts, but serology can add to the diagnosis. A small pulmonary cyst may be asymptomatic; however, giant or ruptured cysts may develop fatal complications. The surgical intervention followed by pharmacological therapy is the treatment of choice for giant hydatid cysts of the lungs. Case description: Here, we present a case of giant right-side hydatid cysts, presented with complaints of dyspnea, fever, and hemoptysis. The patient was successfully managed by right thoracotomy with an uneventful postoperative course. Conclusion: Giant hydatid lung cysts can present with any respiratory symptoms with fatal outcomes. Surgery followed by pharmacotherapy is the treatment of choice for giant pulmonary hydatid cysts.

Hematological and histopathological changes of rat’s hearts experimentally infected with protoscoleces

@#Hydatidosis; is a zoonotic disease caused by Echinococcus granulosus and characterized by infiltration of inflammatory cells. This study was investigated the hematological and histopathological changes in the hearts of rats injected with protoscoleces. Rats were injected with protoscoleces collected from either liver of sheep, goats, and cows (from the abattoir of Al-Muthanna province, south of Iraq) or isolated from infected humans from Al-Hussein Teaching Hospital. Sheep protoscoleces showed a significant increase of lymphocytes that refer to the induction of a high response of the immune system in rats. The numbers of WBC, RBCs, and platelets were generally increased in rats injected with protoscoleces isolated from sheep and goats. These changes could refer to the activation of defense mechanisms against the hydatid injected materials. However, the levels of MCV, MCH, MCHC, MPV and PDW were less than normal values. Heart sections of rats injected with protoscoleces isolated from humans showed clear histological changes. While TSP, TGP and TCP exhibited variant histopathological changes such as infiltration of inflammatory cells, pink glass appearance and congestion of arteries. Thus, these alterations can be considered as additional evidence of how the immune response reacts against the injected materials in the heart.

Left lung and liver hydatid cyst: managed in single surgery

A 35 years male presented with history of pain left chest wall associated with cough, fever and blood in sputum on and off, complaint of pain in abdomen which was dull aching gradually progressive in nature since, 2 months. Radiologically diagnosed to have huge hydatid cysts both in left lung and liver. It is unusual to find such large cysts at multiple sites and organs as in this case. There are reports in the literature of staged management as well as simultaneous management of lung and liver hydatid cysts. Though concomitant cysts in lung and liver may be treated comfortably by one stage surgery. Here both cysts were enucleated in the same sitting by a combined thoracic and abdominal approach (left thoracotomy followed by laparotomy through right subcoastal incision). The technique is safe and results were comparable to two stage surgery. Albendazole treatment in post-operative period helps to prevent recurrence. This report emphasizes that surgical intervention for hydatid cysts at multiple sites done in a single stage is safe, lessens the financial burden and hospital stay by avoiding multiple surgeries and anaesthesia.

Quiste hidatídico subcutáneo: reporte de dos casos en Huancayo, Perú / Subcutaneous hydatidic cyst: report of two cases in Huancayo, Peru

RESUMEN La hidatidosis es una infección zoonótica que puede invadir múltiples órganos en el ser humano. Sin embargo, el tejido subcutáneo es el órgano menos afectado por esta enfermedad, cuando esto ocurre se aprecia escasa sintomatología, lo que ocasiona periodos prolongados de enfermedad asociado a diagnóstico tardío y a una pobre respuesta a la terapia antiparasitaria. La sierra central del Perú es la zona con mayor prevalencia, presumiblemente por las inadecuadas medidas de saneamiento ambiental, la falta de educación y las casi inexistentes medidas de control de la enfermedad. Con el objetivo de discutir los problemas relacionados a la localización subcutánea y su probable fisiopatología, reportamos dos casos de hidatidosis subcutánea que se presentaron con lesiones tumorales de evolución prolongada y que no afectaron al hígado ni a los pulmones y que finalmente fueron tratados mediante extirpación quirúrgica debido a la falta de respuesta al tratamiento con albendazol.

ABSTRACT Hydatidosis is a zoonotic infection that can invade many organs in the human being. Nevertheless, the subcutaneous tissue is the less affected organ by this disease. When this disease appears, little symptomatology is observed, which causes prolonged periods of disease associated to delayed diagnosis and a poor answer to the antiparasitic therapy. The central mountain range of Peru is the geographical zone with the greatest prevalence, presumably due to the inadequate measures of environmental sanitation, the lack of education and the almost non-existent control measures of the disease. With the aim to discuss the problems related to the subcutaneous location and its probable physiopathology, this study reports two cases of subcutaneous hydatidosis that appeared with tumor lesions with a prolonged evolution and that did not affect the liver or the lungs and which were finally treated by means of surgical removal due to the lack of response to treatment with albendazol.

Radical versus conservative surgical treatment of liver hydatid cysts: a meta-analysis / 医学前沿

To date, the efficacy of radical surgery (RS) versus conservative surgery (CS) for liver hydatid cysts (LHC) remains controversial. This meta-analysis was conducted to compare the two interventions. PubMed, Embase, and Web of Science were searched from their inceptions until June 2016. Meta-analysis was performed using STATA 12.0 software. We identified 19 eligible studies from 10 countries by retrieval. In total, 1853 LHC patients who received RS were compared with 2274 patients treated by CS. The risk of postoperative overall complication, biliary fistula, and recurrence was significantly lower, and operation time was significantly longer in the RS group. However, no statistically significant differences were found in terms of mortality risk and the duration of hospital stay between RS and CS. No significant publication biases were observed in all the above analyses. In conclusion, RS reduces the rates of postoperative complications and recurrence, whereas no trend toward such a reduction in mortality was observed in LHC patients.

Pregnancy Following Surgery Of Multiple Pelvic Hydatid Cysts.

Abstracts: Background: Hydatid cyst in pelvic region is very rare. A patient was admitted in Gynaec ward with complaints of , lump and pain in lower abdomen and, constipation since, five months. General examination was normal. Abdominal and gynaecological examination lead to diagnoses as ovarian cyst ? Multiple uterine subserous fibroids? Ultra sonography diagnosis was Hydatid cysts abdomen / Mucininious cystadenoma ovaries . CT Scan abdomen and pelvis confirmed USG findings of Hydatid cysts. On Laprotomy multiple hydatid removed from pelvic region , omentum , ileocaecal junction and liver . Patient put on chemotherapy and follow up was satisfactory.

Ultrasonographic and Computed Tomography Evaluation of Hydatid Disease

Echinococcosis has always been an endemic disease. It remains today a common surgical condition in many parts of the Kurnool district, carrying a significant morbidity and mortality. The development of real-time ultrasound and computed tomography (CT) with greater imaging versatility and diagnostic accuracy has resulted in a change. To know the precise location of the cysts, number, multiple organ involvement, complications like infection, cyst rupture, mass effect, etc., by ultrasound and CT. To measure the size and depth of the cysts in an organ thereby indicating their operability or otherwise monitor the response to medical treatment. A study of 30 patients with palpable abdominal masses, pulmonary cysts, renal cysts, etc. was undertaken. Data was collected based on clinical features, plain radiographic, ultrasonographic and computed tomographic findings. Thirty cases were studied and analyzed according to their anatomical distribution, age, sex distribution, multiplicity of lesions, multi organ involvement and sonographic appearance. With the aim of ultrasonographic and CT evaluation of hydatid disease, 30 cases studied and analysed. Eighteen cases were in males and twelve were in females. Hepatic hydatids comprised the largest group with 26 cases out of 30 cases with next largest pulmonary hydatid cysts. Multiplicity of cysts was noted in eight cases and multiple organ involvement was seen in seven cases. The preponderance of hepatic hydatid cysts is more in 3rd to 5th decades and in 2nd to 6th decades in cases of lung cysts. Right lobe of liver is more involved than the left one.

Rare Coexisting Primary Hydatid Cyst and Mucinous Cyst Adenoma of Right Ovary.

The human hydatid cyst is caused by different species of the tapeworm of genus Echinococcus. In past literatures, the existence of hydatid cysts in various organs has been documented, but one pertaining to the ovary, especially with a coexisting mucinous cystadenoma is an enigma, with an incidence between 0.2 and 2.25%. In our case, a 70-year-old lady presented with a huge ovarian cyst, which was macroscopically and histopathologically proven to be the concomitant existence of a mucinous cyst of ovary and a cluster of mother and daughter hydatid cysts. In this case, no other organ showed evidence of hydatid cysts, notably the liver and lungs, the two commonest sites of involvement.

Multiple Intracranial Hydatid Cysts: A Rare Presentation.

Cerebral hydatid disease is rare accounting for only 1-2% of intracranial space occupying lesion and usually manifests as solitary cystic nonenhancing lesions usually in the MCA territory distribution. It is even rarer to find multiple intracranial hydatid cysts or polycystic disease. We hereby report an interesting and unusual presentation of a patient with multiple intracranial hydatid cysts with a few showing inflammatory edema and minimal rim enhancement, a rare manifestation and review the literature.

Lesões parasitárias encontradas em bovinos abatidos para consumo humano / Parasitic lesions observed in cattle slaughtered for human consumption

During a period of 28 months (January 2011-April 2013) periodical visits were made to four cattle slaughter houses to collect samples of lesions found in cattle slaughtered for human consumption. Three hundred and three lesions were collected, 25% of which were caused by six different parasites: The metacestodes of Echinocccus granulosus (hydatid cysts), Fasciola hepatica, the metacestodes of Taenia saginata (Cysticercus bovis), Oesophagostomum radiatum, Eurythrema coelomaticum, and Paramphistomum cervi. Gross and microscopic aspects of the lesions caused by these worms are profusely illustrated and a detailed description of both pathological aspects, gross and microscopic, are provide in the hopes that the neophyte veterinary meat inspector can benefit from them in the task of recognition and interpretation of the significance of these lesion both to human and animal health. In regard to the two latter objectives, the life cycle, and the pathogenicity to the animal and human hosts, and the destination of the affected carcass or organ in the line of inspection are discussed for each parasite.

Durante um período de 28 meses (janeiro 2011-abril 2013) foram feitas visitas periódicas a quarto abatedouros frigoríficos de bovinos para colher lesões regularmente encontradas em bovinos abatidos para consumo humano. Trezentas e três lesões foram colhidas, 25% das quais eram causadas por seis parasitas diferentes: o metacestoide de Echinocccus granulosus (cisto hidático), Fasciola hepatica, o metacestoide de Taenia saginata (Cysticercus bovis), Oesophagostomum radiatum, Eurythrema coelomaticum e Paramphistomum cervi. Os aspectos macro e microscópicos causados por esses vermes são profusamente ilustrados e uma descrição macro e microscópicadas lesões é fornecida na esperança de auxiliar o inspetor de carnes iniciante na tarefa de reconhecer e interpretar o significado dessas lesões tanto para a saúde animal quanto para a saúde humana. Com respeito a esses últimos objetivos, o ciclo evolutivo, e os efeitos nos hospedeiros animal e humano, e ainda a destinação da carcaça ou órgão afetado na linha de inspeção, são discutidos para cada parasita.

Quiste hidatídico renal: reporte de un caso / Renal hydatid cyst: case report

INTRODUCCIÓN: La hidatidosis es una parasitosis endémica en Chile. Los órganos más frecuentemente afectados son hígado y pulmón. Otras localizaciones, tales como la renal son infrecuentes e implican dificultades diagnósticas. PRESENTACIÓN DEL CASO: Mujer de 25 años, sin antecedentes mórbidos, que consulta por dolor lumbar de un mes de evolución, hematuria autolimitada y distensión abdominal, sin hallazgos patológicos al examen físico En sus estudios de laboratorio realizados en Hospital Base de Puerto Montt, Chile, destaca leucocitosis de 13.500 células/mm3 con eosinofilia relativa de 31,4 por ciento, Velocidad de Eritrosedimentación de 74 mm/h y función renal normal. Se solicita ecotomografía abdominal, en la cual se encuentra un quiste renal izquierdo complejo, hallazgo complementado con Tomografía Axial Computada abdomino-pélvico, la cual confirma quiste renal izquierdo de 13 centímetros de diámetro sin aspecto tumoral y quiste en fosa ilíaca izquierda en posición paravesical e hígado sin lesiones. Adicionalmente se realiza radiografía de tórax, la que resulta de aspecto normal. Se realiza Test para Hidatidosis que resulta positivo. Posteriormente, ante la sospecha de hidatidosis renal, se inicia tratamiento con Albendazol 400 mg al día durante 45 días y posteriormente quistectomía renal, evolucionando de forma satisfactoria. Se decide diferir cirugía de quiste paravesical. DISCUSIÓN: La localización renal de un quiste hidatídico es infrecuente y corresponde a menos del 2 por ciento de los casos, el diagnóstico de un quiste complejo renal debe considerar como diagnóstico diferencial la posibilidad de un quiste hidatídico.

INTRODUCTION: Hydatidosis is an endemic parasitic disease in Chile. The main organs affected are the liver and lungs. Other locations, such as the kidneys, are infrequent and involve diagnostic difficulties. CASE REPORT: A 25 year old woman with no previous history of morbid diseases consulting for a one month evolution of lumbar pain, self-limited hematuria and abdominal distension, with no abnormaities on physical examination. In her laboratory studies there was leukocytosis of 13,500 cells/mm3 with relative eosinophilia of 31.4 percent erythrocyte sedimentation rate (ESR) of 74 mm/h and normal renal function. Abdominal ultrasound found a complex left renal cyst, which was complemented with an abdomen and pelvis computerized axial tomography (CT), which confirmed a 13-centimeter left renal cyst without tumor-like appearance. Additionally, chest x-ray shows normal appearance. Enzyme-linked immunosorbent assay (ELISA) for hydatidosis is performed, which results positive. Subsequently, and based on the renal hydatid disease suspicion, she was treated with Albendazole 400 mg per day for 45 days followed by renal cystectomy, evolving satisfactorily. It was decided to defer paravesical cyst surgery. DISCUSSION: Renal hydatid cysts are rare and correspond to less than 2 percent of all cases. The diagnosis of kidney cyst should consider the hydatid cyst as a differential diagnosis.

Mechanical suction through wide bore catheters for nonsurgical management of Gharbi type III hepatic hydatid cysts.

Aim: To present our experience with management of complex hepatic hydatid cysts (Gharbi type III), using percutaneous large bore catheter drainage followed by active mechanical suction of cyst contents. Methods: Eleven patients (6 males and 5 females with a mean age of 43.2 years), with 13 complex Gharbi type III hepatic hydatid cysts were included in the study. Under sonography guidance the complex heterogeneous hepatic hydatid cysts were treated percutaneously using large bore drainage catheter and active mechanical suction. Results: Successful drainage of all 13 complex Gharbi type III hepatic hydatid cysts was achieved in all patients (n = 11). The mean duration of catheter placement was 11.3 days (range 7 to 40 days). The most common problem encountered was biliary fistula (n = 3), which was effectively managed with prolonged catheter drainage and/ or endoscopic intervention. No serious complications or deaths were encountered. Minor complications were seen in 7 patients including, urticaria in 3, fever in 2 and reactive pleural effusion in 3. All patients responded to symptomatic treatment. Follow up serial ultrasound was performed on all patients, that showed near complete healing in 9 and formation of pseudotumour in 4 patients. There was no recurrence with a mean follow up of 15.23 months (6 months – 2 years). Conclusion: Percutaneous suction and large bore catheter drainage of Gharbi type III hepatic hydatid cysts is a safe and effective alternative therapy.

Laparoscopic treatment of hepatic hydatid cysts:a report of 120 cases / 中国普通外科杂志

Objective To summarize the clinical experience of laparoscopic treatment of hepatic hydatid cysts. Methods The clinical data of 120 patients with hepatic hydatid cysts who received laparoscopic endocyst extraction were retrospectively analyzed .Results The procedure was successful in all cases with no intraoperative leakage of fluid from the hepatic hydatid cysts or occurrence of anaphylactic shock. Postoperatively, there were 4 cases of recurrence , 8 cases of biliary fistula, 8 cases of residual cavity hydrops, and 1 case of postoperative bleeding.All of the cases were cured.The mortality in our study was zero.Conclusions Laparoscopic extraction of endocyst of hepatic hydatid cysts is a safe and effective procedure.