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Introduction: Primary hydatid cyst of the spinal cord is exceedingly rare. Diagnosis at the early stages is difficult as they may be asymptomatic or have mild vague pain. Patients typically present when there are features of cord/root compression. Magnetic resonance imaging (MRI) stands as the primary investigative modality, but even then, preoperative diagnosis might not always be possible as it may resemble other pathological conditions. Methods: This was a case report of a single case with evidence-based discussion. Informed consent was obtained. Case Report: We present a 62-year-old female patient with progressive paraparesis and numbness of bilateral lower limbs. MRI was suggestive of a tubercular pleurospinal lesion at the D9-D10 level. However, intraoperatively, it was identified to be a rare case of primary pleurospinal (thoracic) hydatid cyst. The patient was managed with complete surgical removal of all the cysts and antihelminthic drug therapy with no evidence of recurrence at the 2-year follow-up. Conclusion: Radiological diagnosis might not be accurate and hydatidosis must be kept in mind to avoid intraoperative confusion. Timely diagnosis, appropriate surgical planning, and comprehensive follow-up are crucial for achieving optimal outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the magnetic resonance imaging (MRI) features and classification of echinococcosis of the spinal canal. The clinical manifestations and MRI findings and classification of 19 patients diagnosed with intraspinal echinococcosis over 10 years (2011–2020) were retrospectively analyzed. The mean age of the nine males and 10 females was 39 years (range 28–65 years). Among these, the number of cases with thoracic, lumbar, sacral, thoracolumbar, and lumbosacral, cervical, and lumbar segments was nine (47 %), five (26 %), one (5 %), one (5 %), two (11 %), and one (5 %) cases, respectively. Furthermore, 13 cases (69 %) involved adjacent vertebral bodies, accessories, and surrounding soft tissues. The lesion was confined to the intramedullary, extramedullary subdural, extramedullary epidural, and multiple spaces in one (Type I) (5 %), four (Type II) (21 %), one (Type III) (5 %), and thirteen (69 %) cases, respectively. Moreover, nine cases (47 %) had a history of hydatid disease in the spine or other tissues. The clinical manifestations were chest and lumbosacral pain in 18 cases (95 %) and chest and lumbosacral pain accompanied by lower limb dysfunction in four cases (21 %). The MRI revealed different sizes of T1WI low-signal and T2WI high-signal vesicles with a "grape-like" appearance, with 16 cases (84 %) showing low signals on the edge of the cyst wall. Intraspinal echinococcosis is rare, even in endemic areas. However, intraspinal echinococcosis should be considered when there is a history of echinococcosis in other sites or when there are clear MRI characteristics for the disease. • Echinococcosis is rare in clinical practice, this study selected a more rare location-spinal echinococcosis. • This study provides a new imaging direction for the classification of intraspinal echinococcosis. • This study describes the MRI features of intraspinal echinococcosis. [ABSTRACT FROM AUTHOR]

The differential diagnosis of cystic echinococcosis should be considered in the suspected case of a pelvic mass presenting with vague symptoms. Primary pelvic hydatid cyst is rare, and the achievement of early diagnosis is important, as the involvement of bone in the pelvis is difficult to treat, and the probability of recurrences is greater. This case report presents a rare case of a primary pelvic hydatid cyst in a male in his 30s. The patient presented vague symptoms of difficulty in micturition and chronic pelvic pain. First-line radiological imaging techniques diagnosed it as a neoplastic mass and tuberculosis, while MRI revealed it as a cystic disease, probably a hydatid cyst. Surgical excision and histopathological examination confirmed the diagnosis of a primary pelvic hydatid cyst. Acquaintance with the varied presentation of cystic echinococcosis helps to obtain an accurate diagnosis and thus decreases the severe complication associated with the disease. This case report highlights the importance of considering parasitic infections in the differential diagnosis of cystic pelvic masses, even in regions with low endemicity. [ABSTRACT FROM AUTHOR]

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Retroperitoneal hydatid cysts are extremely rare and difficult to distinguish from other intra-abdominal pathologies, such as synovial sarcoma. In this study, we present a rare case of a complicated retroperitoneal hydatid cyst originating from the psoas muscle without any other focus. A 59-year-old male patient presented to the outpatient clinic with complaints of constipation and a feeling of gradually increasing swelling in the left lower quadrant of the abdomen and left groin area, progressing toward the left leg. In the examinations performed, a multiloculated giant hydatid cyst that filled the left pelvis in the retroperitoneal region, deviated the intra-abdominal organs to the right side, and extended to the left femoral and inguinal canals was detected. The patient underwent surgical excision and was followed up during the postoperative period. No evidence of recurrence was found at the patient's 3rd and 6th month followups. Primary muscle hydatid cysts necessitate a distinct approach to treatment and management when compared with hydatid cysts in other bodily organs. While recurrences remain a potential concern after resection, it is noteworthy that the window for the formation of fertile cysts typically spans up to 10 months. Thus, it is advisable to conduct regular postoperative follow-up examinations during the first year following surgery to ensure comprehensive monitoring and care. [ABSTRACT FROM AUTHOR]

The article describes the case of a 22-year-old male who presented to his provider with leg shoulder pain which had been ongoing for four months and was exacerbated by movement. Topics include finding on a left shoulder X-ray, and his diagnosis of pulmonary echinococcosis which was made after his surgery, and information on echinococcosis.

Background: Echinococcosis is a multisystem disease that might affect all organs, especially the liver and the lungs among adults. Axillary hydatid cyst, an extremely uncommon disease, was rarely reported in the literature. We report herein a case of axillary hydatid cyst which revealed a disseminated hydatid disease among a previously healthy woman. Case presentation: A previously healthy woman, aged 53 years old, presented with a painful mass in her right axillary region. Physical examination revealed a painful semi-mobile right axillary mass, of 12 cm in size. Thoracoabdominal computed tomography scan revealed numerous cystic lesions: right axillary, pulmonary, hepatic, pancreatic, splenic and intraperitoneal lesions. The diagnosis of disseminated hydatid disease was suspected in front of the cystic lesions and the positive serology result for hydatid disease. An excisional biopsy of the axillary mass lesion was performed, confirming the diagnosis of a hydatid cyst. The patient received albendazole after hospital discharge. Conclusions: Although axillary hydatid cyst is an extremely uncommon disease, the diagnosis should be rule out in front of the presence of a mass in the axillary region. Imaging results associated with serological tests might suspect the diagnosis, which can only be confirmed with parasitological or/and histopathological examination. Its management include surgical and medical therapy. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease is a parasitic infection which is endemic in multiple regions across the globe including Indian subcontinent. Although it commonly affects the liver and other solid organs, isolated involvement of the heart is relatively uncommon. Cardiac hydatidosis can be confidently diagnosed on echocardiography, but cross-sectional imaging by computed tomography (CT) or magnetic resonance imaging (MRI) provides accurate information about its location, extent, and multiplicity. Multiple case studies of cardiac hydatid disease have been reported in the literature. However, cardiac hydatidosis with extension into pulmonary vasculature has not been reported commonly. This case report highlights this rare association, with stress upon the altered surgical management. Case presentation: A 50-year-old patient presented with atypical chest pain to the cardiology department of a tertiary care hospital where he underwent multiple blood tests as well as electrocardiography (ECG) and echocardiography as part of the routine examination. Echocardiography revealed a large, multicystic mass invading the posterolateral wall of left ventricle (LV) with no internal vascularity and was provisionally diagnosed as hydatid disease. Subsequent CT study confirmed a large multicystic lesion with the presence of another smaller lesion invading the left atrial appendage (LAA). In order to evaluate the vascular and mediastinal invasion, cardiac MRI was then performed which revealed invasion of right pulmonary artery (PA), right superior pulmonary vein (PV) as well as compression of superior vena cava (SVC) by the smaller lesion. A final diagnosis of cardiac hydatidosis with invasion into right PA and right superior PV was made. Treatment plan for the patient changed, who then underwent an additional reconstruction of right PA and right superior PV after cyst removal. Conclusions: Cardiac hydatid disease is a rare but potentially lethal condition, which tends to show slow growth and local invasion. The diversity of findings in such rare cases makes individual surgical approach extremely valuable with preoperative radiological imaging becoming indispensable for correct localization and appropriate planning. Our case report highlights rare association of cardiac hydatidosis with invasion of both pulmonary artery and vein, which eventually altered the surgical management of patient. [ABSTRACT FROM AUTHOR]

Cystic Echinococcosis (CE) is a worldwide zoonotic infection caused by the larval stage of Echinococcus granulosus. It has a widespread distribution in the human population of Tunisia. The liver hydatid cysts are the most commun abdominal site. However, other rare intra cavity location, can occur. We report the case of 56-year-old patient with surgical history for liver hydatid cyst. Ten years after surgery, he was presented with chronic abdominal pain and constipation. The imaging results were all in favor of a retro rectal hydatid cyst. A total resection of the hydatid cyst was executed good outcomes. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the effects of hypertonic saline and ethanol as a single intracystic agents in the percutaneous treatment of liver hydatid cysts were compared. Methods: The 50 patients were separated into two groups as those administered 30% hypertonic saline alone as the intracystic agent in percutaneous treatment (33 patients, 52 cysts), and those administered 96% ethanol alone (17 patients, 26 cysts). Both groups were compared in terms of percentage of cyst volume reduction, complications, and treatment success. Results: The follow-up period was median 17.0 months (11.0–20.0) in the ethanol group and 17.0 (14.0–22.0) in the hypertonic saline group (p = 0.269). Complications were observed in 5 (19.2%) cysts applied with ethanol as the intracystic agent and in 7 (13.5%) of the cysts where hypertonic saline was used (p = 0.521). Clinical success was evaluated as 100% in both groups. The percentage of cyst volume reduction according to the initial volume was determined as mean 75.6 ± 20.43 (28.19–98.13) in the ethanol group cysts and as 68.2 ± 16.45 (26.39–97.48) in the hypertonic saline group (p = 0.427). Conclusion: The results of this study demonstrated similar efficacy of hypertonic saline and ethanol in the percutaneous treatment of CE1 and CE3A liver hydatid cysts. These results suggest that the use of hypertonic saline as a single intracystic agent in the percutaneous treatment of CE1 and CE3A liver hydatid cysts provides sufficient efficacy of treatment and cyst volume reduction. Nevertheless, there is a need for further prospective, randomized studies to support these findings. [ABSTRACT FROM AUTHOR]

Objectives: Cystic echinococcosis is a worldwide zoonosis that is endemic in many countries including some in the Middle East. Exact prevalence rates for human echinococcosis are unknown for Oman. Methods: Following obtaining ethical approval, data from January 2010 to December 2021 were retrieved from hospital electronic records of Sultan Qaboos University Hospital, Muscat. Results: Over a 12-year period we saw nine cases of hydatid disease; two cases in females and seven cases in males. The median age of our patients was 31 years old. Four patients had pulmonary cysts, four had hepatic cysts, and one patient had pulmonary and hepatic cysts. The majority of patients were from the Ad Dakhiliyah governorate. Contact with animals was reported by three patients, denied by two, and unknown for four. Albendazole was prescribed to three patients with pulmonary cysts that subsequently ruptured reflecting the unfamiliarity of clinicians to best manage pulmonary hydatid cysts. Conclusions: The prevalence of cystic echinococcosis in Oman is unknown but appears rare. For optimal management of this disease, clinicians must become more aware of its diagnosis and management. [ABSTRACT FROM AUTHOR]

Background: Cardiac hydatidosis is a rare disease and the subepicardial region of the left ventricular is commonly affected. However, papillary muscle concomitant with brain involvement has not been previously reported. Case: We report a 44 years old man who complained of headache along with no cardiac symptoms. The patient was diagnosed with cerebral hydatid cyst. Through preoperative cardiac consultant, transthoracic echocardiography revealed cardiac hydatid cyst confined to the anterolateral papillary muscle. Medical treatment was started promptly and successful surgical excision of all cysts was performed. The patient had an uneventful recovery and follow up at 3 months. Conclusion: Early diagnosis of cardiac HC by echocardiography is recommended in all patients with hydatid disease, regardless of HC location. [ABSTRACT FROM AUTHOR]

Background and Aim This study aimed to investigate the clinical and laboratory characteristics of hydatid cyst disease in patients admitted to Imam Reza, Imam Hossein, and Bisotoon hospitals in Kermanshah City, Iran, from 2014 to 2018. Methods & Materials In this descriptive study, we studied and analyzed the medical records of 350 patients with hydatid cysts who were hospitalized and underwent surgical treatment in Kermanshah hospitals from 2014 to 2018. Also, the demographic characteristics of patients, including gender, age, occupation, place of residence, and affected organs, were extracted and recorded. Ethical Considerations The Ethics Committee of Kermanshah University of Medical Sciences approved this study (Code: IR.KUMS.REC.1398.366). Results In total, 350 patients with a Mean±SD age of 43.2±19.7 in women and 43.3±20.7 in men were admitted with a diagnosis of hydatid cyst. The highest and lowest prevalence of hydatid cysts were in the age groups of 41-50 (16.5%) years and 1-10 (4.8%) years, respectively. The prevalence was 181 (51.7%) in women and 169 (48.2%) in men. The organs mostly infected with hydatid cysts were the liver, lung, and brain, with 241 cases (68.8%), 55 (15.7%), and 24 (6.8%), respectively. Conclusion This study shows that hydatid cyst disease is an important disease, especially in rural areas of Kermanshah Province, Iran. [ABSTRACT FROM AUTHOR]

Hydatid cyst disease induced by Echinococcus granulosus is a parasitic disease known since ancient times. Today, it continues to be seen in many countries and creates serious problems. The lung is the second most frequently affected organ by hydatid cysts after the liver. Lung involvement is more prevalent in children than adults, and the growth of the cyst is faster in children. Hydatid cysts are mostly seen in the right lower lobe of the lung. Common symptoms are chest pain, cough, and shortness of breath, with the most diagnostic symptom being the expectoration of cyst fluid or membranes. In endemic areas, the diagnosis of hydatid cysts can usually be made easily by clinical findings, serology tests, and radiological findings. When the hydatid cyst ruptures and becomes complicated, it is clinically and radiologically confused with many diseases, especially lung cancer. Surgery is accepted as primary treatment of lung hydatid cysts all over the world. The surgical approach is related to several factors such as the size of the cyst, whether it is intact or complicated, unilateral or bilateral, solitary or multiple, and the presence of destruction of the lung parenchyma. Although it is stated by some surgeons that capitonnage is not required, the most frequently applied surgical technique is cystotomy and capitonnage. Pulmonary resection should be avoided as much as possible, particularly in children. Albendazole or mebendazole treatment in pulmonary hydatid cyst is generally used after surgery and to prevent recurrences. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis is a life-threatening zoonotic disease caused by Echinococcus multilocularis. The disease usually primarily involves the liver and shows tumor-like growth. Early diagnosis of alveolar echinococcosis is difficult because the disease is usually asymptomatic in the early stages. Untreated cases are fatal and result in death within 10 years of liver involvement. In the diagnosis of alveolar echinococcosis, the patient's medical history, radiological imaging findings, and serological and histopathological tests are used together. Radiological imaging methods are very important for early diagnosis and differential diagnosis of the disease. In this article, we wanted to review the diagnosis and treatment of alveolar echinococcosis and emphasize the importance of keeping it in mind, especially in cystic lesions of the liver, and the importance of early diagnosis of the disease. [ABSTRACT FROM AUTHOR]

Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus. This serious disease continues to be an important public health problem as it is endemic in many parts of the world. Cystic disease affects many organs in the body, most commonly the liver. Hydatid disease can cause a diverse spectrum of symptoms, from asymptomatic infection to potential death. In the presence of clinical suspicion, the diagnosis is made by serology and imaging methods. Imaging findings can range from completely cystic lesions to completely solid appearance and calcification. The imaging method to be used depends on the involved organ and the stage of the cyst. The updated recommendations of the World Health Organ izati on-Ec hinoc occos is Informal Working Group for the stage and treatment of human echinococcosis have had important implications. Accordingly, there are 4 approaches to the clinical management of hydatid disease: surgery, percutaneous techniques and drug therapy for active cysts, and a "watch and wait" approach for inactive cysts. Since it directly affects the treatment, it is necessary to be familiar with the imaging findings of the cyst, especially in endemic areas. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral hydatid cysts are caused by the cranial intraparenchymal settlement and growth of tenia echinococcus embrio. CT reveals well-circumscribed, non-contrast enhanced, intraparenchymal homogenous cystic mass. Cyst fluid is isointense like cerebrospinal fluid (CSF). Operation is the most preferred therapeutic approach in cerebral hydatid cyst. We presented four cases that underwent operation at the past 5 years to attract attention to cerebral hydatid cyst which became evident in our country recently. Methods: We had four cases with cerebral hydatid cyst that underwent operation between 2015 and 2020. Results: We had three male one female patient. Their age was between 9 and 16 and mean age was 13. Three of them had solitary; one patient had multiple hydatid cyst. Common complaint of our cases was headache. The patients had seizure, diplopia, homonim hemianopia, and strabismus due to bilateral 6th nerve palsy. Discussion and Conclusion: Cerebral hydatid cyst is most commonly seen in childhood (70%). All of our cases had headache and papillary stasis. In addition, our 2nd case had epilepsy, 3rd case had right homonim hemianopsia, and 4th case had diplopia. Recently, due to the situations in the middle east, lots of immigrants left their countries and live abroad, some of those were already contaminated. We can state that we have to refresh our knowledge about hydatid cysts and be aware that new cases may arise due to immigration patterns. [ABSTRACT FROM AUTHOR]

Introduction: Echinococcosis or hydatid disease is one of the most important zoonosis across the world. Materials and Methods: The recombinant P29 protein is considered as a suitable candidate for evaluating diagnostic ELISA to reach a more accurate conclusion. Results: In this study the P29 sequence comprised with somewhat similar sequences registered in Gene Bank and showed 100% identity with P29 sequences derived from Echinococcus granolosus (E. granulosus) (XP_024351425.1), E. multilocularis (AHA85396.1), Endophilin B1 protein of E. granulosus (CDS21096.1). The primary and secondary structure of the peptide was analyzed due to its characterization of peptide motifs to be expressed on MHC Class HLA allels. Conclusion: The recombinant P29 derived peptides can be produced and analyzed due to be determined as vaccine design candidate against Hydatidosis. [ABSTRACT FROM AUTHOR]

Introduction: Hydatid cyst is a very rare disease in our days and furthermore central Nervous system involvement is uncommon. Case Report: We present the case of a 46 years old patient that was admitted to the emergency department with complaints of new onset of nonsensical movements, speech and inability to recognize his relatives. He had no known comorbidities. He had been on oral ornidazole and naproxen for two weeks for hydatid cyst and an operation was planned. On physical examination, he was unoriented and incoherent. In laboratory results, hemoglobin level was low; platelets were normal; leukocytes, CRP, ALT, AST, ALP, GGT, bilirubins were elevated. The preliminary report of brain CT imaging was interpreted as normal and In the preliminary report of brain MRI Hydatid cyst was interpreted as central involvement. Lumbar puncture could not be performed in the emergency department because of high INR. Two sets of blood cultures were obtained, Albendazole 2*400 mg; ceftriaxone 2*2000 mg iv and vancomycin 4*500 mg iv were started. Infective endocarditis screening tests were requested. He was hospitalized in the intensive care unit and follow-up was started. He developed a fever in the intensive care unit. Brain MRI report was evaluated in favor of foreground abscess foci. Metronidazole 4*500 mg iv was added to the treatment. Also Streptococcus intermedius was found in the blood culture and gentamicin 5mg/kg was started. The dynamic CT imaging of the liver revealed that intra-abdominal ascites was observed in the preliminary interpretation. The patient underwent paracentesis and leukocytosis was present in the sample cell count. Radiology was consulted again and rupture of one of the abscess foci in the left liver was suspected. The patient underwent emergency operation and five liters of intra-abdominal abscess material was drained. Fluconazole 1*400 mg iv was added. Echocardiography performed for endocarditis revealed no vegetation. The patient was transferred from ICU to gastroenterology clinic. Discussions : The presence of multiple infections in a patient with a Hydatid Cyst can pose challenges in treatment and selecting the appropriate medication. Effective management requires a multidisciplinary approach involving medical specialties such as Infectious Diseases, Intensive Care, Gastroenterology, General Surgery and Radiology. Conclusions: During the follow-up, ESBL positive Klebsiella pneumonıae was grown in sputum culture. Ceftriaxone was discontinued and changed with meropenem 3*2000 mg iv. The patient was evaluated with control tomography imaging and discharged with completely healing. [ABSTRACT FROM AUTHOR]

Primary pelvic hydatid cyst occurs through hematogenous or lymphatic route. Adolescent female presented with complaints of suprapubic discomfort and constipation. Imaging revealed a cystic lesion in pouch of Douglas and removed surgically. This case emphasizes considering hydatid disease as a differential diagnosis of cystic pelvic mass, especially in the endemic regions. [ABSTRACT FROM AUTHOR]

Background and Aim This study aimed to investigate the clinical and laboratory characteristics of hydatid cyst disease in patients admitted to Imam Reza, Imam Hossein, and Bisotoon hospitals in Kermanshah City, Iran, from 2014 to 2018. Methods & Materials In this descriptive study, we studied and analyzed the medical records of 350 patients with hydatid cysts who were hospitalized and underwent surgical treatment in Kermanshah hospitals from 2014 to 2018. Also, the demographic characteristics of patients, including gender, age, occupation, place of residence, and affected organs, were extracted and recorded. Ethical Considerations The Ethics Committee of Kermanshah University of Medical Sciences approved this study (Code: IR.KUMS.REC.1398.366). Results In total, 350 patients with a Mean±SD age of 43.2±19.7 in women and 43.3±20.7 in men were admitted with a diagnosis of hydatid cyst. The highest and lowest prevalence of hydatid cysts were in the age groups of 41-50 (16.5%) years and 1-10 (4.8%) years, respectively. The prevalence was 181 (51.7%) in women and 169 (48.2%) in men. The organs mostly infected with hydatid cysts were the liver, lung, and brain, with 241 cases (68.8%), 55 (15.7%), and 24 (6.8%), respectively. Conclusion This study shows that hydatid cyst disease is an important disease, especially in rural areas of Kermanshah Province, Iran. [ABSTRACT FROM AUTHOR]

Cystic Echinococcosis (CE) is a zoonotic disease caused by the larval stage of a tapeworm of Taeniidae family, genus Echinococcus and species Echinococcus granulosus sensu lato (s.l.). CE is a worldwide public health problem and is highly incident in all Mediterranean areas. Following clinical, image techniques and serological investigations all 83 subjects involved in the study were diagnosed for CE. General and clinical data were entered into a database and evaluated. The 43.37% were female and 56.63% male, mean age was 50.71 while the range most represented (22.7%) was between 61->70 years. The purposes of our survey were to investigate these 83 patients enrolled in the study and to deeply examine 20 (24.10%) patients that developed a new echinococcal cyst. Moreover, the causes at the basis of the onset of a new cyst were analysed, together with a possible correlation with different treatments related to primary infection corresponding to surgery (n=7), albendazole (n=6), PAIR (n=3) and watch and wait (n=4). A possible link with medical treatments of the primary infection was observed in the subjects who underwent surgery or PAIR and a likely correlation attributable to high environmental contamination in subjects managed with drugs or watch and wait was detected. Moreover, our analysis evidenced that patients with a new infection presented a more severe diagnosis along with a major mortality rate. Finally, these data may have an important contribution for an epidemiological point of view concerning the percentage of CE in a specific geographical endemic area, such as Sardinia. [ABSTRACT FROM AUTHOR]

In this study, it was aimed to investigate the general distribution and characteristics of hydatid cyst (HC) cases in society by a single-center comprehensive study. Three thousand ninety consecutive patients who were followed up and treated for HC in our hospital between January 2001 and December 2020 were analyzed retrospectively. It was determined that HC was seen more in males than females (54.84% and 45.16%, respectively) in childhood and more in females than males in adulthood (59.89% and 40.11%, respectively, P < 0.001). Regarding the living areas, 82.01% of the cases were living in the rural area and 17.99% in the city center (P < 0.001). It was observed that the cases increased significantly in the second ten years (72.36%) compared to the first 10 years (27.64%) (P < 0.001). At least one of the liver or lungs was involved in 95.08% of the cases. The liver was involved in 80.23% of the cases (66.87% in children, 84.94% in adults, P < 0.001) and the lung in 22.91% (38.59% in children, 17.38% in adults, P < 0.001). Other regions' involvement percentages were as follows: spleen 2.36%, musculoskeletal system 1.59%, kidneys 1.13%, intracranial region 0.91% (2.61% in children, 0.31% in adults, P < 0.001), omentum 0.91%, mediastinum 0.61%, cardiac region 0.58%, pelvic cavity 0.58%, diaphragm 0.55%, pancreas 0.13%, retroperitoneal area 0.13%, ovarian region 0.13%, uterine wall 0.06%, thyroid glands 0.03%, and nasal cavity 0.03%. HC ratio has increased in recent years. Liver involvement is more common in adults than children. Lung and intracranial involvement are more common in children than in adults. [ABSTRACT FROM AUTHOR]

Objective: This study aims to search for reliable serological biomarkers allowing the early prediction of cystic echinococcosis (CE) post-operative outcomes.Methods: We applied immunoprecipitation (IP) of Echinococcus granulosus protoscolex antigens with pediatric CE patients' plasma collected at 1-month and 1-year post-surgery, followed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). We compared IP proteomic content from relapsed patients within the first-year post-surgery (RCE) to cases with no relapses until 3 post-operative years (NRCE). Selected proteins were recombinantly synthesized and assessed for their prognostic performance by Enzyme-linked immunosorbent assay (ELISA).Results: A total of 305 immunoreactive parasitic proteins were identified, 59 of which were significantly more abundant in RCE than NRCE for both time-points. Four proteins showed the most promising characteristics for predicting CE outcomes: cytoplasmic malate dehydrogenase (Eg-cMDH), citrate synthase (Eg-CS), annexin A6 and severin. ELISA-IgG against the four markers were significantly lower at 1-year post-surgery than 1-month in NRCE, in contrast to RCE that displayed either stable or higher levels. The Eg-cMDH and Eg-CS showed the best prognostic performance, with respective probabilities of being "relapse-free" of 83% and 81%, if a decrease of IgG levels occurred between 1-month and 1-year post-surgery.Conclusion: The Eg-cMDH and Eg-CS are promising biomarkers to predict early CE post-surgical outcomes. [ABSTRACT FROM AUTHOR]

Isolated splenic hydatid cyst is a very rare parasitic infection. This case report presents the diagnosis and treatment process of giant splenic hydatid cyst treated with open spleen-sparing surgery. A 27-year-old female patient presented to the general surgery clinic with abdominal complaints. On computed tomography scan, she had a mass, 150 × 130 × 100 mm in size, at the medial side of the spleen. Spleen-sparing surgery was applied to the patient, who seemed to have a splenic hydatid cyst in the preoperative examinations. The patient was discharged without complications on the fourth postoperative day. Postoperative pathology was compatible with hydatid cyst. Albendazole treatment continued for two more months postoperatively. [ABSTRACT FROM AUTHOR]

Cystic hydatid disease usually affects the liver (50–70%) and less frequently the lungs (15%) and other organs (10%). Isolated renal hydatid cyst is an uncommon condition (1%). Laparoscopic surgery is the mainstay of operative treatment. A 17-year-old youth presented with a large exophytic cyst arising from the lower pole of the left kidney (BOSNIAK-1). The cyst was excised laparoscopically. Histopathology showed it to be a hydatid cyst. Two years later, he presented with an umbilical port site swelling for 6 months, painful for 2 days, and was operated as suspected port site strangulated incisional hernia. At surgery, there was a port site cyst which was removed intact, and the hernia was repaired. Histopathology showed features suggestive of a hydatid cyst. Isolated renal hydatid is an uncommon condition (< 1%). Laparoscopic surgery is safe and feasible in the majority of cases. Port site hydatid cyst recurrence is an extremely rare complication after laparoscopic hydatid surgery. Only one other such case has been reported in literature till now. It occurs due to the lodgment of scolices at the port site during laparoscopy. It can also mimic as strangulated umbilical hernia, and thus, the preoperative diagnosis is challenging. [ABSTRACT FROM AUTHOR]

Case Presentation: A 19-year-old woman presented to our ED with complaints of backache and massive hemoptysis. Her medical history included acute dyspnea that developed within hours caused by angioneurotic edema 6 months earlier. Two days later, she was given thrombolytic treatment because of massive pulmonary thromboembolism. She had been given methylprednisolone 4 mg and tinzaparin sodium 0.7 mL subcutaneously and was still under treatment on the current admission. She had no history of smoking, alcohol, or oral contraceptive use, surgery, trauma, recent travel, clotting disorders, or familial diseases. [ABSTRACT FROM AUTHOR]

Echinococcus disease in children is discussed that includes its epidemiology, clinical manifestations, lifecycle, means of evaluation, and principles of treatment. Concepts of prevention are considered that include health education of people at risk for this infection with attention to proper sanitation procedures. [ABSTRACT FROM AUTHOR]

Purpose: To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design: Interventional case series. Place and Duration of Study: Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods: This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results: Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion: Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. [ABSTRACT FROM AUTHOR]

Objective: Kuwait is considered a non-endemic country for most parasitic infections. However, ∼70% of 4.7 million residents in Kuwait are expatriates from Asian and African countries, which are endemic for parasitic infections. Results of microbiological investigations for schistosomiasis and cystic echinococcosis (CE) performed in a reference national laboratory were retrospectively collected and analyzed to provide an insight on the epidemiology of these 2 neglected tropical diseases in Kuwait.Subjects and Methods: Schistosoma infection in fecal and urine specimens from suspected patients was detected by microscopy. Schistosoma and CE infections were also detected by indirect hemagglutination assays (IHAs) using blood specimens. Patients' epidemiological data were extracted from the laboratory records.Results: The overall prevalence rates of schistosomiasis and CE were 19.0 and 5.8%, respectively. Almost all schistosomiasis cases were seen among Egyptians, especially among males, and a significantly higher prevalence (p < 0.05) was seen for CE cases among the Syrian residents. A decreasing annual trend was observed for both the parasitic infections over time in Kuwait.Conclusions: This study confirmed that schistosomiasis is not autochthonous in Kuwait, as all cases were detected among expatriates from Schistosoma-endemic countries. Our data also showed that CE remains endemic among humans and livestock in Kuwait as is also seen in other Middle Eastern countries. [ABSTRACT FROM AUTHOR]

The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery. [ABSTRACT FROM AUTHOR]

Peritoneal hydatid cysts are rare in children even in endemic areas. The primary or secondary origin of this site remains controversial, especially in children. Secondary peritoneal hydatid cysts are mainly the result of spontaneous or traumatic rupture of concomitant liver cysts or the leakage of cystic content during surgery. The purpose of our study is to present the largest case series of peritoneal hydatidosis in children. In addition, we aimed to assess the clinical and paraclinical findings as well as the management of echinococcosis at this location in children. The present case series is a study of ten children with peritoneal hydatid cysts, who underwent surgical intervention between 2013 and 2018 in the Pediatric Surgery Department, University of Monastir (Monastir, Tunisia). The mean age of the children was six years. All children presented abdominal pain, and underwent ultrasonography and contrast-enhanced computed tomography of the abdomen. Two patients had been operated on for lung hydatid cysts six months prior to the study. In two cases, radiologic investigations revealed the presence of an uncomplicated hepatic hydatid cyst located in segments II and IV. All patients underwent surgery, of which four underwent laparoscopy. Post-surgery, all patients received albendazole for three months, and the follow-up period was uneventful. Currently, all patients are in good health. Peritoneal hydatid disease is frequently secondary to the rupture of a primary hepatic cyst. Diagnosis is performed by abdominal ultrasound, computed tomography, and a positive serology result. Open or laparoscopic excision can be combined with medical treatment. [ABSTRACT FROM AUTHOR]

Intrabiliary rupture is the most common complication of liver hydatid cysts, intraperitoneal rupture is rarely seen, but it can be life-threatening. A 57-year-old female patient complained of abdominal pain and a hydatid cyst was found in the left liver lobe, as well as an intra-abdominal cystic mass due to intraperitoneal rupture. The patient's medical history showed that she was admitted to the emergency department with complaints of abdominal pain two months earlier, the liver hydatid cyst and intra-abdominal fluid were detected. However, there were no acute abdominal findings, so no emergency intervention was done. She was operated on electively. Surgical exploration showed a ruptured hydatid cyst of the left liver lobe, with a cystic mass that limited itself perfectly in the peritoneal cavity. Especially in endemic regions, primary care and emergency physicians should consider ruptured disease for patients with abdominal pain and liver hydatid cyst. The aim of this article, in light of the literature, is to emphasize that the rupture of hydatid cysts may not represent catastrophic clinical signs. [ABSTRACT FROM AUTHOR]

A previously healthy 14-year-old male presented with abrupt onset respiratory failure with hemoptysis and anaphylaxis. Imaging demonstrated a large, cystic lesion with bronchopleural fistula that was consistent with cystic echinococcosis. He underwent thoracotomy for cyst removal and bronchopleural fistula repair, then completed 3 months of albendazole therapy. He developed recurrence of a bronchopleural fistula 4 months after surgery which improved over time with conservative management. This case highlights pathognomonic imaging and pathology findings for cystic echinococcosis. [ABSTRACT FROM AUTHOR]

Hydatid disease (HD) is a zoonosis caused by the larval form of the Echinococcus granulosus parasites in which human is the intermediate host. Hydatid cysts mainly develop in the liver and lungs. However, they can be found in all anatomical locations, especially in endemic areas. Herein, we present a case of HD involving the liver, kidney and breast with the findings of mammography, ultrasonography and computed tomography. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis is a zoonotic infection caused by Echinococcus granulosus. This case report shows the difficulty in differential diagnosis in a patient with highly suspected hydatid disease.Case Presentation: A 29-year-old Chinese woman presented with progressive abdominal distension. Imaging results revealed a large multicystic tumor with typical features of hydatid disease. There was no clear relationship between the cystic tumor and the liver, which led to the assumption of primary extrahepatic cystic echinococcosis. After albendazole therapy was initiated, a laparotomy was performed and a huge ovarian cystadenoma was diagnosed.Conclusions: This case highlights the possible challenges of differential diagnosis in patients with suspicion of hydatid cysts. [ABSTRACT FROM AUTHOR]

Hydatid disease (HD) is an infectious disease caused by echinococcosis. Hydatid cyst (HC) most commonly invades the liver (60-70%) and the lungs (20-25%). However, other parts of the body and even unusual locations can be infected, mimicking a benign lesion that could be easily missed. Primary HC of the chest wall is extremely rare, even in countries where echinococcosis is endemic. We herein present a case of a 40-year-old man with a rightsided growing thoracic wall mass. The patient did not present the relevant history (living in rural areas or being in contact with farm animals) and the serological examination with the indirect hemagglutination test was negative. During surgery, a cystic mass between the eleventh and twelfth ribs was observed. The thoracic wall mass extended to the posterior abdominal wall and was entirely extrapulmonary and extraperitoneal. All cystic structures of the thoracic wall and intrathoracic region were removed, and the primary defect was reconstructed. In endemic areas such as Iran, HD should be considered in the differential diagnosis of mass lesions located in the chest wall or other parts of the body, even without the relevant history or serologic evidence. [ABSTRACT FROM AUTHOR]

Objective: Hydatid cyst is an important health problem for our country. In this study, we aimed to determine the radiological findings of the hydatid cyst cases detected in Antalya region and to present their epidemiological data. Methods: Between March 2017 and March 2019, the reports containing the term "hydatid" were filtered from the radiology information system of our hospital and discharge summaries, laboratory and radiological findings of the patients were reviewed retrospectively. Results: A total of 119 hydatid cysts were detected in 103 patients (74 female and 29 male). The mean age of the patients was 53.5±9.4 years. One or more imaging methods including ultrasonography, computed tomography and magnetic resonance imaging were used in the evaluation of patients. 21 of the patients (2 of which had percutaneous surgery) underwent surgical treatment. 52 of the 103 patients with hydatid disease were evaluated with indirect hemagglutination test and 27 of them were positive. 11 (44%) of the 25 seronegative patients, had type 5 lesions. Conclusions: Hydatid disease remains important for our region, and the physicians should be informed about radiological and serological methods used for diagnosis of the disease. Planned studies are needed to raise public awareness. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE), or hydatid disease, is a neglected tropical disease (NTD) afflicting one million people globally. This study aims to elucidate the presentation, treatment and outcomes of the disease in Pakistan. A review of charts of 225 patients (median age = 42.3 years) with CE admitted at Aga Khan Hospital, Karachi during 2007-2017, was carried out. Abdominal pain was present in 34.7% followed by fever in 26.2%. There were 142 (63.1%) cases of hepatic cysts and 55 (24.4%) of pulmonary hydatid cysts. Combined surgical and medical therapy was given to 130 (57.8%) patients. Surgery only was performed in 23 (10.2%) patients, medical therapy only was given to 35 (15.6%) patients, and puncture, aspiration, injection and reaspiration (PAIR) with medical therapy was given to 15 (6.7%) patients. Recurrence occurred in 14 (6.2%) patients and mortality in 7 (3.1%) patients. Owing to its non-specific presentation, a high index of suspicion is required to diagnose and treat CE in a timely manner. [ABSTRACT FROM AUTHOR]

Background The cestode Echinococcus granulosus causes hydatid disease. In addition to manifestations in the liver and lung, it can lead to cystic lesions in the spine. Case Description We report a 42-year-old male patient with primary hydatid disease in the eighth thoracic vertebra. The only clinical symptom was chronic back pain. Although laboratory findings were normal, imaging displayed lytic destruction that raised the suspicion of a metastatic disease. Diagnostics of the thoraces and abdomen did not reveal other pathologic abnormalities. Follow-up magnetic resonance imaging (MRI) depicted a progressive compression of the spinal cord and inhomogeneous structure in the fat-suppressed sequences. Because the Jamshidi biopsy was inconclusive, the tumor board recommended surgery. Dorsal decompression, spondylodesis of T6–T10, and vertebral column resection of T8 with complete cyst removal were performed. The resected vertebrae showed a mucous-like lesion with white granular tissue interfusing the whole vertebral body. A pathologic examination and enzyme-linked immunosorbent assay confirmed E. granulosus. Thus chemotherapy with albendazole was initiated. A follow-up MRI of the whole spine confirmed complete remission and found no additional resettlements. The patient's back pain was resolved without neurologic deficits. Conclusions For lytic manifestations of the vertebral column, hydatid cysts should be considered a differential diagnosis in addition to malignant metastasis, tuberculosis, and osteomyelitis. Thorough surgical resection and strict follow-up are necessary. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE) is a zoonotic infection caused by the tapeworm of the genus Echinococcus, a cestode endemic in many parts of the world. CE can affect any organ, with the lung being the second most commonly affected organ after the liver. For the management of pulmonary CE, guidelines recommend surgical resection of cysts with adjuvant anti-helminthic therapy. In cases where surgery is not possible, medical therapy alone can be used. However, to date, there is a paucity of data to advocate for one modality over the other. Here, we report two cases of pulmonary CE caused by E. granulosus, one was managed with surgery and adjuvant anti-helminthic therapy while the other was managed with medical therapy alone. Both patients had clinical and radiological resolution outlining the role and efficacy of both modalities of therapy. [ABSTRACT FROM AUTHOR]

Aim of the study: To assess the clinical usefulness of serological tests in the diagnosis and monitoring of treatment of patients with alveolar echinococcosis (AE). Material and methods: The results of serological tests, i.e. Echinococcus multilocularis ELISA (Bordier Affinity Products) and Echinococcus Western Blot IgG (LDBIO Diagnostic), of 66 patients were analysed. Duration of follow-up was two years after diagnosis. In the second phase of the study 11 sera obtained from the patients undergoing surgical treatment, in whom the results of Echinococcus Western Blot IgG assay were still positive, were additionally tested with Anti-Echinococcus EUROLINE-WB (IgG) assay. Results: Statistically significant negativization of the Echinococcus multilocularis ELISA test was observed in the group of patients who underwent radical surgery or liver transplantation. Negativization of Echinococcus Western Blot IgG assay results was observed in some patients, among both those who received conservative treatment and those who underwent surgery, but no statistically significant differences were found between treatment groups. In 54.5% of cases the Anti-Echinococcus EUROLINE-WB (IgG) test result was negative when the results of the Echinococcus Western Blot IgG assay were still positive. Conclusions: Echinococcus multilocularis ELISA proved to be useful in assessing the activity of AE in a group of patients who underwent radical surgery or liver transplantation. The results of our study suggest that Anti-Echinococcus EUROLINE-WB (IgG) is a more dynamic test, which at the time of disappearance of AE activity becomes negative earlier [ABSTRACT FROM AUTHOR]

Primary hydatid cyst of the rib is very rare. Although the diagnosis of hydatid cyst is usually easy in endemic regions, the diagnosis of isolated rib hydatid cyst can be difficult. In this study, images of a case with isolated rib hydatid cyst mimicking a tumor were presented. [ABSTRACT FROM AUTHOR]

Diagnosis of cystic echinococcosis (CE) is at present mainly based on imaging techniques. Serology has a complementary role, partly due to the small number of standardized and commercially available assays. Therefore we examined the clinical performance of the SERION ELISA classic Echinococcus IgG test. Using 10 U/ml as a cut-off point, and serum samples from 50 CE patients and 105 healthy controls, the sensitivity and specificity were 98.0% and 96.2%, respectively. If patients with other infectious diseases were used as negative controls, the specificity decreased to 76.9%, which causes poor positive predictive values. However, if results between 10 and 15 U/ml are classified as indecisive, the specificity of positive results (≥15 U/ml) increased to 92.5% without greatly affecting the sensitivity (92.0%). Using this approach in combination with imaging studies, the SERION ELISA classic Echinococcosis IgG test can be a useful aid in the diagnosis of CE. [ABSTRACT FROM AUTHOR]

• Hydatid disease is endemic in North Africa countries especially in Tunisia. • Sudden death with a hydatid cyst discovered at autopsy leads to his implication in death. • Intact hydatid cyst at autopsy cannot rise the implication of the cyst in death mechanism especially by anaphylaxis. • Anaphylaxis is the most common mechanism of death during hydatid cyst. The discovery of a hydatid cyst at autopsy poses the problem of its involvement in the mechanism of death. The aim of this study is to analyse the epidemiological and etiopathogenic characteristics of death attributed to hydatid disease, to discuss the mechanism of death and to propose preventive measures. This is a retrospective descriptive study of 26 cases of death with hydatid cyst autopsic discovered, collected at the forensic department of Fattouma Bourguiba University Hospital of Monastir (Tunisia) over a period of 27 years (from 1990 until 2017). In 26 cases, hydatid cyst was observed during autopsy of sudden death cases, which corresponds to 0.33% of the total of autopsies in this period. Of the 26 victims, 13 (50%) were men; the mean age was 43 years. Most victims were from rural zones (18 cases). In 20 cases, the complicated cyst was hepatic. It was cardiac in two cases. Of all cases, three cysts were cracked, and nine were broken. Of the 26 cases, only 15 were implicated in the death mechanism. Death was attributed to anaphylaxis in 12 cases, hydatid pulmonary embolism in 1 case, cardiac arythmia in one case and hemothorax in one case. Sudden death is the most dangerous complication of the hydatid cyst which can be discovered at autopsy. Several causes may explain its occurrence, the most common of which is anaphylactic shock. [ABSTRACT FROM AUTHOR]

Alveolar echinococcosis is an aggressive infection caused by the cestode I Echinococcus multilocularis i and most commonly affects the liver; metastatic or disseminated disease can occur but are uncommon. Neuroimaging with computed tomography (CT), followed by magnetic resonance imaging (MRI), showed a dural-based, gadolinium-enhancing lesion in her left frontal lobe, measuring 28 × 12 × 28 mm SP 3 sp with a multicystic appearance and substantial surrounding edema (Figure 1A). A transthoracic echocardiogram to rule out cardiac echinococcosis and a cardiac shunt in the setting of central nervous system alveolar echinococcosis was negative. [Extracted from the article]

The article present a case study of a 9-year-old female from central Quebec, Canada, present a 3-week history of intermittent cough, rhinorrhea, and sore throat. It mentions her chest X-ray revealed a left lower lobe cavity; and also mentions the remainder of her laboratory investigations, including renal function, electrolytes, and liver enzymes, were within normal limits.

Hydatidosis is an important zoonotic parasite disease in several herbivorous mammals. Human cystic echinococcosis (CE) caused by infection with larval stage of Echinococcus granulosus has been frequently reported from different organs. Here, we report the first case of a urinary echinococcosis in Iran with a pain in the lower left abdominal quadrant and severe frequent urination (pollakiuria). We detected a cyst 120 x 15 mm dimensions with heterogeneous mass contain fluid in the back of the urinary bladder neck between the umbilical region and external urethral sphincter. The patient was candidate for open-abdomen surgery and cysts were resected. The isolated cysts from liver and urinary bladder were referred to pathology laboratory, and the tissue sections were stained with Tri-chrome and Hematoxylin/eosin staining methods. Microscopic examination of prepared tissue sections showed protoscoleces of E. granulosus with specific and thick laminated hyaline layer (non-cellular membrane), with covers the thin activate germinal epithelium, which revealed the diagnosis of a hydatid cyst. This rare case illustrates that CE is the necessity of considering in the differential diagnosis from cysts, abscesses, malignant and benignant tumors, especially is essential in endemic areas of CE. [ABSTRACT FROM AUTHOR]