Sonographic diagnosis of primary hydatid disease in the breast: the scroll sign

The "serpent sign"-A classical sign in a nonclassical location: A case report of breast hydatid cyst

Hydatid cyst is a rare breast pathology; however, it should be included in the differential diagnosis of any breast mass. The history and imaging findings can sometimes raise suspicion of the hydatid nature of the mass. The presence of certain imaging signs specific to hydatid cysts can further indicate this diagnosis. Nevertheless, the definitive diagnosis remains histological, and the treatment is principally surgical. Herein, we present a case of a 38-year-old female who was found to have the "serpent sign" on ultrasonography, which is pathognomonic for ruptured hydatid cysts, as part of the imaging workup for a left breast lump. This case report underscores the importance of characteristic imaging features such as the "serpent sign" in the diagnosis of hydatid disease, especially in unusual sites like the breast where the index of suspicion is particularly low. Recognition of such signs elicits special pre- and intraoperative precautions to minimize complications like local dissemination and anaphylactic shock.

Isolated breast hydatid cyst: Imaging features

Hydatid cyst (HC) of the breast is a rare entity, even in endemic areas. We report the radiologic features of an isolated breast HC in a 50‐year‐old woman. Imaging findings may mimic other common breast lesions, but specific imaging features help establish an accurate diagnosis to adapt therapeutic management.

Although very rare, hydatid cyst of the breast should be included in differential diagnosis of breast lumps, especially for patients living in endemic areas. Imaging findings are essential to evoke this potentially serious breast disease in order to adapt therapeutic management.

Ultrasound Visualization of Atypical Abscess Ultimately Containing Bot Fly Larva

BACKGROUND

Because of the rise in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), presentations to the emergency department for the evaluation of cutaneous abscesses have risen dramatically over the past 2 decades. Soft tissue point of care ultrasound (POCUS) differentiates abscess from cellulitis, determines the size and shape, and characterizes the contents of the abscess. It has been shown to improve medical decision-making and therefore the emergency management of cutaneous abscesses over physical examination alone.

CASE REPORT

We report a case of an unusual nonhealing abscess in an 18-year-old woman with a recent history of foreign travel where soft tissue POCUS identified motion within the abscess pocket. This changed the management of the case, leading to the diagnosis of bot fly myiasis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians should entertain a broader differential for an apparent abscess and consider liberal use of soft tissue POCUS in these cases.