Isolated pericardial cystic Echinococcosis: A rare clinical presentation

Isolated pericardial Hydatid cyst without involvement of other viscera is a rare condition with reported incidence of 0.5-2% of all cases of cystic echinococcosis even in the countries endemic for the disease. Hydatid disease is a major public health concern in the animal raising regions worldwide. Pericardial hydatid disease can be asymptomatic or present with varying symptoms from atypical chest pain, arrhythmias, rupture and tamponade to anaphylaxis. Early diagnosis and surgical treatment is necessary to prevent fatal complications. Here we report a case of symptomatic isolated pericardial hydatid cyst who presented with epigastric pain. doi: https://doi.org/10.12669/pjms.38.3.4965 How to cite this:Thapaliya P, Ali TA, Bhutta MM. Isolated pericardial cystic Echinococcosis: A rare clinical presentation. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4965 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Recurrent cardiac hydatid cysts ruptured intraoperatively during anesthetic induction for open-heart surgery

Introduction: Cardiac localization of hydatid disease is rare (<3%) even in endemic countries. Affection characterized by a long functional tolerance and a large clinical and paraclinical polymorphism. Serious cardiac hydatitosis because of the risk of rupture requiring urgent surgery. The diagnosis is based on serology and echocardiography. The aim of this work is to show one of the fatal complications of this condition which arose intraoperatively during anesthetic induction. Methods: We report the observation of a 37-year-old woman operated on in 2010 for a cardiac hydatid cyst presenting a recurrence of cardiac hydatid disease with two left intraauricular cysts expressed by palpitations with dyspnea. Preoperatively: dyspnea stage II of the NYHA. Chest x-ray: CTI at 0.58. ECG: RSR. Echocardiography: Two largest left atrial cysts: 47/40 mm compress the origin of the right pulmonary vein, 2nd cyst of 36/28 mm. The existence of another small caliber lateral cyst. Positive hydatid serology. The patient developed an anaphylactic shock of unexplained cause, which required the assistive CPB facility. Intraoperative exploration: The two ruptured cysts in the left atrium with multiple left intraatrial daughter vesicles. Gesture: Removal of daughter vesicles with sterilization with hypertonic saline. Results: The postoperative consequences were favorable despite a prolonged stay in intensive care following a picture of acute respiratory distress syndrome. Conclusion: Intracardiac rupture is a very serious complication and can produce dramatic pictures with sudden death. It can be responsible for allergic reaction, systemic embolism, pulmonary embolism and systemic metastases. Keywords: Hydatid Cyst; Heart; Relapsing; Rupture; Surgery; Anaphylactic Shock; Cardiopulmonary Bypass; Prevention

The impact of the COVID-19 pandemic on the incidence and mortality of zoonotic diseases in China

BackgroundIt has been reported that strict non-pharmaceutical measures can significantly reduce the incidence and mortality of respiratory and intestinal infectious diseases during the COVID-19 pandemic, but there are limited reports on the impact in terms of the rates of zoonotic diseases.MethodsWe extracted the incidence and mortality data of eight notifiable infectious zoonotic diseases from the website of the National Health Commission of the People’s Republic of China for the period of January 2015 to April 2021.ResultsFirst, the overall incidence of zoonotic diseases decreased from 0.3714 per 100 000 in 2015–2019 to 0.2756 in 2020 (25.79% reduction, p<0.001); however, a dramatic increase in activity was seen in 2021 compared with 2020 (0.4478 per 100 000 in 2021, 62.47% increase, p<0.001). Anthrax, brucellosis, leptospirosis and hydatid disease exhibited significant upward trends in 2021. Second, analysed further by stages, the monthly incidence in the routine stage (from May to December 2020) was much higher than that in the emergency stage of the COVID-19 (from January to April 2020) (55.33% increase, p<0.001). We also found that the monthly observed incidence was significantly lower than the predicted incidence of a 10.29% reduction in the emergency stage. Third, no differences were seen in mortality between 2021 and 2020, while a significant decline was found in 2020 compared with the previous 5 years (72.70%, p<0.001).ConclusionsStrict containment and feasible suppression strategies during the 2020 period of the COVID-19 pandemic had positive impacts on the overall incidence of zoonotic diseases in China. However, anthrax, brucellosis, leptospirosis and hydatid diseases might increase with the relaxation of non-pharmacological interventions in 2021.

Determining Role of TGF-β3 in Some Treatments of Albino Mouse, Mus musculus Linnaeus, 1758 Infected with Hydatid Cyst by Using an Immunohistoflourescent Staining Technique

The present study was conducted as an attempt to treat secondary hydatid disease in white mice strain Balb/c by immunohistoflourescent (IHF) staining technique. For this purpose, the mice were infected with hydatid cysts and treatment was done by oxfendazole (OFZ) at a concentration of 30 mg/kg, praziquantel (PZQ) at a concentration of 40 mg/kg and albendazole (ABZ) at a concentration of 10 mg/kg of body weight. Each drug was given weekly for four months and the same concentrations as above. The results showed that the highest treatment efficiency was in case of OFZ + PZQ treated mice, while the groups treated with OFZ, OFZ + ABZ and ABZ + PZQ showed less treatment efficiency, respectively. The IHF staining technique was used to determine the cytokinesis of TGF-β3 in the spleen and liver of experimental mice. For this reason, OFZ is considered as one of the most promising chemotherapies used in the treatment of hydatid cysts.

Recurrent hydatid disease, a case report and literature review

Hydatid disease (HD) remains endemic in Australia, with estimated incidence highest in rural and indigenous populations. Its recurrence is defined by new active cysts arising after appropriate therapy, and affects anywhere between 2-25% of total cases. Available treatment options include surgical resection, percutaneous drainage, and chemotherapy. Interestingly, their individual contributions to long-term minimisation of recurrence are scarcely described in the literature. We present a unique case of a 27-year-old female with recurrent hepatic HD requiring repeat operations and long-term chemotherapy. Prevention and treatment of recurrent HD requires careful evaluation of a multitude of factors, including disease characteristics, patient attributes, physician expertise and availability of resources. Consistent long-term follow up is required to better ascertain the long-term efficacy of reported treatment modalities for preventing recurrence. Despite a growing body of research looking at treatment of HD, there remains a considerable amount of controversy regarding most effective approach for minimising and preventing its recurrence.

Cardiac hydatid cyst presenting as ventricular arrhythmia: a case report

Background Hydatid disease caused by Echinococcus granulosus commonly involves the liver followed by lungs. Cardiac involvement is a rare occurrence and presents a challenging scenario. Case presentation Our case describes a middle-aged gentleman who presented to the emergency room with an episode of sudden loss of consciousness resulting from ventricular tachycardia. After successful cardiac resuscitation, the patient underwent imaging that showed a lesion compatible with hydatid cyst. Surgical treatment with pharmacologic coverage was provided which resulted in good clinical outcome. Conclusions The case highlights rare occurrence of isolated cardiac hydatid disease presenting as cardiac arrhythmia in contrast to its common routine outpatient presentation involving the liver and lungs. Good knowledge of the unusual presentations and its epidemiology is essential to the proper management of such patients.

Case Report on Hydatid Cysts with Hydropnemonothorax

Introduction: Hydatid disease is caused by a parasite infection induced by an echinococcus tapeworm. The hydatid cyst is one recognized cause of liver mass. It is a significant pathogenic, zoonotic, and parasitic illness (acquired from animals) of humans after consumption of tapeworm eggs produced in the faeces of infected dogs. Hydatid disease is a serious endemic health concern in various regions of the world. Cystic hydatid disease is most often associated with the liver (50–70%), although it can also affect the lung, spleen, kidney, bones, and brain. A hydropneumothorax occurs gradually. Case Presentation: A 35-year-old Man was taken to the Acharya Vinoba Bhave Rural Hospital with the chief complaint of abdominal discomfort, breathlessness (dyspnea) right side pain for 2 days. Approximately to the peritoneal cavity of the right chest by a hydatid cyst in the subscapular posterior part of the right lobe of the liver. For minimal ascites, a contrast study was conducted, revealing a multi-located hypodense cystic lesion spread across the abdomen was recognized as sign of hydatid disease. Conclusion: In a patient with a hydatid disease, physical and psychological therapy should be put together. In this study, we primarily focus on professional management and outstanding nursing care, which may give the comprehensive care that hydatid cyst requires. The complete health care team works together to assist the patient to restore his or her prior level of independence and happiness after a full recovery.