ABSTRACT
BACKGROUND: Lophomonas blattarum is a rare protozoan that causes opportunistic infections, and the co-infection of lophomonas with tuberculosis and human hydatidosis is a serious public problem in the co-endemic areas of developing countries. CASE REPORT: We presented a 58-year-old female with fever, losing weight, and cough with whitish-yellow sputum that started one month ago. Increasing inflammatory markers and hypereosinophilia in laboratory tests, and a cavity with thick, regular walls and undulating air-fluid levels measuring 43 × 30, evident in the upper segment of the right lower lobe (RLL), along with consolidation and the ground glass opacity of the upper segment and posterior basal of the RLL is apparent in CT scan were reported. Then, a bronchoscopy was requested, and the BAL specimen reported a negative fungal and bacterial infection in the samples. Several live and oval flagellated lophomonas protozoa, hydatid cyst protoscoleces (the larval forms of the parasites), and M. tuberculosis were observed in microscopic evaluation. The patient was treated with metronidazole, oral albendazole, and a combination of TB regimen. CONCLUSION: Physicians should always consider the possibility of co-infections of lophomonas with tuberculosis and human hydatidosis and investigate patients with risk factors such as immunodeficiency conditions or treated with immunosuppressive medications.
Subject(s)
Coinfection , Echinococcosis, Pulmonary , Mycobacterium tuberculosis , Tuberculosis , Female , Humans , Middle Aged , Echinococcosis, Pulmonary/complications , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/drug therapy , Coinfection/diagnosis , Coinfection/drug therapy , Metronidazole/therapeutic use , Lung , Tuberculosis/drug therapyABSTRACT
Echinococcosis is primarily a disease of developing nations with poor medical infrastructure, where cohabitation with domesticated animals is common. These conditions, in conjunction with the inherent chronicity of the disease, lead to low rates of diagnosis and high morbidity. Robust surveillance is not readily available in communities with the highest disease burden.WHO classifications assist in diagnostic and treatment endeavours especially in countries where this disease is not commonly encountered. However, the understanding of the pathophysiology of echinococcosis and optimal treatment are still lacking in certain patient populations.We present the case of a female from Central Asia with an isolated pulmonary hydatid cyst. She was diagnosed several months after she had an uncomplicated pregnancy and gave birth to a healthy baby girl. Due to a delay in surgical intervention, our patient received a prolonged course of treatment which resulted in a significant reduction in the size of the cyst. Given her improvement, we questioned the current guidelines set by the WHO regarding surgical resection of pulmonary hydatid cysts, compared with an extended course with albendazole in patients with an unusual and protracted course of the disease. Furthermore, we discuss the possible role of pregnancy in exacerbating symptoms of underlying pulmonary hydatid disease.
Subject(s)
Echinococcosis, Pulmonary , Animals , Female , Humans , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapy , Albendazole/therapeutic use , Animals, DomesticABSTRACT
This case report describes the presentation, diagnosis, and treatment of a 13-year-old boy with pulmonary cystic echinococcosis. The patient presented with low-volume hemoptysis, and lung imaging revealed a large cystic mass, as well as smaller pseudo-nodular lesions, suggesting a large intrathoracic hydatid cyst and ruptured cysts. The diagnosis was confirmed by a positive echinococcosis Western Blot assay, despite equivocal serology. The treatment consisted of surgical removal of the large cyst using thoracoscopy, along with a two-week course of albendazole and praziquantel, followed by albendazole alone for two years. Analysis of the cyst membrane revealed an Echinococcus granulosus protoscolex. The patient had a successful recovery.
Subject(s)
Cysts , Echinococcosis, Pulmonary , Echinococcosis , Echinococcus granulosus , Male , Animals , Humans , Child , Adolescent , Albendazole/therapeutic use , Echinococcosis/diagnostic imaging , Echinococcosis/drug therapy , Lung/diagnostic imaging , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapyABSTRACT
Echinococcosis is caused by tapeworms belonging to the Echinococcus genus. The most common site of infection is the liver although it may involve almost any organ. Symptoms of pulmonary echinococcosis vary depending on the location and structure of the cyst. While uncomplicated cysts usually appear at imaging as well-defined homogeneous lesions with fluid content and smooth walls of variable thickness, complicated lesions may have a more heterogeneous content with higher density making more difficult the distinction from malignancies or other infections. Hereby we describe the case of a 61-year-old Northern African male admitted to our tertiary center for left upper chest pain who then underwent a chest computed tomography (CT) scan which demonstrated a large hypodense lesion, with smooth and thick walls, in the upper left lobe. The following magnetic resonance confirmed the homogeneous fluid content, and the 18 F- fluorodeoxyglucose-positron emission tomography/CT demonstrated a mild uptake of the walls. According to these findings, the main differential diagnoses at imaging included bronchogenic cyst, synovial sarcoma, and pulmonary hematoma although the patient denied any recent trauma. Given the large size and clinical symptoms he underwent surgery. Intra-operative frozen section, supported by imprint cytology, excluded the presence of malignancy while suggested an echinococcal laminar exocyst. The final pathological examination confirmed the diagnosis of echinococcosis (i.e., Echinococcus Granulosus protoscolex). After surgery he was treated with albendazole and at the six-month follow-up he was in good clinical conditions. Our case highlights the importance of considering rare infections, particularly in individuals from endemic areas. Frozen tissue analyses can be a diagnostic challenge and often require ancillary tools such as imprint cytology and serial sections for more sensitive and accurate diagnosis.
Subject(s)
Cysts , Echinococcosis, Pulmonary , Echinococcus granulosus , Animals , Humans , Male , Middle Aged , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/surgery , Echinococcosis, Pulmonary/drug therapy , Frozen Sections , Tomography, X-Ray Computed , Albendazole/therapeutic useABSTRACT
Multilobar lung echinococcosis with multiorgan involvement is an extremely rare entity in pediatric populations. We would like to share an adolescent girl with very demonstrative postero-anterior chest X-ray and computed tomography images.
Subject(s)
Echinococcosis, Pulmonary , Child , Adolescent , Female , Humans , Echinococcosis, Pulmonary/complications , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapy , Tomography, X-Ray Computed , Family , Lung/diagnostic imagingABSTRACT
We report the unusual case of a 5-year-old migrant boy from a rural area of Morocco with an almost-giant lung hydatid cyst that was an incidental finding on a chest X-ray performed during routine visa procedures. Echinococcus granulosus serology test was initially negative with subsequent positive seroconversion. Albendazole was started at 4 weeks before surgery and maintained for 4 months, with a favourable outcome. Cystic echinococcosis (CE) is considered a neglected tropical disease and affects more than one million people worldwide, mostly from a lower socioeconomic background. Preventive measures have been limited in underdeveloped regions. Children with CE are especially vulnerable, due not only to the high pathogenic potential of the disease but also to their frequent involvement in challenging socioeconomic situations, including migration. The incidence of CE is increasing in Europe because of high immigration flows from endemic countries. Nevertheless, CE is not covered by current migrant screening protocols.
Subject(s)
Echinococcosis, Pulmonary , Echinococcus granulosus , Refugees , Transients and Migrants , Animals , Child , Child, Preschool , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapy , Humans , Male , Neglected Diseases/diagnosisSubject(s)
Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/parasitology , Echinococcosis, Pulmonary/surgery , Echinococcus granulosus/isolation & purification , Exudates and Transudates/parasitology , Respiratory System/microbiology , Respiratory System/physiopathology , Albendazole/therapeutic use , Animals , Antiprotozoal Agents/therapeutic use , Child , Echinococcosis, Pulmonary/physiopathology , Humans , Male , Respiratory System/diagnostic imaging , Switzerland , Treatment OutcomeABSTRACT
Hydatid cyst is a common zoonosis caused by larval forms of tapeworms called Echinococcus. The problem often occurs in the liver or lung. Cyst rupture and secondary bacterial infection are the most important complications of pulmonary hydatid cyst (PHC). PHC may mimic serious lung diseases such as treatment-resistant pneumonia, tuberculosis, and tumours. This report discusses the case of a paediatric patient with PHC who presented with chronic cough, hilar lymphadenopathies up to 3 cm, and worsening symptoms despite non-specific pneumonia treatment. Hence, PHC should be considered in patients with treatment-resistant pneumonia and mediastinal lymphadenopathy.
Subject(s)
Echinococcosis, Pulmonary/complications , Lymphadenopathy/etiology , Animals , Anthelmintics/therapeutic use , Child , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/drug therapy , Echinococcus , Humans , Lymphadenopathy/diagnosis , Lymphadenopathy/drug therapy , Mediastinum/pathology , Pneumonia/diagnosis , Pneumonia/drug therapy , Pneumonia/etiologyABSTRACT
CASE PRESENTATION: A 28-year-old woman G1P0 at 22 weeks of gestation and with no significant medical history presented to the ED complaining of worsening dyspnea and right-sided pleuritic chest pain. Symptoms started 2 weeks before presentation, with minimal productive cough and dyspnea on exertion. One week after the initial symptoms, the patient started noticing right-sided chest and shoulder pain along with subjective fevers and night sweats. She denied hemoptysis, weight loss, abdominal pain, diarrhea, nausea, vomiting, arthralgia, or rash. Her pregnancy had so far been uncomplicated. The patient did not use tobacco, alcohol, or recreational drugs. She worked at a daycare center but denied any particular sick contacts. She moved to the United States 7 years ago from Sudan and denied any recent travel.
Subject(s)
Albendazole/administration & dosage , Echinococcosis, Pulmonary , Lung Abscess/diagnosis , Pleural Effusion , Pregnancy Complications , Pseudomonas aeruginosa/isolation & purification , Superinfection , Thoracentesis/methods , Adult , Anthelmintics/administration & dosage , Diagnosis, Differential , Drainage/methods , Echinococcosis, Pulmonary/complications , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/drug therapy , Female , Humans , Pleural Effusion/diagnosis , Pleural Effusion/etiology , Pleural Effusion/physiopathology , Pleural Effusion/surgery , Pregnancy , Pregnancy Complications/microbiology , Pregnancy Complications/physiopathology , Pregnancy Complications/therapy , Pregnancy Outcome , Superinfection/diagnosis , Superinfection/physiopathology , Thoracoscopy/methods , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Female , Child, Preschool , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/parasitology , Echinococcosis, Pulmonary/drug therapy , Tomography, X-Ray Computed , Echinococcus granulosus/isolation & purification , Albendazole/therapeutic use , Antiprotozoal Agents/therapeutic useSubject(s)
Echinococcosis, Pulmonary/diagnosis , Echinococcus granulosus/isolation & purification , Albendazole/therapeutic use , Animals , Dogs , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/surgery , Humans , Male , Occupational Exposure , Pneumonectomy , Radiography, Thoracic , Tomography, X-Ray Computed , Young Adult , Zoonoses/diagnosis , Zoonoses/drug therapy , Zoonoses/pathologyABSTRACT
BACKGROUND: Echinococcus granulosus is causative agent of cystic echinococcosis (CE), which has a cosmopolitan distribution. The current methods for the treatment of human CE include surgery. Therefore, the development of new scolicidal agents with low side effects and more efficacies is an urgent need. PURPOSE: The present study aimed to compare the scolicidal efficacies of silver, iron, copper, silica and zinc oxide nanoparticles (NPs) against hydatid cyst protoscolices in vitro. METHODS: Hydatid cysts of sheep liver and lung were collected. The cyst fluid containing protoscolices was aspirated aseptically. The scolicidal activities of the silver, iron, copper, silica and zinc nanoparticles (Ag-NP, Fe-NP, Cu-NP, Si-NP and Zn-NP) were tested at different concentrations of 0.25, 0.5 and 1 mg/mL following 10, 30 and 60 min of incubation in triplicate. Viability of protoscolices was confirmed by 0.1% eosin staining. RESULTS: Results showed that Ag-NPs at all concentrations tested had the highest scolicidal effect. Ag-NPs at 1 mg/mL concentration after 60 min of exposure time showed 80% mortality rate. Si-NPs had the high scolicidal activity at 1 mg/mL concentration (52.33%), Cu-NPs at 0.5 mg/mL concentration (41%), Fe-NPs at 1mg/mL concentration (28%) and Zn-NPs at concentration of 1mg/mL after 60 mins (15.67%). CONCLUSION: The findings of the present study showed that Ag-NPs, Fe-NPs, Cu-NPs, Si-NPs and Zn-NPs had potent scolicidal effects and that Ag-NPs are recommended as effective scolicidal agents. However, further in vivo studies are required to evaluate the efficacy of these nanoparticles.
Subject(s)
Anticestodal Agents/pharmacology , Echinococcosis/drug therapy , Echinococcus granulosus/drug effects , Metal Nanoparticles/therapeutic use , Animals , Anticestodal Agents/chemistry , Echinococcosis/parasitology , Echinococcosis, Hepatic/drug therapy , Echinococcosis, Hepatic/parasitology , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/parasitology , Echinococcus granulosus/pathogenicity , Metal Nanoparticles/chemistry , SheepSubject(s)
Albendazole/administration & dosage , Antibodies, Helminth/blood , Echinococcosis, Pulmonary , Pneumonectomy/methods , Antiparasitic Agents/administration & dosage , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/immunology , Echinococcosis, Pulmonary/surgery , Female , Humans , Lung/diagnostic imaging , Lung/surgery , Tomography, X-Ray Computed/methods , Treatment Outcome , Young AdultABSTRACT
Hydatid disease is a zoonosis caused by Echinococcus granulosus, and represents a global public health problem. In children the pulmonary location is the most frequent. The hydatid cyst can be asymptomatic and present symptoms when breaking into the bronchial tree or pleura. We present a case of complicated pulmonary hydatid cyst in a 14-year-old girl from Morocco, where this disease is endemic. The initial clinical picture simulated a lung abscess. The management was surgical, associated with albendazole treatment, with a good clinical evolution.
La enfermedad hidatídica es una zoonosis producida por el Echinococcus granulosus, y representa un problema mundial de salud pública. En niños la localización pulmonar es la más frecuente. El quiste hidatídico puede ser asintomático y presentar síntomas al romperse hacia el árbol bronquial o pleura. Presentamos un caso de quiste hidatídico pulmonar complicado en una niña de 14 años residente en Marruecos, donde esta enfermedad es endémica. El cuadro clínico inicial simuló un absceso pulmonar. El manejo fue quirúrgico, asociado a tratamiento con albendazol, con una buena evolución clínica.
Subject(s)
Humans , Female , Adolescent , Echinococcosis, Pulmonary/surgery , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Albendazole/therapeutic use , Anthelmintics/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/diagnostic imaging , Albendazole/therapeutic use , Radiography, Thoracic , Diagnosis, Differential , Hepatomegaly/complications , Immunoglobulin G , Enzyme-Linked Immunosorbent AssayABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Echinococcosis, Pulmonary/complications , Pulmonary Embolism/etiology , Albendazole/therapeutic use , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/drug therapy , Tomography, Emission-Computed , Thorax/diagnostic imagingSubject(s)
Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcus/isolation & purification , Adult , Albendazole/therapeutic use , Animals , Anthelmintics/therapeutic use , Echinococcosis, Hepatic/drug therapy , Echinococcosis, Pulmonary/drug therapy , Female , Humans , Tomography, X-Ray ComputedSubject(s)
Echinococcosis, Pulmonary/diagnostic imaging , Tomography, X-Ray Computed , Aged , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Diagnosis, Differential , Echinococcosis, Hepatic/complications , Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Hepatic/surgery , Echinococcosis, Pulmonary/drug therapy , Female , Hepatomegaly/diagnostic imaging , Hepatomegaly/etiology , Humans , Lung Neoplasms/secondary , RecurrenceABSTRACT
Echinococcosis is a common cause of pulmonary cavities. Aspergillus fumigatus, a saprophytic fungus, can colonise pulmonary cavities caused by tuberculosis, sarcoidosis, echinococcosis, bronchiectasis and neoplasms. Infection by Aspergillus is often seen in immunosuppressed cases. However, co-infection of Aspergillus with pulmonary echinococcosis is unexpected and very unusual, especially in an immunocompetent patient. We present the case of a 45-year-old immunocompetent male who came with non-resolving pneumonia and fever for 8 months and dyspnoea since 15 days accompanied by recurrent episodes of hemoptysis since 5 days. Chest X Ray and Computed Tomography scan showed a cystic lesion in the middle lobe of the right lung. Middle lobectomy with video-assisted thoracoscopic surgery was performed and histopathology revealed ectocyst of Hydatid cyst which was also colonised by septate fungal hyphae exhibiting acute angled branching, morphologically consistent with Aspergillus. Gomori Methanamine Silver and Periodic Acid Schiff stains highlighted the hyphae of Aspergillus as well as the lamellated membranes of ectocyst and an occasional scolex of Echinococcus. Sections from surrounding lung parenchyma also showed these fungal hyphae within an occasional dilated bronchus. Thus a diagnosis of dual infection of Aspergillosis and Pulmonary Echinococcosis was established. The possibility of dual infection by a saprophytic fungus must be kept in mind while dealing with a case of a cavitary lesion in long-standing and non-resolving pneumonia, even in an immunocompetent patient. Establishing the correct diagnosis of Aspergillosis with Echinococcosis is essential for proper and complete management.