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Suwal S, Katwal S, Lamichhane S, Chataut D, Bhusal A, Sharma A. Pericardial hydatid cyst: A comprehensive case report on diagnosis and multidisciplinary intervention in a young patient. Radiol Case Rep 2024; 19:2832-2836. [PMID: 38689818 PMCID: PMC11059308 DOI: 10.1016/j.radcr.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/18/2024] [Accepted: 03/24/2024] [Indexed: 05/02/2024] Open
Abstract
Pericardial hydatid cysts, although rare, present unique diagnostic challenges and require a multidisciplinary approach for effective management. This parasitic infection, caused by Echinococcus granulosus larvae, typically affects the liver and lungs but can manifest in the pericardium, leading to potentially life-threatening complications if untreated. The 22-year-old female's escalating dyspnea posed diagnostic challenges despite inconclusive echocardiography. Employing a multidisciplinary strategy, including preoperative albendazole therapy and surgical excision, effectively managed the condition. This case highlights the intricate diagnostic nature of pericardial hydatid cysts, emphasizing the importance of heightened clinical awareness, especially in endemic regions. The detailed clinical trajectory, imaging methodologies, and therapeutic interventions contribute significant insights to the medical community. The study aims to deepen comprehension and guide clinicians in refined diagnostic and treatment approaches for pericardial hydatid cysts, ultimately improving patient outcomes. It underscores the imperative for continued research in this niche to enhance medical understanding and optimize clinical practices.
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Affiliation(s)
- Sundar Suwal
- Department of Radiology, Maharajgunj Medical College, Kathmandu, Nepal
| | - Shailendra Katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
| | - Suman Lamichhane
- Department of Radiology, Nepal A.P.F. Hospital, Kathmandu, Nepal
| | - Dinesh Chataut
- Department of Radiology, Maharajgunj Medical College, Kathmandu, Nepal
| | - Amrit Bhusal
- Department of Radiology, BP Koirala Institute of Health Sciences, Sunsari, Nepal
| | - Aakriti Sharma
- Department of Cardiothoracic Surgery, Manmohan Cardiac, Vascular and Transplant Center, Kathmandu, Nepal
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Bumann S, Kuenzli E, Lissandrin R, Brunetti E, Goblirsch S, Henning L, Tamarozzi F, Neumayr A. Cardiac cystic echinococcosis-A systematic review and analysis of the literature. PLoS Negl Trop Dis 2024; 18:e0012183. [PMID: 38814859 PMCID: PMC11139302 DOI: 10.1371/journal.pntd.0012183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.
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Affiliation(s)
- Simone Bumann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Esther Kuenzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Raffaella Lissandrin
- Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, WHO Collaborating Centre on Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - Enrico Brunetti
- Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, WHO Collaborating Centre on Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - Sam Goblirsch
- Department of Medicine and Pediatrics, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Lars Henning
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, WHO Collaborating Centre on Strongyloidiasis and other Neglected Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
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Roset-Altadill A, Domenech-Ximenos B, Cañete N, Juanpere S, Rodriguez-Eyras L, Hidalgo A, Vargas D, Pineda V. Epicardial Space: Comprehensive Anatomy and Spectrum of Disease. Radiographics 2024; 44:e230160. [PMID: 38483831 DOI: 10.1148/rg.230160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The epicardial space (ES) is the anatomic region located between the myocardium and the pericardium. This space includes the visceral pericardium and the epicardial fat that contains the epicardial coronary arteries, cardiac veins, lymphatic channels, and nerves. The epicardial fat represents the main component of the ES. This fat deposit has been a focus of research in recent years owing to its properties and relationship with coronary gossypiboma plaque and atrial fibrillation. Although this region is sometimes forgotten, a broad spectrum of lesions can be found in the ES and can be divided into neoplastic and nonneoplastic categories. Epicardial neoplastic lesions include lipoma, paraganglioma, metastases, angiosarcoma, and lymphoma. Epicardial nonneoplastic lesions encompass inflammatory infiltrative disorders, such as immunoglobulin G4-related disease and Erdheim-Chester disease, along with hydatidosis, abscesses, coronary abnormalities, pseudoaneurysms, hematoma, lipomatosis, and gossypiboma. Initial imaging of epicardial lesions may be performed with echocardiography, but CT and cardiac MRI are the best imaging modalities to help characterize epicardial lesions. Due to the nonspecific onset of signs and symptoms, the clinical history of a patient can play a crucial role in the diagnosis. A history of malignancy, multisystem diseases, prior trauma, myocardial infarction, or cardiac surgery can help narrow the differential diagnosis. The diagnostic approach to epicardial lesions should be made on the basis of the specific location, characteristic imaging features, and clinical background. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Adria Roset-Altadill
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Blanca Domenech-Ximenos
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Noemi Cañete
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Sergi Juanpere
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Lucia Rodriguez-Eyras
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Alberto Hidalgo
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Daniel Vargas
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Victor Pineda
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
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Caushi F, Hysa E, Skenduli I, Lisha L, Hatibi A, Bica L, Bala S, Rulli F. A rare and challenging case of intrapericardial hydatidosis. J Cardiothorac Surg 2023; 18:336. [PMID: 37986073 PMCID: PMC10658974 DOI: 10.1186/s13019-023-02455-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/15/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Hydatid cysts are most frequently located in the liver and lungs and very rarely can be found in the pericardium. Diagnosis and treatment are quite challenging, as the disease can present itself in many forms depending to the location and the complications that it might cause. CASE PRESENTATION A 22-year-old man presented to our hospital with ongoing dry cough for more than 1 month prior to admission. Other symptoms included chest pain, fatigue, low grade fever, and night sweats, which have worsened in the past 2 weeks. Physical examination revealed normal respiratory and heart function. Chest X-ray demonstrated mediastinal enlargement and left pleural effusion. Contrast-enhanced computed tomography images showed a walled cystic mass lesion measuring up to 56 × 50 mm in close proximity to the upper left atrium, ascending aorta and pulmonary artery, potentially localized in the pericardium, with a 10 mm endoatrial filling defect, findings were compatible with hydatid cyst, left pleural effusion and peripheral pulmonary upper left lobe consolidation. Cardiac involvement was excluded on magnetic resonance imaging and trans-esophageal ultrasound. The patient underwent fine needle aspiration of the affected lung and thoracocentesis. No malignancy was found, meanwhile the biopsy confirmed the presence of pulmonary infarction. In view of the imaging findings were highly suspicious of a hydatid cyst, we performed a test of antibody titers that was negative. The patient underwent left anterolateral thoracotomy, and after the opening of the pericardium, a cystic mass of 5 cm in diameter was found next to the left atrium and in close proximity with the left pulmonary veins. The content of the cyst was completely removed after the surgical area was isolated with gauze impregnated with hypertonic solution (NaCl 10%). The mass resulted to be an echinococcal cyst with multiple daughter cysts within it that did not penetrate/involve (perforate) the cardiac wall. CONCLUSION Pericardial echinococcosis is a very rare pathology in which a high expertise multidisciplinary approach is required. The compression mass effect caused by the cyst can lead to complications, such as in our case where the pulmonary vein was compressed, leading to pulmonary infarction. The value of radiology studies and transoesophageal ultrasound are very important in the diagnosis. Surgery in these cases is always recommended, but preferred surgical approach is questionable. In cases such as ours, we recommend anterolateral thoracotomy.
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Affiliation(s)
- Fatmir Caushi
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania.
- Department of Surgery, "Our Lady of Good Counsel" University, Tirana, Albania.
| | - Emira Hysa
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Ilir Skenduli
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Lutfi Lisha
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Alban Hatibi
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Loreta Bica
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Silvana Bala
- Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Street "Shefqet Ndroqi", 1001, Tirana, Albania
| | - Francesco Rulli
- Department of Surgery, "Our Lady of Good Counsel" University, Tirana, Albania
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Lungu M, Oprea VD, Zaharia AL, Stan B, Rebegea L, Mocanu DI, Elkan EM, Niculet E, Croitoru A. Stroke-Associating Acute Limb Ischemia Due to the Rupture of a Hydatid Cyst. Curr Issues Mol Biol 2023; 45:2597-2608. [PMID: 36975540 PMCID: PMC10047644 DOI: 10.3390/cimb45030170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
(1) Background: Hydatidosis, or human cystic echinococcosis, is a zoonotic disease. Endemic in some areas, recently it has an increasing incidence in wider regions, determined by population migration. Clinical features depend on the localization and level of infection: asymptomatic or with signs related to hypersensitivity, organic functional deficiencies, expanding mass effects, cyst infection and sudden death. In rare cases, the rupture of a hydatid cyst causes emboli formation by the residual laminated membrane. (2) Methods: We performed an extensive literature review, starting from the case of a 25-year-old patient presenting with neurologic symptoms relevant for acute stroke, associating right upper limb ischemia. (3) Results: Imaging investigations revealed the source of the emboli as the rupture of a hydatid cyst, the patient presenting multiple pericardial and mediastinal localizations. Cerebral imaging confirmed an acute left occipital ischemic lesion, with complete recovery of the neurological deficit after therapy, while surgery for acute brachial artery ischemia had a favorable postoperative evolution. Specific anthelmintic therapy was initiated. An extensive literature review using available databases revealed the scarcity of data on embolism as a consequence of cyst rupture, highlighting the significant risk of clinicians overlooking this possible etiology. (4) Conclusions: An associated allergic reaction should raise the hypothesis of a hydatid cyst rupture as a cause of any level acute ischemic lesion.
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Affiliation(s)
- Mihaela Lungu
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Violeta Diana Oprea
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Andrei Lucian Zaharia
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Bianca Stan
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Laura Rebegea
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Dan Iulian Mocanu
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Eva Maria Elkan
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
- "St. Joan" Pediatric Clinical Emergency Hospital Galati, 800487 Galati, Romania
| | - Elena Niculet
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Ana Croitoru
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
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Althobaity W, Aldeheshi A, Bin Saeedan M. Primary Chest Wall Hydatid Disease: A Case Report with Multimodality Imaging Findings. Case Rep Radiol 2023; 2023:5313067. [PMID: 37089875 PMCID: PMC10118874 DOI: 10.1155/2023/5313067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/15/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Primary chest wall hydatid cyst is a very rare disease in endemic areas. This case report describes a 22-year-old male patient with a 3-year history of chronic left chest pain. He had a history of close animal contact in childhood. Chest computed tomography (CT) scan showed a left upper posterior paravertebral cystic mass with peripheral and intrinsic calcifications. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scan showed no significant FDG uptake. Magnetic resonance imaging (MRI) showed a left paravertebral cystic mass with daughter cysts and a peripheral low T2 wall, compatible with hydatid disease. Medical treatment was started, and a follow-up MRI showed rupture of hydatid cysts. The patient underwent surgical resection, and a hydatid disease diagnosis was confirmed by histopathologic examination. During the postoperative hospital course, the patient developed pneumothorax which was successfully treated with a surgical procedure. The patient was discharged with medical treatment (albendazole). In conclusion, this case highlights the importance of considering hydatid disease in the differential diagnosis of chest wall cystic masses, especially in endemic regions, and the value of multimodality imaging in diagnosis and treatment planning.
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Affiliation(s)
- Waleed Althobaity
- Department of Radiology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ayman Aldeheshi
- Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mnahi Bin Saeedan
- Department of Radiology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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7
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Bajdechi M, Manolache D, Tudor A, Orghidan M, Gurghean A. Cardiac hydatid cysts in a young man: A case report and a literature review. Exp Ther Med 2022; 24:550. [DOI: 10.3892/etm.2022.11487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mircea Bajdechi
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dalia Manolache
- Department of Pneumology and Thoracic Surgery, ‘Marius Nasta’ Institute of Pneumology, 050159 Bucharest, Romania
| | - Adrian Tudor
- Department of Pneumology and Thoracic Surgery, ‘Marius Nasta’ Institute of Pneumology, 050159 Bucharest, Romania
| | - Mihnea Orghidan
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adriana Gurghean
- Department 1, Medical Semiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Abou-Bekr B, Riffi O, Klouche djedid S, emam hassen AK, ouadah A. Pericardial, pulmonary and hepatic hydatid cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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9
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Dind A, Harmer JA, Hansen PS, Harris B. Extensive pulmonary artery embolisation caused by cardiac hydatid cyst rupture. BMJ Case Rep 2021; 14:14/4/e240521. [PMID: 33827876 PMCID: PMC8030676 DOI: 10.1136/bcr-2020-240521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This case study is a rare example of cardiac hydatidosis in a high-income country, where a middle-aged man presented with a ruptured right ventricular cyst causing anaphylaxis, pulmonary emboli and dissemination of Echinococcus throughout the lung. He survived the cyst rupture and underwent cardiac surgery but had incomplete resection and experienced progressive cardiopulmonary hydatidosis despite antihelminthic therapy. As a result, he experienced an array of cardiopulmonary sequelae over his lifespan. This case report highlights rare clinical manifestations of hydatid disease and potential complications of its treatment.
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Affiliation(s)
- Ashleigh Dind
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jason A Harmer
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter S Hansen
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin Harris
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
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10
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Concurrent intrapericardial-pulmonary hydatidosis: an unusual multisystem echinococcosis. Indian J Thorac Cardiovasc Surg 2021; 37:438-441. [PMID: 34220028 DOI: 10.1007/s12055-020-01109-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022] Open
Abstract
A 46-year-old male presented with breathlessness for a few months. He had been operated twice for liver hydatid cysts and once for right pulmonary hydatid cysts at other hospitals. Now he was found to have one hydatid cyst in the upper lobe of the left lung and multiple hydatid cysts adjoining left heart border. On computed tomography (CT) scan chest and echocardiography, it was difficult to ascertain whether these cysts were pulmonary or intrapericardial. Left ventricular ejection fraction (LVEF) was 25%. Enzyme-linked immunosorbent assay (ELISA) was positive for hydatid. Left posterolateral thoracotomy revealed dead hydatid cyst in upper lobe of the lung that was removed. Infected mother hydatid cyst was encountered inside pericardial sac. Scores of daughter hydatid cysts, varying in size from 1 to 30 mm, were scooped out intact from the pericardial cavity. There was significant improvement in cardiac activity, once the tamponade effect of hydatid cyst was removed. Pericardium was about 1 cm thick with lot of purulent and necrotic slough. To prevent future constrictive pericarditis, subtotal pericardiectomy was done. Intrapericardial hydatid cyst should be kept in mind whenever it obscures the heart border and patient has features of cardiac tamponade. Early surgical intervention may be required in these cases.
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11
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Saeedan MB, Aljohani IM, Alghofaily KA, Loutfi S, Ghosh S. Thoracic hydatid disease: A radiologic review of unusual cases. World J Clin Cases 2020; 8:1203-1212. [PMID: 32337194 PMCID: PMC7176618 DOI: 10.12998/wjcc.v8.i7.1203] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/24/2020] [Accepted: 03/22/2020] [Indexed: 02/05/2023] Open
Abstract
Hydatid disease or echinococcosis is a zoonotic parasitic disease. The lung is the second most commonly affected organ after the liver. Intra-thoracic and extra-pulmonary hydatid disease is uncommon and may involve the pleura, mediastinum, heart, diaphragm, and chest wall. Unusual locations or complications of thoracic hydatid disease may pose a diagnostic challenge. We present imaging findings of cases with unusual location and presentations of thoracic hydatid disease with emphasis on their clinical implications.
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Affiliation(s)
- Mnahi Bin Saeedan
- Department of Radiology, King Faisal Specialist Hospital and Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Ibtisam Musallam Aljohani
- Department of Radiology, King Faisal Specialist Hospital and Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | - Khalefa Ali Alghofaily
- Medical Imaging Department, Qassim University, College of Medicine, Buraydah 52571, Saudi Arabia
| | - Shukri Loutfi
- Medical Imaging Department, Chest Radiology Section, King Abdulaziz Medical City, Riyadh 12746, Saudi Arabia
| | - Subha Ghosh
- Imaging Institute, Section of Thoracic Imaging, Cleveland Clinic, Cleveland, OH 44195, United States
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Zaimi S, Bellamlih H, Nassar I. Hydatid pulmonary embolism: An exceptional complication of hydatid disease. Radiol Case Rep 2020; 15:545-547. [PMID: 32180858 PMCID: PMC7063108 DOI: 10.1016/j.radcr.2020.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 11/29/2022] Open
Abstract
We present an extremely rare case of a young man with hydatid pulmonary embolism caused by a direct invasion of the pulmonary artery by a hydatid cyst. Even if it is a benign parasitic disease, it can lead to serious complications such as arterial, systemic, or multivisceral dissemination or being responsible for an anaphylactic shock. Because of the clinical polymorphism, the diagnosis can be delayed. Therefore, it is necessary to know when conduct a chest CT angiography which is the gold standard for the positive diagnosis.
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Affiliation(s)
- Soukaina Zaimi
- Central Radiology Department, Ibn Sina Hospital, Mohamed V University, BP 10100, Rabat, Morocco
| | - Habib Bellamlih
- Central Radiology Department, Ibn Sina Hospital, Mohamed V University, BP 10100, Rabat, Morocco
| | - Ittimade Nassar
- Central Radiology Department, Ibn Sina Hospital, Mohamed V University, BP 10100, Rabat, Morocco
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13
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Hydatid cyst of the heart with mitral valve stenosis; Case report. Ann Med Surg (Lond) 2019; 49:49-52. [PMID: 31890197 PMCID: PMC6926137 DOI: 10.1016/j.amsu.2019.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 12/27/2022] Open
Abstract
Hydatid cyst of the heart is very rare, the left ventricle is the commonest site of myocardial involvement due to dominant left coronary vessels and thicker wall. Isolated cardiac involvement is extremely rare. Patients may be quite asymptomatic but the cyst may cause palpitation, dyspnea, chest pain, or when ruptured in to the cardiac or pericardial cavities may cause emergency presentations like anaphylactic reactions, sudden collapse due to pericardial tamponade or even sudden death. A middle age female presented with exertional shortness of breath for 2 years. Echocardiography showed mitral valve stenosis. Computerized tomography scan of the chest showed a big complicated hydatid cyst arising from the wall of the right ventricle. Median sternotomy was done with excision of the hydatid cyst, and repair of mitral stenosis by commissurotomy. The patient received three cycles of albendazole for three months. Surgery is the best options of treatment of cardiac hydatid disease, when the disease is affecting the pericardium complete excision may be possible, but when the myocardium is involved it may be difficult or even impossible to do complete excision, in this situation the cyst contents should be evacuated completely, preventing spillage is very mandatary to prevent recurrence. Care must be taken to avoid damage to the conductive system, the papillary muscles, the aortic and the mitral valves. Medical treatment with anthelminthic medications is used after surgery to reduce the recurrence rate. Hydatid cyst of the heart is a very rare clinical finding. It may be encountered during any other kinds of cardiac surgeries. The heart may be primarily affected of may be secondary to other organ involvement.
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14
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Vural U, Aglar AA, Kayacioglu İ. Intracoronary Hydatid Cyst Resulted in Coronary Artery Disease in a Young Patient. Braz J Cardiovasc Surg 2019; 34:107-110. [PMID: 30810684 PMCID: PMC6385834 DOI: 10.21470/1678-9741-2018-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac
involvement. Only 10% of these become symptomatic. Considering the long time
interval between the start of infestation and symptoms to occur, it is hard to
diagnose cystic echinococcosis. When detected, even if it is asymptomatic,
intramyocardial hydatid cyst requires surgical intervention due to risks of
spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst
located in the coronary arterial wall has been reported. Twenty-two-year-old
male patient with previous history of pulmonary cystic echinococcosis was
referred to us with typical symptoms of coronary artery disease. Coronary
cineangiography revealed proximal left diagonal artery (LAD) occlusion.
Pre-operative transthoracic echocardiography of the patient planned to undergo
coronary artery bypass grafting unveiled an intracoronary calcified cystic mass.
In operation, the calcified cystic mass with well-defined borders and size of
2x2 cm located within wall of proximal segment of the LAD artery was excised and
double bypass with left internal thoracic artery (LITA) and great saphenous vein
grafts to the LAD and first diagonal arteries, respectively, was done.
Pathological analysis of the mass revealed it to be an inactive calcified
hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole
treatment (2x400 mg/day) was launched postoperatively and the patient was
discharged on 7th postoperative day.
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Affiliation(s)
- Unsal Vural
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - Ahmet Arif Aglar
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
| | - İlyas Kayacioglu
- Departament Cardiovascular Surgery, Doktor Siyami Ersek Gogus Kalp ve Damar Cerrahisi Egitim ve Arastirma Hastanesi Ringgold Standard Institution, Istanbul, Turkey
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15
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Multiple primary cardiac hydatid cysts in the interventricular septum—A rare case report. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.ihjccr.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Bouassida I, Pricopi C, Mangiameli G, Arame A, Auliac JB, Gorbatai B, Riquet M, Le Pimpec Barthes F. [Cardiac compression of hydatid origin]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:248-252. [PMID: 29779892 DOI: 10.1016/j.pneumo.2018.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/26/2018] [Accepted: 03/30/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Cardiac hydatid disease is uncommon and occurs in 0.5 to 2% of patients with hydatidosis. Isolated intrapericardial hydatid cystic disease is extremely rare. OBSERVATION We report the case of a young woman with cardiac compression due to multiple primary intrapericardial hydatid cysts. Since 1 year, she had gradual general health deterioration including dyspnoea, sweats and weight loss of 8kg. A widening of the mediastinum was observed on chest X-ray. The CT-scan, echocardiography and the dynamic IRM showed multiple mediastinal cysts with mass effect on the heart and main pulmonary artery. The size of the main pulmonary artery was reduced to 5 mm in diameter and the right upper pulmonary vein was nearly closed by posterior cysts. The right and left ventricular ejection fractions were estimated at about 34%. A complete resection of the cysts was performed by sternotomy. The surgical procedure was technically difficult because of major local inflammatory process. The postoperative outcome after an initial pulmonary embolism event was finally favourable. CONCLUSION Hydatidosis can lead to severe cardiac involvement. These rare forms of hydatid cystic disease must be known even in non endemic regions by surgeons because of increasing mobility of the world's population.
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Affiliation(s)
- I Bouassida
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - C Pricopi
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| | - G Mangiameli
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - A Arame
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - J B Auliac
- Service de pneumologie, centre hospitalier François-Quesnay, 2, boulevard Sully, 78200 Mantes-La-Jolie, France
| | - B Gorbatai
- Service de pneumologie, centre hospitalier François-Quesnay, 2, boulevard Sully, 78200 Mantes-La-Jolie, France
| | - M Riquet
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - F Le Pimpec Barthes
- Service de chirurgie thoracique, université Paris-Descartes, hôpital Européen-Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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17
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Bakkali A, Jaabari I, Bouhdadi H, Razine R, Bennani Mechita N, El Harrag J, Belkhadir A, Benlafqih C, Laaroussi M. [Cardiac hydatid cyst about 17 operated cases]. Ann Cardiol Angeiol (Paris) 2017; 67:67-73. [PMID: 28554702 DOI: 10.1016/j.ancard.2017.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/27/2017] [Indexed: 11/17/2022]
Abstract
Cardiac hydatid cyst is a rare parasitic disease. The purpose of this study was to describe the clinical, pathological features and the outcome of the surgical treatment of cardiac hydatid disease in our unit over a twenty-year period. METHODS Between May 1994 and May 2014, seventeen cases of cardiac hydatid cysts were operated at our unit. Overall, twelve patients were male (mean age 25±13years). All patients were complaining of dyspnea and 71% presented with chest pain. The diagnosis, based on histological examination, was suspected on echocardiography and computed tomography of chest. RESULTS Our study revealed five possible locations, which were in decreasing order of frequency: left ventricle, interventricular septum, right ventricle, left atrium and pulmonary artery. The surgical procedure was a controlled puncture and aspiration of the cyst content, with cystectomy (69%), or pericystectomy (31%). The resulting cavity left open in 6 cases (37.5%) or carefully closed in 10 (62.5%). Hospital mortality was 11.8% (n=2). Morbidity was marked by conduction abnormalities (n=2), bleeding and hematoma of the residual cavity that required surgical treatment (n=3). Eleven patients were followed with a mean period of 40.5±19.4 months. At follow-up, neither late deaths nor recurrence have occurred. CONCLUSION Cardiac hydatid cyst is a serious disease whose treatment is surgical. Cystectomy and pericystectomy remain the two surgical techniques able to offer good chance of cure with acceptable morbidity and mortality.
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Affiliation(s)
- A Bakkali
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc.
| | - I Jaabari
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
| | - H Bouhdadi
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
| | - R Razine
- Laboratoire de biostatistique, de recherche clinique et d'épidémiologie, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Maroc
| | - N Bennani Mechita
- Laboratoire de biostatistique, de recherche clinique et d'épidémiologie, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Maroc
| | - J El Harrag
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
| | - A Belkhadir
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
| | - C Benlafqih
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
| | - M Laaroussi
- Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc
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18
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Ben Khalfallah A, Ben Slima H. [Cardiac hydatid cyst. Which imaging modality for an accurate diagnosis?]. Ann Cardiol Angeiol (Paris) 2017; 66:102-108. [PMID: 28342525 DOI: 10.1016/j.ancard.2016.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 12/21/2016] [Indexed: 11/25/2022]
Abstract
Cardiac echinococcosis is rare. Its spontaneous course is serious because of the risk of rupture. Its clinical manifestations are variable, often latent and misleading. The diagnosis is sometimes referred to by chest radiography. It is much facilitated by non-invasive imaging techniques in particular transesophageal and transthoracic echocardiography, CT scan and magnetic resonance imaging. The latter through a morphological and topographical analysis accurate diagnosis of hydatid cyst and its relationship to cardiac muscle and surrounding tissue. Through functional analysis in cine cyst movements relative to the heart wall, it confirms its free or fixed character in the heart chambers, determines its insertion area, its deformability, the risk of rupture and its impact on myocardial contraction. Our case illustrates the relative contribution of these different imaging techniques and their respective contributions to the identification of hydatid cyst of its wall, its contents, its relationship with the various tunics and heart chambers and its relations with the lungs and mediastinum.
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Affiliation(s)
- A Ben Khalfallah
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de cardiologie, hôpital De Menzel Bourguiba, 7050 Bourguiba, Tunisie.
| | - H Ben Slima
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de cardiologie, hôpital De Menzel Bourguiba, 7050 Bourguiba, Tunisie
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19
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Itumur K, Tamam Y, Karabulut A, Guzel A, Kilic N. Co-occurrence of Cardiac and Cerebral Hydatid Cysts: A Case Report. Scott Med J 2016. [DOI: 10.1258/rsmsmj.51.3.50d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cardiac and cerebral hydatid cysts are rarely encountered. In this case, we report a male patient admitted to our hospital with hemiparesis, headache and dysphasia which occurred as a result of complications of both 3,1x3,5 cm single hydatid cyst in the left cardiac ventricle and multiple cerebral hydatid cysts (approximately 18 particles, the largest being 3× 2,2cm). He had undergone surgery 17 month earlier due to a multiple brain hydatid cysts. Although he had been treated with albendazole, multiple cerebral hydatid cysts re-appeared 17 months after operation. This was a rare case in which left ventricular intracavitary hydatid cyst occurred together with brain multiple cysts at the same time. Physicians should be alert about the probability of cardiac involvement when a cerebral hydatid cyst is diagnosed and appropriate investigations should always be conducted.
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Affiliation(s)
- K Itumur
- Dicle University Faculty Of Medicine Department Of Cardiology, Diyarbakir, Turkey
| | - Y Tamam
- Dicle University Faculty Of Medicine Neurology, Diyarbakir, Turkey
| | - A Karabulut
- Dicle University Faculty Of Medicine Department Of Cardiology, Diyarbakir, Turkey
| | - A Guzel
- Dicle University Faculty Of Medicine Neurosurgery Diyarbakir, Turkey
| | - N Kilic
- Dicle University Faculty Of Medicine Pathology, Diyarbakir, Turkey
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20
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Mohammad Nijres B, Srour S. Isolated Multiple Subepicardiac and Epicardiac Echinococcosis. Indian J Pediatr 2016; 83:1018-9. [PMID: 26806204 DOI: 10.1007/s12098-015-2008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 12/23/2015] [Indexed: 10/22/2022]
Affiliation(s)
| | - Samir Srour
- Department of Pediatric Cardiology, Children's Hospital-Damascus University, Damascus, Syria
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21
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Martín-Izquierdo M, Martín-Trenor A. [Hydatidosis simulating a cardiac tumour with pulmonary metastases]. CIR CIR 2016; 84:318-23. [PMID: 26738651 DOI: 10.1016/j.circir.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/08/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The presence of multiple symptomatic pulmonary nodules and one cardiac tumour in a child requires urgent diagnosis and treatment. Until a few decades ago, the diagnosis of a cardiac tumour was difficult and was based on a high index of suspicion from indirect signs, and required angiocardiography for confirmation. Echocardiography and other imaging techniques have also helped in the detection of cardiac neoplasms. However, it is not always easy to make the correct diagnosis. CLINICAL CASE The case is presented of a 12 year-old boy with pulmonary symptoms, and diagnosed with a cardiac tumour with lung metastases. The presence of numerous pulmonary nodules was confirmed in our hospital. The echocardiogram detected a solid cardiac nodule in the right ventricle. Magnetic resonance imaging confirmed the findings and the diagnosis. Puncture-aspiration of a lung nodule gave the diagnosis of hydatidosis. He underwent open-heart surgery with cardiac cyst resection and treated with anthelmintics. The lung cysts were then excised, and he recovered uneventfully. DISCUSSION This child had multiple pulmonary nodules and a solid cardiac nodule, and was suspected of having a cardiac tumour with pulmonary metastases. However, given the clinical history, background and morphology of pulmonary nodules, another possible aetiology for consideration is echinococcosis. The clinical picture of cardiac hydatidosis and its complications is highly variable. The clinical history is essential in these cases, as well as having a high index of suspicion. CONCLUSION Hydatidosis should be included in the differential diagnosis of a solid, echogenic, cardiac nodule. The treatment for cardiopulmonary hydatid cysts is surgical, followed by anthelmintics.
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Affiliation(s)
- Marta Martín-Izquierdo
- Servicio de Pediatría y Puericultura, Clínica San Miguel, Igualatorio Médico Quirúrgico de Navarra, Pamplona, España
| | - Alejandro Martín-Trenor
- Departamento de Cardiología y Cirugía Cardíaca, Sección de Cirugía Cardíaca, Clínica Universidad de Navarra, Pamplona, España.
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22
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Tzili N, Ahbeddou S, Ahmimech J, Abboud H, Boutarbouch M, El Hassan A, Berraho A. Swollen eyelid reveals multiple intracranial hydatid cysts associated with a palpebral cyst. J Fr Ophtalmol 2015; 39:210-2. [PMID: 26598810 DOI: 10.1016/j.jfo.2015.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 06/11/2015] [Accepted: 06/16/2015] [Indexed: 11/30/2022]
Abstract
We report a case of a hydatid cyst of the eyelid in a 12-year-old boy associated with cerebral involvement. The patient was initially treated by neurosurgeons for brain cysts. The course after an interval of two months was marked by regression of the palpebral cyst on albendazole.
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Affiliation(s)
- N Tzili
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco.
| | - S Ahbeddou
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - J Ahmimech
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - H Abboud
- Service de neurochirurgie, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - M Boutarbouch
- Service de neurochirurgie, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - A El Hassan
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - A Berraho
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
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23
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Sabzi F, Vaziri S, Faraji R. Right ventricular hydatid cyst ruptured to pericardium. Ann Card Anaesth 2015; 18:445-8. [PMID: 26139761 PMCID: PMC4881708 DOI: 10.4103/0971-9784.159825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 04/21/2015] [Indexed: 11/04/2022] Open
Abstract
Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.
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Affiliation(s)
- Feridoun Sabzi
- Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Siavoosh Vaziri
- Department of Infectious Diseases and Tropical Medicine, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Faraji
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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24
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Hidatidosis cardiopulmonar. Rev Clin Esp 2015; 215:63-4. [DOI: 10.1016/j.rce.2014.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 09/01/2014] [Indexed: 11/17/2022]
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25
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Mouhsine A, Belkouch A, Athmane EM, Roukhssi R, El Fikri A, Belyamani L, Mahfoudi M. Hydatid cyst of the pericardium: a case report. Pan Afr Med J 2014; 19:330. [PMID: 25918570 PMCID: PMC4405061 DOI: 10.11604/pamj.2014.19.330.5542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/06/2014] [Indexed: 11/11/2022] Open
Abstract
Pericardial hydatid cystis a rare condition; its clinical presentation is variable. It can reveal straightaway at the stage of life threatening complications. We report the case of a 17 years old female Arab patient, who complained of a sudden onset dyspnea, clinical examination was poor; the diagnosis was suspected by echocardiography and confirmed by the CT scan and hydatid serology. Furthermore, no other location was noted. Surgical treatmentwas proposed. The modern cross-sectional imaging especially CT scan and MRI revolutionized the diagnosis of this rare hydatid location.
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Affiliation(s)
- Abdelilah Mouhsine
- Department of Radiology, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Marrakech, Morocco
| | - Ahmed Belkouch
- Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - El Mehdi Athmane
- Department of Radiology, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Marrakech, Morocco
| | - Redouane Roukhssi
- Department of Radiology, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Marrakech, Morocco
| | - Abdelghani El Fikri
- Department of Radiology, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Marrakech, Morocco
| | - Lahcen Belyamani
- Emergency Department, Mohamed V Military Hospital of Instruction, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Mbarek Mahfoudi
- Department of Radiology, Avicenna Military Hospital, Faculty of Medicine and Pharmacy, Marrakech, Morocco
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26
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El Kharras A, Atmane M, El Fenni J, Chaouir S, Amil T. [Cardiac and renal hydatid disease--contribution of imaging: report of a case]. Pan Afr Med J 2014; 18:153. [PMID: 25419291 PMCID: PMC4236841 DOI: 10.11604/pamj.2014.18.153.2410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 01/21/2014] [Indexed: 11/11/2022] Open
Abstract
L’échinococcose cardiaque est rare, elle représente 0.2 à 2% des cas d'hydatidose. Elle siège essentiellement au niveau du ventricule gauche. La localisation péricardique est exceptionnelle. L’échocardiographie et la tomodensitométrie jouent un rôle primordial et sont généralement suffisantes pour poser le diagnostic de cette affection. Nous rapportons une observation d'une association de deux localisations peu courantes d'hydatidose rénale et péricardique partiellement rompu et l'intérêt de l'imagerie dans le diagnostic de ces lésions kystiques.
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Affiliation(s)
| | - Mehdi Atmane
- Services d'Imagerie Médicale, Hôpital Militaire d'Instruction Mohamed V Rabat, Maroc
| | - Jamal El Fenni
- Services d'Imagerie Médicale, Hôpital Militaire d'Instruction Mohamed V Rabat, Maroc
| | - Souad Chaouir
- Services d'Imagerie Médicale, Hôpital Militaire d'Instruction Mohamed V Rabat, Maroc
| | - Touria Amil
- Services d'Imagerie Médicale, Hôpital Militaire d'Instruction Mohamed V Rabat, Maroc
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27
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Epidemiology of hydatid disease in Qatar: a hospital based study from 2000 to 2013. ASIAN PAC J TROP MED 2014; 7S1:S85-7. [DOI: 10.1016/s1995-7645(14)60209-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 05/09/2014] [Accepted: 06/11/2014] [Indexed: 11/17/2022] Open
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Beheshtirouy S, Kakaei F, Oliaei-Motlagh M, Teimouri-Dereshki A, Jalilzadeh-Binazar M. Syncope in a patient with a large left ventricular hydatid cyst: an unusual presentation. Int J Cardiol 2014; 172:e385-6. [PMID: 24461965 DOI: 10.1016/j.ijcard.2013.12.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 12/30/2013] [Indexed: 11/16/2022]
Affiliation(s)
| | - Farzad Kakaei
- Imam Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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29
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Alizadeh-Ghavidel A, Kyavar M, Sadeghpour A, Totonchi Z, Mirmesdagh Y, Almassi N, Madadi S. Unusual clinical presentation of a giant left ventricle hydatid cyst. J Cardiovasc Thorac Res 2014; 5:175-8. [PMID: 24404351 DOI: 10.5681/jcvtr.2013.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/01/2013] [Indexed: 11/17/2022] Open
Abstract
A 39-year-old woman was hospitalized in our center due to chest and left shoulder pain. Having a history of tamponade and tuberculosis, she was under treatment for the previous two months. Echocardiography, chest CT and MRI documented intramyocardial and pericardial hydatid cyst which was later confirmed by further pathological studies. Later, the cyst was removed surgically.
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Affiliation(s)
| | - Majid Kyavar
- Cardiology and Cardiac Imaging Department, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
| | - Anita Sadeghpour
- Echocardiography Research Center, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
| | - Zia Totonchi
- Cardiac Anesthesia Department, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
| | - Yalda Mirmesdagh
- Heart Valve Disease Research Center, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
| | - Nooshin Almassi
- Infectious Disease Consultant, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
| | - Shabnam Madadi
- Cardiology and Cardiac Imaging Department, Rajaei Cardiovascular Medical & Research Center, Tehran, Iran
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30
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Bogdanovic A, Radojkovic M, Tomasevic RJ, Pesic I, Petkovic TR, Kovacevic P, Rancic Z. Presentation of pericardial hydatid cyst as acute cardiac tamponade. Asian J Surg 2014; 40:175-177. [PMID: 24393813 DOI: 10.1016/j.asjsur.2013.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 10/05/2013] [Accepted: 10/11/2013] [Indexed: 11/27/2022] Open
Abstract
We report a case of a 47-year-old man with isolated pericardial hydatid cyst (without myocardial involvement) that presented as acute pericardial tamponade. After initial investigation and transthoracic echocardiography, emergent pericardial drainage was performed for downgrading the urgency of a definitive treatment for a hydatid cyst. A computed tomography examination after the pericardial drainage showed a pericardial cyst without heart muscle involvement, making the treatment possible through anterior thoracotomy and without performing cardiopulmonary bypass. Complete surgical removal of the cyst was performed. The postoperative course was uneventful. The patient received postoperative albendazole treatment. He remained asymptomatic and no recurrence was observed during a 1-year follow-up period.
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Affiliation(s)
- Aleksandar Bogdanovic
- Cardiothoracic Surgery Clinic, Clinical Center, Bulevar Zorana Djindjica 48, 18000 Nis, Serbia
| | - Milan Radojkovic
- Department of General Surgery, Medical School, Bulevar Zorana Djindjica 81, 18000 Nis, Serbia.
| | | | - Ivan Pesic
- Department of General Surgery, Medical School, Bulevar Zorana Djindjica 81, 18000 Nis, Serbia
| | | | - Predrag Kovacevic
- Department of General Surgery, Medical School, Bulevar Zorana Djindjica 81, 18000 Nis, Serbia
| | - Zoran Rancic
- Division of Cardiovascular Surgery, University Hospital, Raemistrasse 100, 8091 Zurich, Switzerland
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Abstract
Cardiac Hydatidosis is a rare but potentially very serious complication of hydatid disease. It is a diagnostic and therapeutic challenge due to the variability of signs and symptoms at presentation. A case of disseminated hydatidosis, affecting the heart muscle, which failed to surgical evacuation and followed by spread to the brain and elsewhere in the body, is presented, discussed, together with a review of the literature. The disease, hydatididosis, remains a challenge even in our days. Systematic radical control in the Middle East is required. Alternative surgical options include heart transplantation when the disease affects the heart muscles and there is more than one cyst which fails to surgical evacuation.
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32
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El Malki H, Chetoui A, Fenane H, Benyoussef H, Rhissassi J, Sayah R, Laaroussi M. Intracavitary hydatid cyst of the left ventricle in child: an emergency surgery case report. Pan Afr Med J 2014; 19:401. [PMID: 25995797 PMCID: PMC4430140 DOI: 10.11604/pamj.2014.19.401.5770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/28/2014] [Indexed: 11/25/2022] Open
Abstract
Hydatid cysts of the heart are very rare in child. In this report we describe an interesting and unique case of an 8-year-old boy with a large cardiac intracavitary hydatid cyst filling the left ventricle. Echocardiography, computerized tomography, magnetic resonance imaging and serologic test were necessary for the diagnosis. Once assessing the diagnosis, an emergency open heart surgery was necessary to prevent the complications. Surgery associated to medical treatment provides good results as demonstrated in this case report.
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Affiliation(s)
- Hicham El Malki
- Department of Cardiovascular Surgery A, Ibn Sina Hospital, Rabat, Morocco
| | | | - Hicham Fenane
- Department of Thoracic Surgery, Ibn Sina Hospital, Rabat, Morocco
| | - Hicham Benyoussef
- Department of Cardiovascular Surgery A, Ibn Sina Hospital, Rabat, Morocco
| | - Jaafar Rhissassi
- Department of Cardiovascular Surgery A, Ibn Sina Hospital, Rabat, Morocco
| | - Rochde Sayah
- Department of Cardiovascular Surgery A, Ibn Sina Hospital, Rabat, Morocco
| | - Mohamed Laaroussi
- Department of Cardiovascular Surgery A, Ibn Sina Hospital, Rabat, Morocco
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33
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Naeem SN, Burhan H, Khan G. Hydatid cyst of the cardiac interventricular septum. Asian Cardiovasc Thorac Ann 2013; 23:320-2. [DOI: 10.1177/0218492313506125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hydatid cysts of the cardiac interventricular septum are rare and present a diagnostic and therapeutic challenge. We report the case of a 48-year-old woman who was successfully treated with cyst excision and capitonnage.
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Affiliation(s)
- Syed Nadir Naeem
- Department of Cardiac Surgery, Tabba Heart Institute, Karachi, Pakistan
| | - Hira Burhan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Ghufranullah Khan
- Department of Cardiac Surgery, Tabba Heart Institute, Karachi, Pakistan
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34
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Intracavitary cardiac hydatid cysts with a high risk of thromboemboli. Invasive nature of cardiac echinococcosis. Herz 2013; 39:882-6. [PMID: 23982833 DOI: 10.1007/s00059-013-3932-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 07/28/2013] [Indexed: 10/26/2022]
Abstract
Hydatid cysts are a serious health problem in many countries that raise farm animals, and they usually involve the liver and lungs. Although cardiac involvement is a rare manifestation of hydatid cyst disease, its early diagnosis and surgical management are crucial. Patients with cardiac hydatidosis may develop acute life-threatening complications secondary to their invasion of surrounding cardiac structures, such as cyst rupture together with systemic and pulmonary dissemination. Therefore, surgical excision is the definitive method of treatment for cardiac hydatid cysts in order to prevent these potential life-threatening complications, even for asymptomatic patients. Herein, we report the case of a 36-year-old man who initially presented with pleuritic chest pain, hemoptysis, and dyspnea. This was followed by the revelation of multiple cardiopericardial hydatid cysts which were discovered via transesophageal echocardiography and multislice computed tomography. In this case, there was a higher risk of cyst rupture and thromboembolism during systemic and pulmonary circulation due to the invasive nature of the cysts which were located in the left atrium as well as between the pulmonary artery and aorta. The patient successfully underwent the removal of the multiple cardiac cysts under cardiopulmonary bypass by taking into account their relationship with the surrounding cardiac structures and the potential risk of local, systemic, and pulmonary dissemination. A pathological evaluation of the surgical specimens confirmed the diagnosis of cardiac echinococcosis and the aggressive nature of the cardiopericardial hydatid cysts by demonstrating their myocardial invasion.
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35
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Abstract
Hydatid disease is endemic to various regions of the world, with an incidence of 0.4 per 100,000 persons. Isolated cardiac involvement is rare and occurs in only 0.02%-2% of cases. As the majority of cases are asymptomatic, can present catastrophically, and lead to high mortality, it has become increasingly important to identify the disease in an early stage and treat it with surgical excision. This review aims to familiarize the readers with the varied presentations, early diagnosis, and management of cardiac hydatid disease.
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Affiliation(s)
- Vijayakumar Abhishek
- Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, India.
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36
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Serraj M, Smahi M, Kamaoui I, El Houari A, Sahnoune F, Ouadnouni Y, Amara B, El Biaze M, Tizniti S, Benjelloun MC. [Hydatic pulmonary embolism: a rare complication of hepatic hydatid cyst]. Rev Mal Respir 2013; 30:215-21. [PMID: 23497931 DOI: 10.1016/j.rmr.2012.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 03/18/2012] [Indexed: 11/17/2022]
Abstract
Hepato-pulmonary hydatidosis is a parasitic disease common in Mediterranean countries. Hydatid pulmonary embolism is extremely rare and is due to rupture of a cardiac hydatid cyst or, more rarely, rupture of a hepatic hydatid cyst. We report three cases of hydatid pulmonary embolism secondary to rupture of a hydatid cyst into the inferior vena cava. Thoracic imaging, mainly CT angiography and MRI, was important for both the diagnosis and decisions on treatment. The prognosis of intra-arterial pulmonary hydatid cyst is poor because of the risk of acute fatal complications such as anaphylactic shock and vascular rupture and also of chronic progression to cor pulmonale and respiratory failure. The therapeutic management is difficult and often only partially effective hence the importance of focusing on preventative treatment.
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Affiliation(s)
- M Serraj
- Service de pneumologie, CHU Hassan II, BP 5552, 30006 Fès Sidi Brahim, Fès, Maroc.
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37
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Giant Liver Hydatid Cyst. ARS MEDICA TOMITANA 2013. [DOI: 10.2478/v10307-012-0010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Hydatiosis due to Echinococcus granulosus is an endemic parasitic zoonosis characterized by worldwide distribution. The most commonly involved anatomical locations are the liver and lung. The autors present a 12-year-old patient with a giant hepatic echinococcus cyst misdiagnosed as an abdominal malignancy during formal investigation. The patient was admitted to the hospital complaining for abdominal pain and with an important abdominal distention. Abdominal computed tomography revealed a giant abdominal mass: 23/21 cm, resembling a tumor, adherent to the liver edges and parietal peritoneum. The patient was taken into operation, and an a giant liver hydatid cyst was removed despite the radiological findings and the preoperative clinical suspicion.
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38
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Noomene R, Ben Maamer A, Bouhafa A, Haoues N, Oueslati A, Cherif A. Primary hydatid cyst of the gallbladder: an unusual localization diagnosed by magnetic resonance imaging (MRI). Pan Afr Med J 2013; 14:15. [PMID: 23504393 PMCID: PMC3597911 DOI: 10.11604/pamj.2013.14.15.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 04/16/2012] [Indexed: 12/19/2022] Open
Abstract
Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare. We report in this observation a new case of primary hydatid cyst of the gallbladder diagnosed by Magnetic Resonance Imaging (MRI).
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Affiliation(s)
- Rabii Noomene
- Service de chirurgie générale hôpital Habib Thameur, Tunis, Tunisia
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39
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Bonardi M, Dellabianca C, Valle VD, Valentini A, Raineri C, Dore R. Hydatid cyst of the cardiac interventricular septum. Int J Cardiol 2012; 158:e45-6. [DOI: 10.1016/j.ijcard.2011.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
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40
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Abstract
Hydatid cyst is a serious endemic parasitic disease found in cattle-raising areas of the world. Cardiac hydatid cysts are rare and appear in 0.5% to 2% of hydatid cyst cases. A 24-year-old male patient was admitted to the hospital because of chest pain. A cystic mass (4 4 3 cm) was demonstrated with transthoracic echocardiography, computed tomography, and magnetic resonance imaging. A hydatid cyst was located in the right ventricular wall near the inferior branch of the acute marginal branch of the right coronary artery and was located such that it pushed the tricuspid valve inward. The cystic materials were removed with the patient on cardiopulmonary bypass. The surgery for cardiac hydatid disease is safe, and the results are satisfactory.
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Affiliation(s)
- Mehmet Oc
- Department of Cardiovascular Surgery, Selcuk University, Konya, Turkey.
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41
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Elkarimi S, Ouldelgadia N, Gacem H, Zouizra Z, Boumzebra D, Blelaabidia B, Elhattaoui M. [Tamponade reveals an intra-pericardial hydatid cyst - a case report]. Ann Cardiol Angeiol (Paris) 2012; 63:267-70. [PMID: 22436634 DOI: 10.1016/j.ancard.2012.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Accepted: 01/26/2012] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hydatid disease is a parasitic infection caused by the development of the larval form of the Teania of Echinococcus granulosus. It is endemic in many regions of the world such as the Mediterranean basin. Location without pericardial cardiac involvement is extremely rare. In this case study, we will elaborate the case of an intra-pericardial hydatidosis disease without cardiac location revealed by a tamponade. OBSERVATION AA is a 60-year-old man with no pathological history and who was admitted for a tamponade assessment. Indeed, the cardiovascular examination showed a muffling of the heart sound and signs of a right heart failure. Besides, the ECG shows a microvoltage, and the chest radiography shows cardiomegaly. Moreover, the transthoracic echocardiogram confirmed the presence of an abundant pericardial effusion along with signs of a tamponade. It also reifies the presence of, at the intra-pericardial level, a multiple vesicular formation giving a cluster of grapes highly suggestive of an intra-pericardial hydatid disease. An emergency surgical drainage allowed removing about two liters of suspicious fluid along with cysts and white membranous. The pathological examination of the membranous confirmed the diagnosis of a pericardial hydatid cyst. The performance of a chest CT and an abdominal ultrasound's scan to identify other locations shows no further anomalies. The patient was put under medical treatment (Albendazole(®)) and is showing a good clinical improvement. CONCLUSION The intra-pericardial hydatid disease is another cause of tamponade not to fail despite its rareness, as it is endemic to North African countries.
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Affiliation(s)
- S Elkarimi
- Service de cardiologie, FMPM, PCIM, CHU Mohammed VI, Marrakech, Maroc.
| | - N Ouldelgadia
- Service de chirurgie cardiovasculaire, CHU Mohammed VI, Marrakech, Maroc
| | - H Gacem
- Service de cardiologie, FMPM, PCIM, CHU Mohammed VI, Marrakech, Maroc
| | - Z Zouizra
- Service de chirurgie cardiovasculaire, CHU Mohammed VI, Marrakech, Maroc
| | - D Boumzebra
- Service de chirurgie cardiovasculaire, CHU Mohammed VI, Marrakech, Maroc
| | - B Blelaabidia
- Service d'anatomie pathologique, CHU Mohammed VI, Marrakech, Maroc
| | - M Elhattaoui
- Service de cardiologie, FMPM, PCIM, CHU Mohammed VI, Marrakech, Maroc
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42
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Díaz-Menéndez M, Pérez-Molina JA, Norman FF, Pérez-Ayala A, Monge-Maillo B, Fuertes PZ, López-Vélez R. Management and outcome of cardiac and endovascular cystic echinococcosis. PLoS Negl Trop Dis 2012; 6:e1437. [PMID: 22235354 PMCID: PMC3250507 DOI: 10.1371/journal.pntd.0001437] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 10/30/2011] [Indexed: 12/29/2022] Open
Abstract
Background Cystic echinococcosis (CE) can affect the heart and the vena cava but few cases are reported. Methods A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995–2009) is reported. Results Main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. Cysts were located mostly in the right atrium and inferior vena cava. Nine patients were previously diagnosed with disseminated CE. Echocardiography was the diagnostic method of choice, although serology, electrocardiogram, chest X-ray, computed tomography/magnetic resonance imaging and histology aided with diagnosis and follow-up. Nine patients underwent cardiac surgery and nine received long-term antiparasitic treatment for a median duration of 25 months (range 4–93 months). One patient died intra-operatively due to cyst rupture and endovascular dissemination. Two patients died 10 and 14 years after diagnosis, due to pulmonary embolism (PE) and cardiac failure, respectively. One patient was lost to follow-up. Patients who had cardiac involvement exclusively did not have complications after surgery and were considered cured. There was only one recurrence requiring a second operation. Patients with vena cava involvement developed PEs and presented multiple complications. Conclusions Cardiovascular CE is associated with a high risk of potentially lethal complications. Clinical manifestations and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas. Cardiac and vascular involvement are infrequent in classical cystic echinococcosis (CE), but when they occur they tend to present earlier and are associated with complications that may be life threatening. Cardiovascular CE usually requires complex surgery, so in low-income countries the outcome is frequently fatal. This case series describes the characteristics of cardiovascular CE in patients diagnosed and treated at a Tropical Medicine & Clinical Parasitology Center in Spain. A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995–2009) is reported. The main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. The clinical picture and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas. CE is a neglected disease and further studies are necessary in order to make more definite management recommendations for this rare and severe form of the disease. The authors propose a general approach based on cyst location: exclusively cardiac, endovascular or both.
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Affiliation(s)
- Marta Díaz-Menéndez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José Antonio Pérez-Molina
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Francesca Florence Norman
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Ana Pérez-Ayala
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Pilar Zamarrón Fuertes
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- * E-mail:
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43
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Tokgoz HC, Tanboga IH, Uslu ZA, Tuncer A, Kaymaz C. Huge intramyocardial echinococcal cyst resulting in a significant left ventricular cavity obliteration evaluated by real-time 3-dimensional transesophageal echocardiography and multidetector computed tomography before and after complete excision. Circulation 2011; 124:1692-3. [PMID: 21986776 DOI: 10.1161/circulationaha.110.985432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hacer Ceren Tokgoz
- Kartal Kosuyolu Yuksek Ihtisas ve Egitim ve Arastirma Hastanesi, Kardiyoloji Klinigi, Cevizli 34865, Kartal, Istanbul, Turkey
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44
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45
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Leila A, Laroussi L, Abdennadher M, Msaad S, Frikha I, Kammoun S. A cardiac hydatid cyst underlying pulmonary embolism: a case report. Pan Afr Med J 2011; 8:12. [PMID: 22121421 PMCID: PMC3201579 DOI: 10.4314/pamj.v8i1.71061] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 02/12/2011] [Indexed: 11/17/2022] Open
Abstract
Hydatid cysts located in the interatrial septum are especially rare but when they occur, they might cause intracavity rupture. We report on a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interatrial septum. A 16-year-old-boy with an uneventful history was hospitalized for exercise-induced dyspnea and blood expectorations. Multiple and bilateral opacities were visualized on standard chest x-ray. Signs of right-sided hypertrophy were seen on ECG. Imaging findings led to the diagnosis of pulmonary embolism complicating cardiac hydatid cysts. An operation was performed through median sternotomy to remove the cardiac cyst. The pleural cavity was entered through the fifth intercostal space to withdraw lung hydatid cysts. Operative recovery was uneventful and the patient resumed his normal activities 19 months later. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.
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Affiliation(s)
- Abid Leila
- Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
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46
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Molavipour A, Javan H, Moghaddam AA, Dastani M, Abbasi M, Ghahramani S. Combined medical and surgical treatment of intracardiac hydatid cysts in 11 patients. J Card Surg 2010; 25:143-6. [PMID: 20492027 DOI: 10.1111/j.1540-8191.2009.00973.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Echinococcosis is a human parasitic disease common in sheep-rearing regions, which is caused by the larval stage of Echinococcus granolosus and can involve any heart region. We report 11 cases of cardiac hydatidosis who were treated medically and surgically. PATIENTS AND METHODS Eleven patients diagnosed with cardiac echinococcosis were referred to the Cardiac Surgery Department of Shahid Madani Hospital from 1992 to 2004. Symptoms included dyspnea, palpitation, limb ischemia, fever, weight loss, hemiplegia, and loss of consciousness. Patients underwent surgical removal of the cyst followed by medical treatment until the titer of echinococcus hemaglutination test came to normal. RESULTS Hospital stay and recovery time were uneventful in nine patients. One patient died due to acute renal failure before hospital discharge (9%) and another patient experienced cerebral hydatidosis 12 months after surgery (probably due to cyst embolism). The other nine patients had no complications during five years of follow-up. CONCLUSION Surgical excision using cardiopulmonary bypass combined with medical therapy provides the most optimal treatment for cardiac echinococcosis.
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Affiliation(s)
- Alireza Molavipour
- Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Iran
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47
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Abstract
Parasitic infections previously seen only in developing tropical settings can be currently diagnosed worldwide due to travel and population migration. Some parasites may directly or indirectly affect various anatomical structures of the heart, with infections manifested as myocarditis, pericarditis, pancarditis, or pulmonary hypertension. Thus, it has become quite relevant for clinicians in developed settings to consider parasitic infections in the differential diagnosis of myocardial and pericardial disease anywhere around the globe. Chagas' disease is by far the most important parasitic infection of the heart and one that it is currently considered a global parasitic infection due to the growing migration of populations from areas where these infections are highly endemic to settings where they are not endemic. Current advances in the treatment of African trypanosomiasis offer hope to prevent not only the neurological complications but also the frequently identified cardiac manifestations of this life-threatening parasitic infection. The lack of effective vaccines, optimal chemoprophylaxis, or evidence-based pharmacological therapies to control many of the parasitic diseases of the heart, in particular Chagas' disease, makes this disease one of the most important public health challenges of our time.
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48
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Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114:1-16. [PMID: 19931502 DOI: 10.1016/j.actatropica.2009.11.001] [Citation(s) in RCA: 1152] [Impact Index Per Article: 82.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2009] [Revised: 11/02/2009] [Accepted: 11/04/2009] [Indexed: 12/13/2022]
Abstract
The earlier recommendations of the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) for the treatment of human echinococcosis have had considerable impact in different settings worldwide, but the last major revision was published more than 10 years ago. Advances in classification and treatment of echinococcosis prompted experts from different continents to review the current literature, discuss recent achievements and provide a consensus on diagnosis, treatment and follow-up. Among the recognized species, two are of medical importance -Echinococcus granulosus and Echinococcus multilocularis - causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. For CE, consensus has been obtained on an image-based, stage-specific approach, which is helpful for choosing one of the following options: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and wait. Clinical decision-making depends also on setting-specific aspects. The usage of an imaging-based classification system is highly recommended. For AE, early diagnosis and radical (tumour-like) surgery followed by anti-infective prophylaxis with albendazole remains one of the key elements. However, most patients with AE are diagnosed at a later stage, when radical surgery (distance of larval to liver tissue of >2cm) cannot be achieved. The backbone of AE treatment remains the continuous medical treatment with albendazole, and if necessary, individualized interventional measures. With this approach, the prognosis can be improved for the majority of patients with AE. The consensus of experts under the aegis of the WHO-IWGE will help promote studies that provide missing evidence to be included in the next update.
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Affiliation(s)
- Enrico Brunetti
- Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S.Matteo Hospital Foundation, WHO Collaborating Center for Clinical Management of Cystic Echinococcosis, 27100 Pavia, Italy.
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Emlik D, Kiresi D, Sunam GS, Kivrak AS, Ceran S, Odev K. Intrathoracic extrapulmonary hydatid disease: radiologic manifestations. Can Assoc Radiol J 2010; 61:170-6. [PMID: 20110156 DOI: 10.1016/j.carj.2009.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 11/20/2009] [Accepted: 12/04/2009] [Indexed: 12/20/2022] Open
Affiliation(s)
- Dilek Emlik
- Department of Radiology, Selcuk University Meram Medicine School, Konya, Turkey.
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Molavipour A, Javan H, Moghaddam AA, Dastani M, Abbasi M, Ghahramani S. Combined Medical and Surgical Treatment of Intracardiac Hydatid Cysts in 11 Patients. J Card Surg 2010. [DOI: 10.1111/j.1540-8191.2010.00973.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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