A rare presentation of hydatid cyst, involvement of uncommon sites with sparing of typical locations.

Hydatid cyst (HC) is a serious health problem in endemic areas. Liver and lung are the most common involved organs while the involvement of muscles, heart, kidney, brain, and spleen is rare. The involvement of these rare locations for HC is mostly in association with infestation of common sites. We report a case of 43-year-old man with a history of surgery of HC in brain and heart who complained from chest pain. In imaging modalities, three cystic lesions were seen in heart and kidney which were confirmed to be recurrence of HC by serologic tests. However, no evidence of involvement of liver and lungs as the most common infected organs of HC was seen in recent and previous imaging mo®dalities. The patient refused another surgery and just accepted anthelmintic drugs. The practical point of this case report is that when we see any cystic lesion in imaging modalities in uncommon sites for HC, while common sites are spare, we should still consider the possibility of HC and not rule out it just because of lack of simultaneous infestation of its common involved organs.

The association of pathergy reaction and active clinical presentations of Behçet's disease.

OBJECTIVES: The pathergy skin test is a hypersensitivity reaction to a prick skin trauma caused by a pin or a needle, which is considered as a specific presentation in Behçet's disease (BD) and the precise mechanism of this test is not well elucidated. This study was designed to evaluate the association of pathergy reaction (PR) with the active clinical manifestations of BD patients, to assess the clinical importance of PR. MATERIALS AND METHODS: This was a cohort study on 1675 BD patients who fulfilled the entry criteria based on the International Criteria for Behçet's Disease (ICBD) from 1975 to 2011. The patients were divided into two groups; the pathergy positive group included 841 patients (50.2%) and the pathergy negative group 834 patients (49.8%). The active mucocutaneous and systemic disease manifestations were analyzed according to the presence of the PR. The odds ratio and 95% confidence interval (95% CI) were calculated for each item. RESULTS: In this study, 841 patients (50.2%) had a positive pathergy test. Patient's mean age and mean disease duration were similar in the two groups (pathergy positive and pathergy negative patients). There was no association between positive pathergy test and age of patients, or disease duration. The PR was associated with male gender (p = 0.013), oral aphthosis (p < 0.001), pseudofolliculitis (p < 0.001), anterior uveitis (p = 0.001) and posterior uveitis (p = 0.028). CONCLUSIONS: The presence of PR was associated with male gender, as well as some of mucocutaneous manifestations and uveitis in adult patients. There was no association with retinitis and vascular involvements. PR isn't associated with the severity of the disease.

Splenic vein enlargement, a rare cause of nutcracker syndrome.

Abnormal enlargement of the splenic vein is one of the etiologies of nutcracker syndrome that should be considered when examining the causes of this syndrome. Because knowing rare etiologies can help correct diagnose and reduce mortality.