An unusual cause of stroke and sudden death: Intracavitary left ventricular echinococcosis

Zghal, Fathia; Boudiche, Sélim; Zongo, Timothee; Rekik, Bassem; Ouali, Sana; Mourali, Mohamed Sami

doi:10.1016/j.ijid.2019.10.018

Cited by 2 publications

(7 citation statements)

References 2 publications

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“…Surgery is the treatment of choice, but the risk-benefit ratio and shared decision making with the patient must be considered. The available data from non-surgical patients shows that three of them died shortly after diagnosis (<2 months) (19,41,55) and two of them had a good outcome (23,27). In the present case, the patient refused cardiac surgery and chose medical treatment.…”

Section: Literature Reviewmentioning

confidence: 62%

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Cardiac hydatid cysts in a young man: A case report and a literature review

et al. 2022

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Cystic hydatid disease commonly affects the liver and lungs. Cardiac hydatid cysts are a rare occurrence and can cause fatal complications, including anaphylactic shock, systemic or pulmonary embolism, dissemination, arrhythmias, valvular dysfunction or sudden death. The case of a 19-year-old male from a rural area who was admitted to the emergency room with anaphylactic shock is presented in the current study. The patient was subsequently referred to the Department of Pneumology due to a mild fever, a dry cough and thoracic pain. Pneumonia was suspected and antibiotics were administered. As the patient didn't respond to the antibiotics, a pulmonary CT-scan was performed, which demonstrated a bilateral pulmonary embolism of the segmental arteries and the patient was referred to the Department of Cardiology. Transthoracic echocardiography (TTE) demonstrated the presence of a right ventricular mass of ~25x18 mm, attached to its free wall, adjacent to the tricuspid valve causing no tricuspid inflow obstruction. Blood tests were positive for echinococcal infection. Considering that previous reviews had included cases published up until 2018, the present study also included a short literature review of the studies published between 2018 and 2021. The review showed that cardiac hydatid cysts are diagnosed more often in underdeveloped countries, especially in men. Transthoracic echocardiography is the most useful non-invasive imaging technique for diagnosis. Surgery is the treatment of choice, but consideration must be given to the risk-benefit ratio and the shared decision-making approach. The complete surgical removal of the cyst(s) is the major prognosis factor of the cardiac manifestation. This study emphasizes the importance of considering cardiac echinococcosis as a potential diagnosis in patients from endemic or farming areas.

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Section: Literature Reviewmentioning

confidence: 62%

“…Most of the patients were followed-up for 12 months (surgical and non-surgical patients). A total of four patients died shortly after diagnosis; three deaths were caused by postoperative complications and one was caused by stroke (20,34,41,53).…”

Section: Literature Reviewmentioning

confidence: 99%

Cardiac hydatid cysts in a young man: A case report and a literature review

et al. 2022

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

Lungu

Oprea

Zaharia

et al. 2023

CIMB

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(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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An unusual cause of stroke and sudden death: Intracavitary left ventricular echinococcosis

Cited by 2 publications

References 2 publications

Cardiac hydatid cysts in a young man: A case report and a literature review

Cardiac hydatid cysts in a young man: A case report and a literature review

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

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