Atypical Presentations of Hydatid Cyst: A Case Series of Three Unusual Clinical Manifestations from Eastern India.

Arvind Kumar; Supriya Kumari

doi:10.51168/m1a9j464

Autori

Arvind Kumar Assistant Professor, Department of General Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Supriya Kumari Senior Resident, Department of Microbiology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India

DOI:

https://doi.org/10.51168/m1a9j464

Cuvinte cheie:

Hydatid cyst, Echinococcus granulosus, Renal hydatid disease, Pulmonary hydatid disease

Rezumat

Background:

Hydatid disease, caused by Echinococcus granulosus, commonly affects the liver and lungs. However, atypical locations and unusual clinical presentations may mimic other conditions, complicating diagnosis and delaying appropriate management. This case series describes three unusual presentations of hydatid disease encountered at AIIMS Deoghar, Eastern India.

Case Presentation:

Three patients with atypical hydatid disease were managed between 2024 and 2025. The first was a 12-year-old boy with recurrent abdominal pain whose renal cyst was initially interpreted radiologically as a Bosniak type II cyst. Surgical excision and histopathological examination confirmed renal hydatid disease. The second was a 58-year-old dairy farmer who presented with fever, respiratory distress, pleural effusion, and septic shock. Investigations revealed an infected hepatic hydatid cyst with secondary bacterial infection, managed with antibiotics, percutaneous puncture, aspiration, injection, and re-aspiration (PAIR), followed by definitive surgery. The third patient, a 26-year-old man with prolonged cough and fever, had near-complete opacification of the right hemithorax on chest radiography. Surgery revealed a giant pulmonary hydatid cyst measuring 24 × 16 × 4 cm, subsequently confirmed by histopathology.

Conclusion:

These cases demonstrate the varied clinical manifestations of hydatid disease and the potential for atypical lesions to mimic benign renal cysts, severe bacterial infection, or other thoracic conditions. Hydatid disease should be considered in the differential diagnosis of cystic lesions, particularly in endemic regions. Clinical suspicion, appropriate imaging, and parasitological or histopathological confirmation are essential for accurate diagnosis and timely management.

Takeaway lessons:

Hydatid disease should be considered even at uncommon anatomical sites. Infected cysts may present with life-threatening sepsis, while giant pulmonary cysts may mimic other thoracic pathologies. Combining clinical assessment, imaging, and laboratory confirmation can help guide appropriate treatment.

Biografii autori

Arvind Kumar, Assistant Professor, Department of General Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.

is an Assistant Professor in the Department of General Surgery at the All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India. His contribution to this case series concerns the clinical and surgical management of patients with atypical presentations of hydatid disease.
Supriya Kumari, Senior Resident, Department of Microbiology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India

is a Senior Resident in the Department of Microbiology at the All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India. Her contribution to this case series concerns the microbiological investigation and laboratory confirmation of hydatid disease.

Referințe

1. Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease: radiologic and pathologic features and complications. Radiographics. 2000;20(3):795-817. https://doi.org/10.1148/radiographics.20.3.g00ma06795

2. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1-16. https://doi.org/10.1016/j.actatropica.2009.11.001

3. Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev. 2004;17(1):107-35. https://doi.org/10.1128/CMR.17.1.107-135.2004

4. Bandyopadhyay A, Khatua S, Das S, Bose K, Konar K. A rare case of primary renal hydatid cyst presenting with hydatiduria. J Parasit Dis. 2015;39(3):577-80. https://doi.org/10.1007/s12639-013-0362-x

5. Mongha R, Narayan S, Kundu AK. Primary hydatid cyst of kidney and ureter with gross hydatiduria: a case report and evaluation of radiological features. Indian J Urol. 2008;24(1):116-7. https://doi.org/10.4103/0970-1591.38617

6. Misra A, Mandal S, Das M, Mishra P, Mitra S, Nayak P, et al. Isolated renal hydatid disease: varied presentations, treatments, dilemmas, and the way ahead: case report series. Afr J Urol. 2021;27:83. https://doi.org/10.1186/s12301-021-00183-5

7. McManus DP, Zhang W, Li J, Bartley PB. Echinococcosis. Lancet. 2003;362(9392):1295-304. https://doi.org/10.1016/S0140-6736(03)14573-4

8. Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis. 2009;13(2):125-33. https://doi.org/10.1016/j.ijid.2008.03.037

9. Basnet P, Chapagain S, Neupane R, Thapa A. Rare encounter of renal hydatid cyst: a case report. J Nepal Med Assoc. 2021;59(239):716-8. https://doi.org/10.31729/jnma.6994

10. Al Taei TH, Al Mail SA, Al Thinayyan AH, Alsetrawi A. Renal hydatid cyst: a case report. Radiol Case Rep. 2022;17(6):2063-6. https://doi.org/10.1016/j.radcr.2022.03.036