Acute arterial embolism as the clinical presentation of a disseminated hydatidosis: case report

Abstract

Hydatidosis is a parasitic infection caused by the Echinococcus granulosus larvae, transmitted by the ingestion of infected food, characterized by the formation of cysts in vital organs. In Argentina, the disease is spread throughout the territory, constituting an important public health issue. The disease usually affects the liver and lungs. The affection of other organs is rare, and even more uncommon the affection of the heart. We present the case of a disseminated hydatidosis in a pediatric patient, whose initial clinical manifestation was an acute arterial embolism of the right limb caused by the rupture of a hydatidic cardiac cyst.

Stroke-Associating Acute Limb Ischemia Due to the Rupture of a Hydatid Cyst

“…The treatment of hydatid cysts is an emergency for cardiac/cerebral/pulmonary lesions due to the high risk of mortality and dissemination [ 21 , 24 , 43 , 48 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ]. Surgery or PAIR (puncture, aspiration, injection of protoscolicidal agent and reaspiration) are required for cystic lesions.…”

“…Surgery or PAIR (puncture, aspiration, injection of protoscolicidal agent and reaspiration) are required for cystic lesions. Embolectomy is recommended in all situations of acute arterial obstruction [ 42 , 43 , 44 , 45 , 46 , 58 , 59 , 60 , 61 , 62 , 63 ]. For better treatment outcomes, surgery should be completed with medical therapy comprising benzimidazole drugs (albendazole +/− praziquantel is considered the standard, aiming for scolicidal and anti-cystic activity) [ 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ].…”

“…For better treatment outcomes, surgery should be completed with medical therapy comprising benzimidazole drugs (albendazole +/− praziquantel is considered the standard, aiming for scolicidal and anti-cystic activity) [ 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. The follow-up to detect the appearance of new lesions is mandatory [ 42 , 57 , 58 , 59 , 60 ].…”

“…Hydatid cysts of the heart are very rare and are characterized by clinical latency. Rupture with the left-sided chambers may cause systemic emboli with various localizations, but embolization to brain or a limb artery is very rare [ 14 , 18 , 52 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ].…”

“…Peripheral arterial embolism in the brachial artery is an extremely rare clinical situation, the literature citing only few cases involving the femoral or popliteal arteries [ 4 , 10 , 16 , 29 , 31 , 33 , 35 , 36 , 59 ]. Additionally, we identified very few reports of stroke due to embolism after a ruptured hydatid cyst [ 12 , 14 , 17 , 18 , 21 , 22 , 30 , 61 , 62 ].…”