A 26-year-old male patient from the highlands of Peru was admitted with a 2-month history of early satiety, nausea, and progressive dyspnea. The physical examination showed decreased breath sounds on the left lung and abdominal distention with multiple painless palpable masses. The chest X-ray showed a well-defined rounded cystic pulmonary lesion located in the left lower lobe (Figure 1A). The abdominal computed tomography scan revealed multiple thin-walled abdominal cystic lesions in the liver and spleen and within the abdominal cavity (Figure 1B and C). A serum Western blot test was positive for hydatidosis. Multiple hydatid cysts were surgically removed (Figure 1D). The patient was treated with a prolonged course of albendazole with good clinical evolution.
(A) Rounded cystic lesion located on the left lobe of the lung. (B) Multiple intra-abdominal cystic lesions. (C) Multiple intrahepatic, splenic, and intra-abdominal cystic lesions. (D) Macroscopic aspect of surgically removed intra-abdominal hydatid cysts.
Citation: The American Society of Tropical Medicine and Hygiene 89, 3; 10.4269/ajtmh.13-0083
Hydatidosis caused by Echinococcus granulosus remains a major public health problem in developing countries. Disseminated intra-abdominal hydatidosis is an infrequent condition that usually results from the rupture of a liver cyst, with subsequent seeding of protoscolices in the abdominal cavity.1 There is no standard treatment for this disorder; careful surgical removal of the cysts and prolonged medical treatment with albendazole with or without praziquatel are recommended.2
- 1.↑
Majbar MA, Souadka A, Sabbah F, Raiss M, Hrora A, Ahallat M, 2012. Peritoneal echinococcosis: anatomoclinical features and surgical treatment. World J Surg 36: 1030–1035.
- 2.↑
Cobo F, Yarnoz C, Sesma B, Fraile P, Aizcorbe M, Trujillo R, Diaz-de-Liaño A, Ciga MA, 1998. Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus. Trop Med Int Health 3: 462–466.