Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report

Abstract

BackgroundHydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown.Case presentationWe deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss.ConclusionPrimary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.

Cystic lesion of pectoralis minor muscle: learning from mistakes

“…The multivesicular lesion is formed by the grouping of multiple daughter vesicles within the original cyst is characteristic but not pathognomonic, though 4 , 6. When the cysts are not viable, they do not produce fluid;5 the case presented corresponded to a non-viable hydatid cyst. In some cases, an inflammatory reaction may produce changes that resemble an atypical complex or solid lesion, challenging the differential diagnosis.…”

“…Imaging exams are fundamental to the diagnosis and include some typical patterns as the unilocular cyst, the multivesicular lesion (highly characteristic), and the atypical complex or solid lesion 4 , 5. The multivesicular lesion is formed by the grouping of multiple daughter vesicles within the original cyst is characteristic but not pathognomonic, though 4 , 6.…”

“…In some cases, an inflammatory reaction may produce changes that resemble an atypical complex or solid lesion, challenging the differential diagnosis. The MRI is considered the imaging exam of choice, because of the higher sensitivity and specificity 5 , 6…”

A case report of primary hydatidosis of ulna and adjacent soft tissue

“…Hydatid disease, is caused by Echinococcus species, mainly involves Echinococcus granulosus and less commonly Echinococcus multilocularis, and Echinococus oligarthrus. A hydatid cyst of Echinococcus Granulosus often leads to cyst formation in carnivores like dogs, wolves, and foxes, as well as in intermediate hosts like sheep, goats, and cattle, with humans serving as incidental intermediate hosts in this context [1] . Humans can become infected with the parasite through direct contact with contaminated animals or by ingesting the parasite through the fecal-oral route.…”

Designing a Recombinant Multi-Epitope Antigen of Echinococ-cus granulosus to Diagnose Human Cystic Echinococcosis

“…The clinical manifestations of CE are not critically pathognomonic; hence, searching for an accurate diagnostic method is vitally important (3,9). Ultrasonography (US), computerized tomography (CT), and magnetic resonance imaging (MRI) are the main primary diagnostic methods for CE (3,10). US is used for the diagnosis of both hepatic and extrahepatic CE (11), while CT is used to detect the presence of daughter cysts and calcification in the cyst wall (12).…”