Hidatidosis pulmonar: comparación de los resultados de la cirugía con y sin capitonaje mediante Propensity Score Matching / Pulmonary hydatidosis: comparison results of surgery with capitonnage versus surgery without capitonnage using Propensity Score Matching

Resumen Introducción: El tratamiento de elección del Quiste Hidatídico Pulmonar (QHP) es la resección quirúrgica. Actualmente, existe controversia sobre la superioridad de la cirugía con capitonaje (CC) versus la cirugía sin capitonaje (SC). Objetivo: Comparar los resultados de la cirugía conservadora CC y SC mediante Propensity Score Matching (PSM). Materiales y Método: Se realizó un estudio analítico retrospectivo de los pacientes con QHP tratados quirúrgicamente en el Hospital Guillermo Grant Benavente, Concepción, Chile; entre enero-1995 y diciembre-2018. Se realizó un PSM con una relación 1:1 entre los pacientes operados con la técnica CC y SC. Posterior al PSM se balancearon las características basales. Resultados: Total 205 episodios de QHP en el período. Se realizó cirugía conservadora en 165 casos, 101 CC y 64 SC. Posterior al emparejamiento se obtuvieron 53 pacientes operados CC y 53 SC. No se observaron diferencias significativas en la presencia de fuga aérea persistente (CC = 9,4%; SC = 11,3%, p 0,75), empiema (CC = 3,8%; SC = 0%, p 0,49), días con pleurotomía (CC = 9,1 ± 8,9; SC 10,1 ± 10,7, p 0,39, mediana 6 versus 6 días, respectivamente), ni días de estadía posoperatoria (CC = 10,4 ± 9,0; SC = 11,7 ± 11,9, p 0,22, mediana 7 versus 7 días, respectivamente). Conclusiones: La cirugía SC demostró resultados comparables a la técnica CC en el tratamiento quirúrgico conservador del QHP.

Background: The treatment of choice for Pulmonary Hydatid Cys (PHC) is surgical resection. There is currently controversy about the superiority of surgery with capitonage (SC) versus surgery without it (SWC). Aim: To compare the results of conservative surgery with capitonnage and versus surgery without capitonnage using Propensity Score Matching (PSM). Materials and Method: A retrospective analytical study was carried out with patients with PHC treated surgically at the Guillermo Grant Benavente Hospital, Concepción, Chile, between January-1995 and December-2018. A PSM was performed with a 1:1 ratio. Results: Conservative surgery was done in 165 cases, 101 SC and 64 SWC. After matching, 53 SC and 53 SWC operated patients were obtained. No significant differences were observed in the presence of persistent air leak (9.4% vs11.3%, SC vs SWC respectively, p 0.75), empyema (3.8% vs 0%, p 0.49), days with pleurotomy (9.1 ± 8.9 vs 10.1 ± 10.7, p 0.39), nor days of postoperative stay (10.4 ± 9.0 vs 11.7 ± 11.9, p 0.22). Conclusión: The SWC demonstrated comparable results to the SC technique in the conservative surgical treatment of PHC.

Coexistencia de Aspergilosis e Hidatidosis Pulmonar. Reporte de un caso / Coexistence of Pulmonary Aspergillosis and Hydatidosis. Case report

RESUMEN La hidatidosis es una zoonosis causada por el parásito Echinococcus granulosus. Perú es una zona endémica para esta infección, presentamos el caso de una mujer de 33 años, procedente de la región de Ica; que durante la gestación se le diagnosticó hidatidosis hepática y pulmonar y posterior al término de la gestación fue referida con tubo de drenaje torácico, disnea y dolor torácico en hemitórax derecho, de curso progresivo e imagen tomográfica de tórax que mostró quiste pulmonar basal posterior derecho. Los exámenes serológicos fueron positivos, la paciente fue sometida a resección quirúrgica con resultado histopatológico de quiste hidatídico pulmonar complicado no viable y estructura micótica consistente con aspergiloma. La coexistencia de estas dos entidades es rara y pueden ser amenazas potenciales para los pacientes. El diagnóstico y tratamiento tempranos son vitales para prevenir posibles complicaciones como la hemoptisis masiva o incluso enfermedad invasiva.

ABSTRACT Hydatidosis is a zoonosis caused by the parasite Echinococcus granulosus and Peru is an endemic zone for this infection. We present the case of a 33-year old woman from the region of Ica who, during gestation, was diagnosed with liver and pulmonary hydatidosis. After gestation was terminated, she was referred with thoracic drainage tube, dyspnea, and thoracic pain in right hemithorax, with progressive course and tomographic image of thorax showing right posterior basal pulmonary cyst. The serological analysis was positive, the patient underwent surgical resection with histopathologic result as complex non-viable pulmonary hydatidic cyst and mycotic structure consistent with aspergilloma. The coexistence of these two diseases is rare and can mean potential threats for patients. The early diagnosis and treatment are vital to prevent possible complications such as massive hemoptysis or even invasive disease.

Hidatidosis pulmonar bilateral: Reporte de caso / 0 BILATERAL PULMONARY HYDATID DISEASE: CASE REPORT AND REVISION

La hidatidosis es una zoonosis de distribución mundial producida por cestodos del género Echinococcus. Afecta principalmente regiones agrícolas y ganaderas. Es una enfermedad endémica en nuestro país, las mayores incidencias reportadas en Sudamérica corresponden Argentina, Chile, Uruguay y Brasil. El hígado es el principal órgano en el humano, le sigue en frecuencia el pulmón. La clínica suele ser inespecífica. Los síntomas más frecuentes son la tos y el dolor torácico, siendo un hallazgo en estudios imagenológicos. El diagnóstico de sospecha es a través de imágenes, apoyado en antecedentes epidemiológicos y serológicos. La radiografía de tórax asociada a la clínica permite el diagnóstico certero en hasta el 95% de los casos, sin embargo, los avances en la TC y su capacidad de caracterización la han hecho parte habitual del estudio preoperatorio. El tratamiento de la hidatidosis pulmonar es quirúrgico y consiste en la erradicación de los quistes, la corrección de los efectos de la presencia del quiste en el órgano (periquística y cavidad residual) y tratar las complicaciones que el quiste ha provocado en su evolución (fístulas bronquiales y siembra pleural). El tratamiento médico está reservado para quistes múltiples, únicos univesiculares menores de 5cm, pacientes de alto riesgo quirúrgico o inoperables y como quimioprofilaxis pre y postoperatoria. Existe consenso en que la cirugía con preservación de parénquima pulmonar es la elección, reservándose las resecciones pulmonares para aquellos casos en los que el tejido adyacente se encuentra seriamente dañado o infectado o cuando las aéreas de atelectasias son presumiblemente irrecuperables

Hydatidosis is a worldwide distribution zoonosis caused by Cestodes of the genus echinococcus. Mainly affects agricultural and livestock regions. Is an endemic disease in our country, the highest reports in South America correspond to Argentina, Chile, Uruguay and Brazil. The liver is the main target of the parasite, followed in frequency by the lungs. The clinical signs are usually non-specific. Most common symptons are cough and pain chest, being a finding in imaging studies. The presumptive diagnosis is made trough images, support by epidemiological and serological records. The chest x-Ray associated with the clinical symptons allows 95% of accuracy, however advances in CT allows to visualize the difference between the cyst and the normal tissue, this has turned it into a usual step in preoperative studies. The treatment of pulmonary hydatidosis is surgical and consists of the elimination of the cysts, the correction of the effects made by the presence of them in the organ (pericysts and residual cavity) and heal the complications the cysts may have done during the evolution (bronchial fistulas and pleural seeding). The medical treatment (non surgical) is only indicated in multiple cysts or unique uni vesiculares cysts under 5 cm, high risk surgical or inoperable patients and as pre and postoperative chemoprophylaxis. There is general agreement that lung parenchymal preservation surgery is the choice, reserving the pulmonary resections in cases that adjacent tissue is severely damaged of infected or when areas of atelectasis are presumably lost

Coexistent pulmonary hydatid disease and tuberculosis in an adult male

Hydatid disease with pulmonary tuberculosis coexisting in a patient is an extremely rare occurrence. A patient presenting with nonspecific chest symptoms must be adequately investigated and hydatidosis must be ruled out. This case report presents the unusual coexistence of tuberculosis and hydatid disease in an adult male and its subsequent diagnosis and management

Hidatidosis pulmonar / Pulmonary hydatidosis

Pulmonary hydatidosis is a parasitic disease caused by Echinococcus granulosus in its larval form that parasitizes the intestine of the dog and infects humans as accidental intermediate host. Is related to socio-poor sanitary conditions. It has a worldwide distribution with peaks in Argentina, Uruguay and Chile and European countries like Greece, Portugal and Spain. In Venezuela is rare. In general, patients remain asymptomatic for a long time due to slow growth of cysts that can affect any organ of the anatomy, but are located in most cases in liver and lung. Most patients have a single cyst, that is more common in the lower lobe of the right lung. Chest radiography to visualizethe cavitated lesions, specifying the location, number and sizes through the chest tomography or resonance. Immunoserological studies can confirm the diagnosis. Surgical treatment is preferred, but medical treatment is reserved for multiple cysts, only single vesicle les than 5 cm, patients at high surgical risk or inoperable as pre and postoperative chemoprophylaxis. The drug of choice is albendazole. This condition is very rare in Venezuela, however radiologic imaging characteristics orient the diagnosis to confirm with immunoserologycs. In the case report draws attention to the bilateral nature of the condition is less common and good evolution with medical treatment in a short time.

La hidatidosis pulmonar es una enfermedad parasitaria producida por el Echinococcus granulosus en su forma larvaria que parasita el intestino del perro e infecta al ser humano como huésped intermediario accidental. Está en relación con condiciones socio-sanitarias deficientes. Tiene una distribución mundial siendo más frecuente en Argentina, Uruguay y Chile y países europeos como Grecia, Portugal y España. En Venezuela es poco frecuente. En general los pacientes permanecen asintomáticos durante mucho tiempo, debido al crecimiento lento de los quistes que pueden afectar a cualquier órgano de la anatomía, aunque se localizan en la mayoría de los casos en hígado y pulmón. La mayoría de los enfermos presentan un solo quiste y es más frecuente en el lóbulo inferior del pulmón derecho. La radiografía de tórax permite visualizar la lesiones cavitadas, precisándose su ubicación, número y tamaños a través de la tomografía o resonancia de tórax. Los estudios inmunoserológicos permiten confirmar el diagnóstico. El tratamiento quirúrgico es de elección, sin embargo, el tratamiento médico está reservado para quistes múltiples, únicos univesiculares < 5 cm, pacientes de alto riesgo quirúrgico o inoperables y como quimioprofilaxis pre y postoperatoria. El fármaco de elección es el albendazol. Esta patología es muy poco frecuente en Venezuela, sin embargo, las imágenes radiológicas características permiten orientar el diagnóstico para confirmarlo con los estudios inmunoserológicos. En el caso reportado llama la atención de la bilateralidad de la afección que es lo menos común y la buena evolución con tratamiento médico en corto tiempo.

Pulmonary hydatid cyst disease in South of Iraq: short term outcome after surgical intervention

To discuss the clinical presentation, diagnosis, surgical treatment and outcome of 300 patients. A retrospective study of 300 patients with pulmonary hydatid cyst disease was conducted, who were treated surgically at cardiothoracic surgical department in Basra teaching hospital from June2005 to June 2011. The records of all patients were reviewed taking in account the complete clinical history, clinical examination and chest radiology. All the patients were treated surgically. There were 225 [75%] patients of age, 18 years and above, with 149 [66%] males and 76 [34%]females, while 75 [25%] patients were below 18 years of age, including 36 [48%] boys and 39 [52%] girls. The cough was the common presenting symptom [56.6%]. Chest radiology was diagnostic in 95.7% of patients, the right lung was the common site [60%], and 20% presented with associated extrpulmonary hydatid cysts. Only 12.3% have postoperative complications. Surgery is the treatment of choice for pulmonary hydatid cysts, with very low mortality and morbidity

Serological and Molecular Characteristics of the First Korean Case of Echinococcus multilocularis

In December 2011, we reported an autochthonous case of Echinococcus multilocularis infection in a 42-year-old woman in Korea. The diagnosis was based on histopathological findings of the surgically resected liver cyst. In the present study, we evaluated the serological and molecular characteristics of this Korean E. multilocularis case. The patient's serum strongly reacted with affinity-purified native Em18 and recombinant Em18 antigens (specific for E. multilocularis) but negative for recombinant antigen B8/1 (reactive for Echinococcus granulosus). In immunoaffinity chromatography, the serum also strongly reacted with E. multilocularis and only weakly positive for E. granulosus. We determined the whole nucleotide sequence of cox1 (1,608 bp) using the paraffin-embedded cystic tissue which was compared with E. multilocularis isolates from China, Japan, Kazakhstan, Austria, France, and Slovakia. The Korean case showed 99.8-99.9% similarity with isolates from Asia (the highest similarity with an isolate from Sichuan, China), whereas the similarity with European isolates ranged from 99.5 to 99.6%.

Quince años de experiencia clínica con hidatidosis / Clinical presentation of hydatid disease during 15 years: a case series from Santiago, Chile

Introduction: Hydatidosis is a neglected parasitic disease that is endemic in Chile. We present the clinical experience of a single center in Santiago from 1996 to 2010. Methods: Cases were identified using hospital's database. Clinical and pathological features, treatment and outcomes were retrospectively analyzed. Results: In total, 23 patients were identified requiring 30 surgical interventions. Median age was 40 years old (range 5 to 73), and 76.5% visited or resided in regions of known endemicity in Chile. Abdominal cysts were predominant (78.3%), and most patients were symptomatic (73.9%). Elimination of cyst material by cough was reported in 42.9% of patients with symptomatic thoracic cysts. Eosinophilia was present in 41.2% of patients, and 57.1% had positive serology for hydatidosis. Aill patients underwent surgical treatment, in 60.9% in combination with albendazole treatment. While the majority of liver cysts (88.9%) were treated by complete cyst resection, lung cysts (83.3%) were predominantly treated by cyst resection plus capitonnage. Pathological examination revealed fertile cysts in 24%. Postsurgical morbidity was frequent (37.9%), and 13.3% of the series required readmission for this cause. Near 25% of patients remained in hospital > 14 days, a feature associated with fever during admission (p < 0.05). No recurrence was reported in the fraction of patients that were followed-up for 2 years or more. Conclusions: Our analysis of 23 cases demonstrates that patients were mainly adults suffering from abdominal cysts. Most patients were successfully treated by surgery with or without antiparasitic drugs but complications leading to prolonged hospital stays and readmissions were not infrequent.

Introducción: La hidatidosis es una enfermedad endémica en Chile. Se presenta la experiencia clínica de un hospital en Santiago, desde 1996 al 2010. Métodos: Los casos fueron identificados usando las bases de datos institucionales y se analizaron las características clínicas y patológicas, el tratamiento y la evolución en forma retrospectiva. Resultados: Se identificaron 23 pacientes intervenidos en 30 oportunidades. La mediana de edad fue de 40 años (rango 5 a 73) y 76,5% visitó o residía en zonas endémicas en Chile. Los quistes abdominales fueron predominantes (78,3%) y la mayor parte de los pacientes eran sintomáticos (73,9%). Un 42,9% de aquellos con quistes sintomáticos torácicos reportó eliminación de vesículas con la tos. Un 41,2% presentó eosinofilia y 57,1% tuvo serología positiva para hidatidosis. Todos los pacientes fueron tratados quirúrgicamente, en 60,9% en combinación con albendazol. La mayoría de los quistes hepáticos fueron tratados con cirugía radical (88,9%) y los pulmonares predominantemente con quistostomía y capitonaje (83,3%). Un 24% de los quistes eran fértiles. La morbilidad post-quirúrgica fue frecuente (37,9%) y 13,3% de la serie requirió reingresos por esta causa. Cerca de 25% de los pacientes estuvo hospitalizado por más de 14 días, un fenómeno asociado con la presencia de fiebre por complicación séptica al ingreso (p < 0,05). No se registraron recurrencias en la fracción de pacientes seguidos por más de dos años. Conclusiones: La hidatidosis afecta principalmente a adultos en su cavidad abdominal. Aunque los pacientes fueron tratados exitosamente con cirugía, las complicaciones, estadías prolongadas y reingresos por esta causa no fueron infrecuentes.

Quiste hidatídico pulmonar en un escolar: reporte de un caso / Pulmonary hydatid cyst in a schoolchild: a case report

Introducción: La parasitosis por Equinococus granulosus es un problema de salud pública en Chile. El hombre, huésped intermediario, se infecta por fecalismo, generando el Quiste Hidatídico (QH), con mayor frecuencia en hígado y pulmón. Su diagnóstico generalmente es incidental mediante radiografía de tórax (RTx). Habitualmente su tratamiento es quirúrgico. Presentación del caso: Escolar, sexo femenino, 6 años; consulta en Hospital de Yungay por exacerbación de dolor en hemitórax izquierdo (HI) de 4 días de evolución, no irradiado, tipo puntada, EVA10/10, comienzo súbito, con tope inspiratorio, limita la deambulación y se asocia ese día a fiebre de 38°C. Vivienda con servicios básicos, ocasionalmente faenan animales para consumo propio, actualmente sin mascotas. Examen físico: Murmullo Pulmonar (MP) disminuido en base izquierda. RTx muestra imagen redondeada. Se deriva a Hospital Clínico Herminda Martin de Chillán. Ingresa afebril, hospitalizándose en el Servicio de Cirugía Infantil. Exámenes de Laboratorio: PCR 57,5 mg/L, GB 15,88x103/uL, VHS 54 mm/hr. Imagenológico: Ecografía: Opacidad de 6,4 cm de diámetro en HI, que por alta endemia en la zona sugiere ser QH. Hígado normal. Al séptimo día de hospitalización se realiza Quistectomía Pulmonar, la extracción de membrana hidatídica confirma diagnóstico. Alta al séptimo día postoperatorio dada evolución asintomática y normalización de exámenes. Discusión: El diagnóstico de QH requiere de alta sospecha clínica, ayuda de exámenes e imagenología. Al tratamiento quirúrgico puede asociarse el uso de Albendazol si durante el procedimiento se genera ruptura del QH.

Introduction: The Equinococus granulosus’s parasitic infection is a public health problem in Chile. Human beings are intermediate host that get infected by contact with feces of an infected animal, creating the hydatid cyst (HQ), which is more often located in liver and lung. Its diagnosis is usually incidental throw a chest x-ray (RTx). Usually the treatment is surgical. Case report: Child, female, 6 years old. She consults in Yungay’s Hospital because of an episode of exacerbated left hemithorax (LH) pain of 4 days of evolution, none irradiated, with stabbing pleuritic character and EVA10/10 intensity, sudden onset that limitedambulation and that was associated with fever of 38°C. House with basic services where occasionally animal slaughters where done for their own consumption, currently without pets. Physicalexamination: pulmonary murmur (MP) decreased in LH. RTx showed a rounded image. She’s derived to Herminda MartinClinical Hospital of Chillán, where she’s hospitalized in the Pediatric Surgery Service presenting no fever. Laboratory Tests: CRP 57.5 mg/L, 15.88 GBx103/uL, VHS 54 mm/hr. Ultrasound-Scan: Opacity of 6.4 cm of diameter in LH, which, because the area was highly endemic, suggested a HQ. Normal liver. On the seventh day of hospitalization a Pulmonary Cystectomy is made. Hydatid membrane extraction confirmed diagnosis. Discharge on the seventh postoperative day because of asymptomatic evolution and normal tests results. Discussion: The diagnosis of HQ requires high clinical suspicion and imaging tests support. Surgical treatment may be associated with the use of albendazole if during the procedure the HQ is broken rupture.

[Clinical signs, symptoms, diagnosis and outcomes of patients with complicated lung hydatid cysts]

Hydatid cysts caused by the Echinococcus Granulosus and Multilocularis. Liver and them lungs are the most common sites of lodgment of it. Because the clinical symptoms, diagnosis and outcome of treatment are not well discussed, we want to discussion this problem. Survey of the clinical signs, symptoms, diagnosis and outcomes of patients with complicated lung hydatid cysts. We retrospectively examined 54 records of patients with ruptured lung hydatid cyst in 152 patients who were hospitalized in Rasht hospitals, since 1993 to 2005, and were surgically treated. Data collection tools were a predetermined review form; and findings are presented in relative frequencies tables. 54 cases 38[70.3%] were male. Age rang of patients was 4-63 years. Chief complaints of the patients were cough in 47 cases [87%], dyspnea in 42[77.8%], sputum in 37[68.5%], chest pain in 31[57.5%], and hemoptysis in 13[24%]. Most common lodgment of cysts in the lungs was right lower lobe in 38[57.5%]. Ruptures occurred in tracheobronchial tree in 39[73%], and in pleural space in 10[23%]. Complication after surgery occurred in 15 patients. Three patients [5.5%] were needed reoperation for treatment: bronchopleural fistula treatment in two cases and bilio-pleural fistula in one case. After surgical treatment, 53 patients [98.1%] were completely cured; recurrence occurred in one patient [1.9%] who treated with Albendazol. There was no hospital mortality. In endemic area all cystic lesions of lung must be ruled out for hydatid cysts; because some patients with lung hydatid cysts present complications: the cause of complication are, lately referring to physician and delay in diagnosis. Early treatment with medical and surgical approach recommended

Echinococcal tension pneumothorax in a pregnant woman

Pulmonary hydatid cyst in pregnancy is a very rare pathology and its diagnosis and treatment is stilt a complex of problem. We report a rare case of ruptured giant pulmonary hydatid cyst presenting with tension pneumothorax during pregnancy. According to our knowledge this is the first report of such a case. A 21 -year old pregnant woman was admitted to our hospital with complaints of left-sided chest pain, cyanosis and dyspnea. Chest radiograph showed tension pneumothorax, mediastinal shift, and tracheal displacement. Echocardiography revealed perforated hydatid cyst adjacent to pericardium. She was taken to the operating room immediately. During operation, a giant perforated hydatid cyst [12x10cm] was found, outside the pericardium displacing and compressing the left lower lobe. Histopathological examination confirmed the diagnosis. Approximately 5 months later she had a spontaneous vaginal delivery. Both the patient and her baby were healthy. Perforated pulmonary hydatid cyst should be kept in mind in the differential diagnosis of tension pneumothorax in a pregnant woman and surgical intervention should be performed promptly

Management of hydatid disease in Al-gamhouria Teaching Hospital

This is a retrospective descriptive study performed in Algamhouria Teaching Hospital, Aden-Yemen, using the registry of the Surgical Department during the period January 2005 through to June 2007. The main objectives were to analyze the age, sex, localization, and management of hydatid disease in human, and compare them with the literature. The total number of cases of hydatid disease was 28 patients: female to male ratio 1.15:1, The result shows that the age group mostly affected was 21-40 years old. All cases treated surgically except one patient. 92.9% of cases have one cyst. 71.4% located in the liver, 286% are located in the lung. The surgery was the main method applied for hydatid disease

Case report: Pulmonary hydatid disease

A.N.

A Giant Pulmonary Hydatid Cyst Treated without Lobectomy

A 20 year-old woman was admitted to our clinic complaining of dyspnea, cough, chest pain and pleural effusion. The diagnosis of pulmonary hydatid cyst was made on the basis of parasitology laboratory findings, computed tomographic results and chest radiographic findings. A giant pulmonary hydatid cyst (33x14x12 cm) was located in the left lower lobe, which involved more than 90% of the lobe. The patient was treated surgically using cystotomy and capitonnage. This is a case of a giant pulmonary hydatid cyst published in the literature, which was surgically treated without a lobectomy, by preserving the lung parenchyma.

Evaluation of Two ELISA and Two Indirect Hemagglutination Tests for Serodiagnosis of Pulmonary Hydatid Disease

To establish a definite diagnosis for pulmonary hydatid disease, combination of radiology and serology is useful. In this study, 19 preoperative sera from patients with surgically confirmed pulmonary hydatidosis, 40 sera from patients with other parasitosis and pulmonary diseases, and 20 sera from healthy donors were evaluated using 4 different serological tests, i.e., the commercial ELISA (ELISA-kit) test, the ELISA (ELISA-lab) test prepared in our laboratory, the commercial indirect hemagglutination assay kit (IHA-kit) test, and the IHA test using sensitized sheep red blood cells with tannic acid (IHA-TA). The ELISA-kit was the most sensitive (84.2%) and the most specific test (100.0%). The ELISA-kit also demonstrated the highest positive (100.0%) and negative (95.2%) predictive values. The sensitivity of the ELISA-lab test, that we prepared, was found to be 73.6%, whereas the IHA-kit test and the IHA-TA test were found to be 73.6% and 68.4%, respectively. The specificity of these tests was 96.6%, 98.3%, and 83.3%, respectively. When all 4 tests were assessed together, it was found that the sensitivity had risen to 94.7%. When the ELISA-kit was assessed with the IHA-kit and IHA-TA together, it was found that the sensitivity was 89.5% and 84.2%, respectively. Likewise, the combination of the ELISA-lab and IHA-kit or IHA-TA allowed us to achieve a sensitivity of 84.2% in cases of pulmonary echinococcosis. In conclusion, the diagnosis would be imminent if least 2 tests were applied together.

Diagnosis and treatment of pulmonary cystic hydatidosis.

OBJECTIVE: Hydatidosis is a parasitic infection that is still an important public health problem in Turkey. In the present study, it was planned to review the diagnostic and treatment options. METHODS: The study was conducted in pediatric pulmonary chest ward of Izmir Chest Diseases and Surgery Training Hospital, a referral tertiary hospital for pulmonary diseases in Western Turkey. Cases were evaluated in clinical presentations, radiological, histopathologic and serological features retrospectively. RESULTS: Consecutive 17 (11 male and 6 female; mean age 11.29 + 2.44) pediatric cases between 1996 and 2001 were evaluated. Liver involvement was found in 8 (47%) cases. Casoni skin test and IHA test were found positive in 7 (63.6%) and 8 (72.7%) out of 11 cases, respectively. Surgical treatment was performed only in 7 (41.1%) cases as well as surgical plus medical treatment was given in 3 (17.6%) cases. Seven (41.1%) cases were treated just medically. CONCLUSION: Hydatidosis should be considered in the existence of appropriate clinical and radiological findings as a probable diagnosis in all children in our region. Surgery should be the first choice for treatment but, medical therapy was considered as effective for treatment complicated and/or nonsurgical pediatric cases.

Hydatid disease of the lung mimicking a pericardial cyst.

We report a young girl who presented to us with chest discomfort and had a paracardiac mass on chest radiograph. Computerised tomographic (CT) scan of the thorax was suggestive of pericardial cyst. Hydatid serology was negative. The cyst was excised.

[Radiologic findings in Hydatid cyst of lungs]

Hydatid cyst of lungs is mainly diagnosed by imaging procedures such as chest Roentgenogram and chest CT Scan. In endemic area, hydatid cyst may be discovered during the surgery appearing in a form which is not usually identified with typical Hydatidosis of lungs. The objective of this study was to give a description of the most important atypical radiological presentation of lung Hydatidosis. All the patients diagnosed as having pulmonary Hydatidosis through a surgical exploration were included in this study. Standard chest Roentgenograms and computed Tomographies were evaluated before the surgery for diagnosing any lung cyst or unknown lesion. Radiological findings were divided into two categories: 1-Typical Hydatid cysts which have already been described in literature as having imaging presentations such as intact cyst, water lily sign and crescent sign. 2- Atypical Hydatid cysts that do not resemble any feature of typical Hydatid cysts as mentioned above. 1614 subjects who had already been diagnosed with pulmonary Hydatidosis over a period of 28 years went under surgical operations. Seventy nine of them received standard Thoracic CT scan. Atypical cysts were detected in 35% of the subjects that were X-rayed by chest and in 32 of them [40.5%] who received CT Scan. The most frequent chief complaint was coughing as reported by 68 [87%] of the cases. None of the clinical and demographic findings were significantly more frequent in the subjects with atypical Hydatid cyst. The most frequent manifestation illustrated in the radiological pictures was thick cavity wall in 9 subjects [28%]. Other findings were as follows: solid mass in 7 [21%], abscess in 6 [18%], consolidation in 3 [9%], fungus ball in 3 [9%], collapse [atelectasis] in 2 [6%] and round pneumonia in 2 [6%]. Cavity was significantly more frequently seen in the right lung [90%] and mass like opacity was significantly more frequent in the lower lung field [100%]. Hydatid cyst showing atypical features is relatively common; thus, physicians should be cautious about the possibility of Hydatid cyst while evaluating most of the radiological pictures of the lung, no matter what the localization, size and count of the lesion

Fifteen years experience with pulmonary hydatidosis in Zahedan, Iran

Hydatid disease is a major world health problem and pulmonary hydatidosis is a widespread disease. It is presented with different clinical manifestations. In order to determine the most clinical manifestation, diagnostic methods and clinical outcome in our patients, we conducted this study. Forty-nine patients with pulmonary hydatid cysts who were admitted to our hospital in Zahedan [Southeast of Iran] between 1990 and 2005, evaluated. We retrospectively reviewed the patients' symptomatology, diagnostic studies, treatment options, and morbidity as well as mortality rate. The ages of the patients ranged from 16 to 68 years [mean 43 years]. Seventy-five percent of patients were from male gender. Hemoptysis was one of the most common clinical presentations in our patients. Radiological studies were the main diagnostic tool. The correct preoperative diagnosis was made in 92% of the patients by chest roentgenogram plus chest CT-Scan. Eighty seven percent of patients were treated by surgical route. Only one patient was expired during surgery. Upon the results emerged from this study, hemoptysis is one of the most prevalent clinical manifestation in patients with pulmonary hydatidosis and it can mimic pulmonary tuberculosis in endemic area