Complete Resolution of Bilateral Pulmonary Hydatid Cysts with Prolonged Administration of Albendazole: A Rare Occurrence

Hydatid disease is a zoonotic disease caused by Echinococcus species. Echinococcus granulosus is the most common species which is responsible for hydatid disease in the humans who act as accidental intermediate hosts in the life cycle of the parasite. Pre-operative albendazole therapy followed by surgery is the mainstay of treatment for pulmonary and hepatic hydatid cyst at present. Not much data is available to support the sole use of albendazole for complete cure apart from its usage for those patients who have refused surgery or cannot undergo surgery because of any reason. We hereby report the case of a 12 year old female patient who was diagnosed with bilateral pulmonary hydatid cysts that responded well to Albendazole 15mg/kg /day given for a period of nine months with a drug free interval of one week every month. There was complete clinical and radiological resolution of hydatid cyst after the treatment. There has been no recurrence on follow-up of one year.

Evaluation of Two ELISA and Two Indirect Hemagglutination Tests for Serodiagnosis of Pulmonary Hydatid Disease

To establish a definite diagnosis for pulmonary hydatid disease, combination of radiology and serology is useful. In this study, 19 preoperative sera from patients with surgically confirmed pulmonary hydatidosis, 40 sera from patients with other parasitosis and pulmonary diseases, and 20 sera from healthy donors were evaluated using 4 different serological tests, i.e., the commercial ELISA (ELISA-kit) test, the ELISA (ELISA-lab) test prepared in our laboratory, the commercial indirect hemagglutination assay kit (IHA-kit) test, and the IHA test using sensitized sheep red blood cells with tannic acid (IHA-TA). The ELISA-kit was the most sensitive (84.2%) and the most specific test (100.0%). The ELISA-kit also demonstrated the highest positive (100.0%) and negative (95.2%) predictive values. The sensitivity of the ELISA-lab test, that we prepared, was found to be 73.6%, whereas the IHA-kit test and the IHA-TA test were found to be 73.6% and 68.4%, respectively. The specificity of these tests was 96.6%, 98.3%, and 83.3%, respectively. When all 4 tests were assessed together, it was found that the sensitivity had risen to 94.7%. When the ELISA-kit was assessed with the IHA-kit and IHA-TA together, it was found that the sensitivity was 89.5% and 84.2%, respectively. Likewise, the combination of the ELISA-lab and IHA-kit or IHA-TA allowed us to achieve a sensitivity of 84.2% in cases of pulmonary echinococcosis. In conclusion, the diagnosis would be imminent if least 2 tests were applied together.