Pulmonary echinococcosis: A rare pseudotumour of the lung.

Cystic echinococcosis is a widely endemic helminthic disease worldwide but occurs only rarely in Central Europe. Humans are infected as 'aberrant' hosts by Echinococcus granulosus and develop cysts in numerous different organs. 20%-30% of the affected individuals develop hydatid disease in the lungs with associated complications including pleuritis, lung abscess and pneumothorax. Radiologically, the pulmonary lesions of cystic echinococcosis occasionally pose difficulties in the differential diagnosis of primary lung carcinoma or metastatic disease and vice versa. Herein we report on a case of pulmonary hydatid disease in a 25-year-old Iraqi male presenting with a cystic lesion of the lung associated with thoracic pain and involuntary weight loss. Despite of its rare occurrence in Central Europe, clinicians, radiologists and pathologists should be aware of this entity and its pulmonary manifestations. During frozen section examination, imprint cytology specimens may facilitate the detection of the pathogens.

Right-Sided Cardiac Hydatid Cyst Complicated With Pulmonary Embolization: A Pediatric Case Report.

Echinococcosis is an endemic zoonotic parasitic infection found in Morocco, due to Echinococcus granulosus. Cardiac localization is a rare form, presenting in various ways. The right heart is an uncommon site of cardiac involvement. We report a case of a right-sided cardiac hydatid cyst complicated with multiple pulmonary embolism, revealed by dyspnea at rest, in a 15-year-old male. The patient successfully underwent surgical removal which confirmed the diagnosis. This case report demonstrates one of the various clinical presentations of this condition, and the importance of early treatment in order to prevent its potentially fatal complications, particularly in the young.

Ruptura aguda de quiste hidatídico hepático hacia tórax / Acute rupture of a liver hydatid cyst into the thorax

El quiste hidatí­dico es una enfermedad parasitaria humana causada por el estado quí­stico del parasito Echinococcus granulosus. En el Perú hay zonas hiperendémicas de hidatidosis humana. Los quistes hidatí­dicos hepáticos son los más frecuentes, y la ruptura hacia el tórax es rara, siendo menor de 1% de los casos. Presentamos el caso de una paciente con quiste hidatí­dico hepático roto agudamente hacia tórax que es una patologí­a de difí­cil abordaje y de alto riesgo para el paciente y como fue resuelto en forma multidisciplinaria. (AU)

Hydatid cyst is a human parasitic disease caused by the cystic stage of Echinococcus granulosus. There are hyperendemic areas of hydatidosis in Peru. Liver involvement is the common affection of the disease, rupture of liver cysts into the thorax is rare (less than 1% of cases). We present the case of a female patients who presented with a liver cyst rupture to the thorax, a multidisciplinary approach was needed to cure the patient. (AU)

Elevated incidence of alveolar echinococcosis in immunocompromised patients.

INTRODUCTION: Recent experimental data has revealed that the course of alveolar echinococcosis (AE) depends on adaptive immunity. For this study, we aimed to analyze the incidence and outcome of AE in immunocompromised humans. MATERIAL AND METHODS: Retrospective analysis of 131 patients with a median age of 54 years treated for AE between 1971 and 2017 at a Swiss tertiary referral Centre. Fifty-two percent were females and 65 patients (50%) were diagnosed incidentally. Fourteen patients (16%) were operated on laparoscopically. Overall, median follow-up was 48 months. RESULTS: New diagnoses have increased fourfold in immunocompetent and tenfold in immunocompromised patients in the past decade (p ≤ 0.005). Forty-one patients (31.3%) had co-existing or previous immunosuppressive conditions including 16 malignancies (36%), 11 auto-immune diseases or immunosuppressive therapies (31%), 5 infectious diseases (11%), 4 chronic asthma conditions (9%), 2 previous transplantations (4%) and 4 other immunocompromising conditions (9%). Serum levels of anti-Em18, -Em2 and -EgHF antibodies were neither associated with immunocompetence at diagnosis nor during follow-up, but significantly decreased after treatment with benzimidazole (n = 43) or surgery (n = 88) in all patients. Adjuvant therapy for ≥1 year (p = 0.007) with benzimidazole and resection status (R0) (p = 0.002) were both correlated with recurrence-free survival. Survival at 5 and 10 years after surgery was 97% and 94%, respectively, and after conservative treatment 91% and 73%, respectively. Curative surgery (p = 0.014) and immunocompetence (p = 0.048) correlated significantly with overall survival. CONCLUSION: The incidence of human AE has increased over the last 2 decades with surgical interventions resulting in excellent outcomes. We have observed an association of immunosuppressive conditions with both incidence and survival of AE eventually justifying the implementation of a screening program for patients at risk in endemic regions.

Periprosthetic pathologic fracture following tibial Echinoccocosis: A case report.

INTRODUCTION: Hydatid disease in humans caused by the parasitic tapeworm Echinococcus granulosus has an osseous involvement of about 0.5%-2.5% of all cases in humans. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis and treatment is challenging. CASE REPORT: This paper presents a patient, with a long term, well tolerated, bilateral total knee arthroplasty (TKA), treated at our clinic, with a recent history of pain and oedema in her left upper leg. After achieving a, radiologically and histhopathologically, well documented, diagnosis of Echinoccocosis lesion in her left proximal tibia, a surgical intervention was planed, a wide resection of the cyst performed, and a specific anti-helmintic therapy was instituted. Four years later, she returns to our observation complaining of pain and unable to bear weight on her left knee, from which a pathologic fracture, adjacent to the tibial component, was diagnosed. After surgical debridement of the newly advanced hydatid cyst growth, the TKA was revised, and due to the tibial component failure and the femoral implant loosening, a semi-constrained total knee revision arthroplasty was executed. Functional outcome was excellent. CONCLUSION: Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce, and those resulting in a prosthetic failure have not been published. The authors intend to add data concerning the therapeutic approach to this entity.

Quiste hidatídico intracardíaco en una niña: Reporte de caso / Cardiac Hydatid Cyst in a Child: A Case Report

RESUMEN La equinococosis es una infección parasitaria provocada por Echinococcus granulosus, que, en su estado quístico, forma al denominado quiste hidatídico. Presenta morbilidad importante, con posibles secuelas relacionadas con la ubicación, y altos costos debido al tratamiento quirúrgico y farmacológico prolongado. El hígado y el pulmón son las ubicaciones anatómicas más usuales, mucho más raras son el riñón, bazo, cerebro y corazón, este último representa el 0,5 % a 2 % del total de casos. El Perú es un país endémico de esta antropozoonosis y principalmente registra casos procedentes de la sierra central (95 %). Se presenta el caso de una niña de diez años, con diagnóstico de esta entidad, clasificación ecográfica CE 1, grupo clínico 1 (confirmado por anatomía patológica) con posterior tratamiento quirúrgico y farmacológico específico (albendazol). La paciente se recuperó satisfactoriamente de la cirugía practicada, y fue dada de alta a los 16 días, sin complicaciones.

ABSTRACT Echinococcosis is a parasitic infection caused by Echinococcus granulosus, which, in its cystic state, forms the socalled hydatid cyst. It presents important morbidity, with possible sequelae related to the location, and high costs due to surgical and prolonged pharmacological treatment. The liver and the lung are the most common anatomical locations, and much rarer are the kidney, spleen, brain, and heart, where the latter represents 0.5 to 2% of total cases. Peru is an endemic country of this anthropozoonosis and mainly records cases in the central highlands (95%). This paper presents the case of a 10-year-old girl, diagnosed with this disease, CE1 ultrasound classification, clinical group 1 (confirmed by pathological anatomy) with specific surgical and pharmacological treatment (albendazole) afterward. The patient recovered satisfactorily from the surgery and was discharged at 16 days, without complications.

Evaluación de echinococcosis canina en la zona de alta montaña en la provincia de Tucumán, Argentina / Evaluation of canine echinococcosis in the high mountain area of province of Tucumán, Argentina / Avaliação de equinococose canina na zona de alta montanha na província de Tucumán, Argentina

La echinococcosis es un serio problema para la salud pública en Argentina. Es una zoonosis producida por el cestode de la familia Taeniidae, Echinococcus granulosus, siendo el perro el principal hospedador definitivo. El objetivo de este trabajo fue evaluar la echinococcosis en perros en la zona de alta montaña de la provincia de Tucumán. La principal actividad económica en esta zona es la cría de ganado para consumo familiar, sobre todo ovino. Las condiciones climáticas, las distancias y la falta de movilidad adecuada hacen difícil el acceso a los servicios de salud y a los establecimientos educativos. Se evaluaron seis parajes en un primer estudio con 103 muestras de materia fecal canina y se encontró que el 39,8% (41/103) fueron positivas. El estudio se repitió en dos localidades después de desparasitar a los perros mensualmente durante dos años. En estas áreas se observó una disminución de muestras con resultado positivo; en Chaquivil la variación fue del 57,1% al 10,0% y en San José de Chasquivil, fue del 47,1% al 11,1%. Estos resultados llevan a la conclusión de que es necesario realizar y planificar las actividades de control. Sería de suma importancia realizar la evaluación en otras localidades.

Canine echinococcosis is a serious public health problem in Argentina. It is a parasite zoonosis produced by a cestode of the Taeniidae family, Echinococcus granulosus, the dog being the principal definite host. The objective of this work was to evaluate echinococcosis in dogs in the high mountain area of the province of Tucumán. The main economic activity in this area is livestock breeding, mostly sheep, for family consumption. Climate conditions, distances and the lack of adequate mobility make it difficult to access to health services and educational facilities. Six places of the region were evaluated. The first study was carried out with 103 samples of canine faeces, 39.8% (41/103) being positive. The study was repeated in two localities, after deworming dogs monthly for two years. In these areas, a decrease of positive specimens was obtained: in Chaquivil, variation was 57.1% to 10.0% and in San José de Chasquivil, it was 47.1% to 11.1%. These results lead to the conclusion that it would be necessary to conduct and plan control activities. The assessment of other locations would be of utmost importance.

A equinococose é um problema sério para a saúde pública na Argentina. É uma zoonose produzida pelo cestode da família Taeniidae, Echinococcus granulosus, sendo o cão o principal hospedeiro definitivo. O objetivo deste trabalho foi avaliar a equinococose em cães na zona de alta montanha da Província de Tucumán. A atividade econômica principal nesta zona é a criação de gado para consumo familiar, principalmente o ovino. As condições climáticas, as distâncias e a falta da mobilidade adequada tornam difícil o acesso aos serviços da saúde e aos estabelecimentos educacionais. Seis lugares da região foram avaliados num primeiro estudo com 103 amostras da matéria fecal canina, sendo que 39.8% (41/103) foram positivas. O estudo foi repetido em duas localidades, depois de desverminar os cães mensalmente durante dois anos. Nessas áreas foi observada uma diminuição de amostras com resultado positivo; em Chaquivil a variação foi de 57.1% para 10.0% e em San José de Chasquivil, foi 47.1% para 11.1%. Estes resultados levam à conclusão de que é necessário realizar e planejar as atividades do controle. Seria de extrema importância fazer a avaliação em outras localidades.

Estudio de infestación de caninos con Echinococcus granulosus en la provincia de La Rioja, Argentina / Study of infestatioon of dogs with Echinococcus granulosus in the province of La Rioja, Argentina

Este trabajo fue realizado en la provincia de La Rioja, ubicada en el noroeste argentino. El objetivo fue estimar el porcentaje de heces de caninos con presencia de antígenos de Echinococcus sp. en las distintas regiones de la provincia. Se tomaron un total de 269 muestras de materia fecal seca de caninos, que fueron analizadas por la técnica de copro-ELISA. La zona más afectada fue la zona IV, que contó con un 30,5% de muestras positivas. La zona I, que corresponde al Departamento Capital, tuvo un 12% de positividad. En el resto de las zonas, los porcentajes variaron entre el 11,4 y el 14,8%. Este es el primer estudio en la provincia sobre la existencia de la enfermedad en caninos. La falta de estrategias para el control de la equinococosis ha permitido la dispersión de la enfermedad

This work was conducted in the province of La Rioja, located in northwestern Argentina. The aim of this study was to estimate the percentage of dog feces showing the presence of antigens of Echinococcus sp. in different regions of the province. A total of 269 samples of dried canine stool were taken, which were analyzed by the copro-ELISA technique. The most affected area was zone IV, which had 30.5% of positive samples. Zone I corresponding to the Capital Department of the province had 12% of positivity. In other areas, the percentages ranged between 11.4% and 14.8%. This is the first study in the province of La Rioja on the existence of this disease in dogs. The lack of control strategies has allowed the spread of echinococcosis

[Study of infestation of dogs with Echinococcus granulosus in the province of La Rioja, Argentina]. / Estudio de infestación de caninos con Echinococcus granulosus en la provincia de La Rioja, Argentina.

This work was conducted in the province of La Rioja, located in northwestern Argentina. The aim of this study was to estimate the percentage of dog feces showing the presence of antigens of Echinococcus sp. in different regions of the province. A total of 269 samples of dried canine stool were taken, which were analyzed by the copro-ELISA technique. The most affected area was zone IV, which had 30.5% of positive samples. Zone I corresponding to the Capital Department of the province had 12% of positivity. In other areas, the percentages ranged between 11.4% and 14.8%. This is the first study in the province of La Rioja on the existence of this disease in dogs. The lack of control strategies has allowed the spread of echinococcosis.

Abordaje transtorácico para la hidatidosis pulmonar derecha y hepática concomitante / Transthoracic approach for concurrent right lung and liver hydatid cysts

Introduction: Pulmonary and hepatic hydatid disease occurs concomitantly in 4 to 33 percent of cases. When the condition is localized in the right lung and liver dome surgical resolution in one time is possible. Objective: To describe the transthoracic-transfrenic approach and review the available literature. Material and Methods: We report two cases operated at our institution through a right posterolateral thoracotomy and frenotomy in one stage, with uneventful postoperative evolution. A systematic review of the literature was conducted in the PubMed database period 1990-2011. Five studies met the inclusion criteria. Conclusions: Transthoracic-transfrenic approach is feasible and safe, allowing the surgical resolution in one time through a single incision, without another anesthetic procedure or subsequent laparotomy, with low morbidity and mortality.

Introducción: La hidatidosis pulmonar y hepática concomitante se presenta en el 4 a 33 porciento de los casos. Cuando la afección está localizada en el pulmón derecho y el domo hepático la resolución quirúrgica en un tiempo es posible. Objetivo: Describir el abordaje transtorácico-transfrénico y revisar la literatura disponible. Material y Métodos: Se presentan dos casos clínicos resueltos quirúrgicamente en nuestro centro a través de toracotomía posterolateral derecha y frenotomía en un tiempo, con evolución satisfactoria sin complicaciones. Se realizó una revisión sistemática de la literatura en la base de datos PubMed, período 1990-2011. Cinco estudios cumplieron los criterios de inclusión. Conclusiones: El abordaje transtorácico-transfrénico es factible y seguro, permitiendo la resolución en un tiempo quirúrgico a través de una sola incisión, sin necesidad de otro evento anestésico ni de una laparotomía posterior, con baja morbilidad y mortalidad.