Primary Splenic Hydatidosis

Hydatid Cyst of Spleen Presenting with Vague Symptoms: A Diagnostic Conundrum

“…Similarly, in our case, abdominal US depicted multiple well defined cystic hypoechoic lesions in the spleen and multiple splenic hypodense lesions associated with enlarged abdominal lymph nodes were noticed on abdominal CT. With no improvement from triple antibiotic therapy, the patient was advised for a serologic test. Abdominal radiographic findings in combination with positive immune-electrophoresis test have a sensitivity of more than 90% for the diagnosis of hydatid disease [4]. The diagnosis of splenic hydatid cyst was confirmed in this patient by positive radiologic findings and IgG antibodies against echinococcus.…”

“…Diagnosis of splenic hydatid cyst is made by complete blood profile showing eosinophilia, radiological modalities like US and CT scan and specific serum immune-electrophoresis tests [4]. Due to unrelated findings in our case, a few differential diagnoses were kept in mind.…”

“…Children with splenic hydatid cyst usually present with non-specific complaints or it may be detected incidentally. The signs and symptoms are related to splenomegaly, abdominal distension, and compression of adjacent structures [4]. However, it can present with local or referred pain which is postural in majority cases.…”

“…Although anti-helminthic regimen, in combination with surgery, is not considered as the treatment of choice due to poor absorption, low oral bioavailability, and inadequate concentration in cyst cavity to kill parasites, our patient responded well to the treatment [11,12]. The standard treatment of hydatid splenic cysts is splenectomy as it has low morbidity and mortality rate and complete resection removes all parasitic and pericystic tissues, but it was not performed as the fever subsided and US findings improved with medical management [4,13].…”