Pancreatic Hydatid Cyst Misdiagnosed as Mucinous Cystadenoma: CT and MRI Findings.

Isolated hydatid cysts of the pancreas are rare lesions, even in endemic regions. In this report, we present the case of a 76-year-old patient who was admitted to our clinic with a diagnosis of a cystic lesion in the tail of the pancreas. On preoperative computed tomography (CT) and magnetic resonance (MR) examination, the cyst was characterized as a mucinous cystadenoma. A laparoscopic distal pancreatectomy followed. A histopathological examination revealed a large hydatid cyst in the tail of the pancreas.

Evaluación de echinococcosis canina en la zona de alta montaña en la provincia de Tucumán, Argentina / Evaluation of canine echinococcosis in the high mountain area of province of Tucumán, Argentina / Avaliação de equinococose canina na zona de alta montanha na província de Tucumán, Argentina

La echinococcosis es un serio problema para la salud pública en Argentina. Es una zoonosis producida por el cestode de la familia Taeniidae, Echinococcus granulosus, siendo el perro el principal hospedador definitivo. El objetivo de este trabajo fue evaluar la echinococcosis en perros en la zona de alta montaña de la provincia de Tucumán. La principal actividad económica en esta zona es la cría de ganado para consumo familiar, sobre todo ovino. Las condiciones climáticas, las distancias y la falta de movilidad adecuada hacen difícil el acceso a los servicios de salud y a los establecimientos educativos. Se evaluaron seis parajes en un primer estudio con 103 muestras de materia fecal canina y se encontró que el 39,8% (41/103) fueron positivas. El estudio se repitió en dos localidades después de desparasitar a los perros mensualmente durante dos años. En estas áreas se observó una disminución de muestras con resultado positivo; en Chaquivil la variación fue del 57,1% al 10,0% y en San José de Chasquivil, fue del 47,1% al 11,1%. Estos resultados llevan a la conclusión de que es necesario realizar y planificar las actividades de control. Sería de suma importancia realizar la evaluación en otras localidades.

Canine echinococcosis is a serious public health problem in Argentina. It is a parasite zoonosis produced by a cestode of the Taeniidae family, Echinococcus granulosus, the dog being the principal definite host. The objective of this work was to evaluate echinococcosis in dogs in the high mountain area of the province of Tucumán. The main economic activity in this area is livestock breeding, mostly sheep, for family consumption. Climate conditions, distances and the lack of adequate mobility make it difficult to access to health services and educational facilities. Six places of the region were evaluated. The first study was carried out with 103 samples of canine faeces, 39.8% (41/103) being positive. The study was repeated in two localities, after deworming dogs monthly for two years. In these areas, a decrease of positive specimens was obtained: in Chaquivil, variation was 57.1% to 10.0% and in San José de Chasquivil, it was 47.1% to 11.1%. These results lead to the conclusion that it would be necessary to conduct and plan control activities. The assessment of other locations would be of utmost importance.

A equinococose é um problema sério para a saúde pública na Argentina. É uma zoonose produzida pelo cestode da família Taeniidae, Echinococcus granulosus, sendo o cão o principal hospedeiro definitivo. O objetivo deste trabalho foi avaliar a equinococose em cães na zona de alta montanha da Província de Tucumán. A atividade econômica principal nesta zona é a criação de gado para consumo familiar, principalmente o ovino. As condições climáticas, as distâncias e a falta da mobilidade adequada tornam difícil o acesso aos serviços da saúde e aos estabelecimentos educacionais. Seis lugares da região foram avaliados num primeiro estudo com 103 amostras da matéria fecal canina, sendo que 39.8% (41/103) foram positivas. O estudo foi repetido em duas localidades, depois de desverminar os cães mensalmente durante dois anos. Nessas áreas foi observada uma diminuição de amostras com resultado positivo; em Chaquivil a variação foi de 57.1% para 10.0% e em San José de Chasquivil, foi 47.1% para 11.1%. Estes resultados levam à conclusão de que é necessário realizar e planejar as atividades do controle. Seria de extrema importância fazer a avaliação em outras localidades.

[Fistulized renal hydatic cyst in a patient on chronic hemodialysis]. / Kyste hydatique rénal fistulisé dans les voies urinaires chez un hémodialysé chronique.

Hydatidosis is a parasitic infection caused by the larval stage of Echinococcus granulosus. Renal hydatic cyst is unusual. It may fistulize into the urinary excretory system, requiring specific management. The aim of our study was to highlight the diagnostic and therapeutic specificity of this pathology in patients on chronic hemodialysis among whom diuresis is not always preserved, in order to focus attention on hydaturia and to give an indication to diagnosis. We report the case of a 47-year old patient with a 4-year history of hemodialysis due to glomerular nephropathy detected at the final stage. Moreover, the patient had a 6-month histoiry of impaired general condition associated with right lower back pain, without fever. Abdominal CT scan showed right kidney measuring 13.4cm, with important ureteropyelocaliceal dilation, pushing the renal parenchyma associated with renal pelvis measuring 4.3cm, without detectable lithiasic obstacle. However, it showed membranous cyst at the level of the lower right renal polar parenchyma, measuring approximately 76.5 x 54 mm, contacting the renal pelvis, also containing a few membranes. The patient underwent thorough interview revealing the presence of hydaturia in the few drops of residual diuresis. Given that the patient had end stage chronic renal failure and that he was under renal replacement therapy, therapeutic approach was based on total nephrectomy.

Situación de la hidatidosis humana en la provincia de Santiago del Estero, República Argentina

La Hidatidosis Humana es una enfermedad grave, de evolución crónica, causadda por el estadio larval del echinococcus granulosus que en su ciclo biológico convierte al ser humano en un huésped intermediario, causando estragos en la salud de quien la padecen por las secuelas orgánicas y psicológicas ocasionadas por la implantación del tumores originados por dicho parásito, en diversos órganos de la economía.

Human Hydatidosis is a serious disease of chronic evolution caused by the larval stage of the Echinococcosis Granulosis. During its biological cycle it turns the human being into an intermediate host. It still causes havoc to the health of those who suffer from it because of the organic and psychological sequels caused by the implantation of tumors originate by such parasite.

Primary mediastinal hydatid disease leading to popliteal artery hydatid cyst embolization.

Hydatid disease is a zoonosis caused by Echinococcus granulosus . Infected dogs release eggs through their feces and the eggs infect humans through food and water. The most common locations of hydatid cysts are the liver and lungs, but primary mediastinal involvement, though rare, can be encountered. We report on a 16-year-old female with a primary mediastinal hydatid cyst leading to popliteal arterial embolization. The mediastinal lesion was treated with partial pericystectomy with removal of the germinal membrane and prophylactic albendazole. In endemic areas, it is important to consider hydatid cysts in the differential diagnosis of an acute arterial occlusion.

Species identification of human echinococcosis using histopathology and genotyping in northwestern China.

Human cystic echinococcosis, caused by infection with the larval stage of Echinococcus granulosus, and alveolar echinococcosis, caused by the larval form of E. multilocularis, are known to be important public health problems in western China. Echinococcus shiquicus is a new species of Echinococcus recently described in wildlife hosts from the eastern Tibetan plateau and its infectivity and/or pathogenicity in humans remain unknown. In the current study, parasite tissues from various organs were collected post-operatively from 68 echinococcosis patients from Sichuan and Qinghai provinces in eastern China. The tissues were examined by histopathology and genotyped using DNA sequencing and PCR-RFLP. Histopathologically, 38 human isolates were confirmed as E. granulosus and 30 as E. multilocularis. Mitochondrial cob gene sequencing and PCR-RFLP with rrnL as the target gene confirmed 33 of 53 of the isolates to have the G1 genotype of sheep/dog strain of E. granulosus as the only source of infection, while the remaining 20 isolates were identified as E. multilocularis. No infections were found to be caused by E. shiquicus. Additionally, 5 of 20 alveolar echinococcosis patients were confirmed to have intracranial metastases from primary hepatic alveolar echinococcosis lesions. All these cases originated from four provinces or autonomous regions but most were distributed in Sichuan and Qinghai provinces, where high prevalence rates of human alveolar echinococcosis and cystic echinococcosis were previously documented.

The action of albendazole on hydatid cysts in sheep experimentally infected with eggs of Echinococcus granulosus.

According to the Brazilian Agricultural Ministry, the prevalence of cystic echinococcosis in the state of Rio Grande do Sul, Brazil has decreased between 1990 and 1998, possibly due to the common use of albendazole to control parasites in sheep. Therefore, albendazole (ABZ) action was tested on hydatid cysts of sheep experimentally infected with eggs of Echinococcus granulosus in Uruguaiana County (RS) with the aim of evaluating the observed changes in the parasite's prevalence. The sheep were divided into three groups of 15 animals each and treated as follows. Group 01 was a control (without treatment), groups 02 and 03 received 7.5 mg/kg and 15 mg/kg, respectively, of ABZ orally for 12 months, at intervals between 36 and 45 days. At the end of the studied period the animals were necropsied and the viability of the hydatid cysts was evaluated. Lung and hepatic cysts of sheep treated with ABZ were reduced in size. Degeneration and evident calcification were seen in 87.3% (group 02) and 75.7% (group 03), which were significantly different (P < 0.01) from the 17.3% demonstrated in the control group. It could be concluded that ABZ used early and over long periods, even in small doses, is capable of promoting lesions that devitalize the cysts. This leads to a decrease in fertility of E. granulosus in sheep and could be the reason why the prevalence of cystic echinococcosis has decreased in recent years.

Precocious development of hydatid cysts in a macropodid host.

This study describes the pathological changes associated with an experimental infection of captive wallabies with Echinococcus granulosus. Adult and juvenile tammar wallabies (Macropus eugenii) were infected orally with 0, 1,000, 2,500 or 8,000 E. granulosus eggs. Lung cyst progression was monitored by chest radiography every 4 months until 16 months p.i. Animals were necropsied from 9 to 16 months after infection. Cysts were detected radiographically from 4 months onwards. The number of cysts per animal varied from one to 10 and the majority (36/40) of cysts established in the lungs. Infection rate was low (35.5%), but cyst development was more rapid and onset of fertility much earlier than has been recorded in sheep. Cyst growth resulted in loss of functional lung capacity, up to an estimated 28% within 14 months of infection. Degenerative changes in cysts were less common in tammars than has been reported in sheep, with gross degeneration of cysts identified in only two animals. Complications associated with lung cyst development included fatal anaphylaxis, pneumothorax and atelectasis. Seven of the 11 infected tammars died or were euthanased as a result of infection during the experiment. From the parasite's perspective, infection of this host allows a shortened life cycle and correspondingly greater biotic potential. We believe this is the first published study that demonstrates the susceptibility of tammar wallabies to hydatid disease and confirms their suitability as a laboratory model for studying the disease in macropodids.