HEPATIC CYSTIC ECHINOCOCCOSIS STUDIED IN A FAMILY GROUP

• Published in: International journal of medical dentistry Vol. 8; no. 4; pp. 346 - 350
• Main Authors: Botezatu, Cristian, Duceac, Letiţia-Doina, Mastalier, Bogdan, Stafie, Liviu, Jităreanu, Cristina-Maria, Luca, Alina Costina, Ţarcă, Elena, Mitrea, Geta, Iordache, Alin Constantin, Pătraşcu, Traian
• Format: Journal Article
• Language: English
• Published: Iasi Apollonia University of Iasi, Medical Dentistry Faculty 01.10.2018
• Subjects: Abdomen; Albendazole; Amikacin; Calculi; Children & youth; Colistin; Cysts; Echinococcosis; Echinococcus granulosus; Eggs; Endoscopy; Families & family life; Food contamination; Food contamination & poisoning; Hospitals; Infections; Liver; Nephrolithiasis; Pathology; Patients; Risk factors; Surgery; Ultrasonic imaging; Ultrasound
• ISSN: 2066-6063; 2392-8018

The mother was admitted in the Colentina Hospital Surgery Clinic in 2014, after an initial evaluation in the Clinic of Parasitology, where she was diagnosed with giant hydatid cyst located in the right liver lobe, after abdominal ultrasound was performed and ELISA test was positive for Echinococcus granulosus antibodies. Abdominal CT examination identified hepatomegaly with cranio-caudal diameter of the right hepatic lobe of 20 cm, cystic wall-shaped cavity which occupies almost completely segments VIII, VII and IV A with axial diameters of 15/11 cm and a cranio-caudal diameter of 11 cm, with the lower pole in segment V, with decolated membrane, daughter cells and areas of bleeding in the upper parietal pole, containing non-iodophilic clear liquid, the mass affecting the vascular structures, especially the suprahepatic veins and portal veins, as well as the left hepatic biliary duct, causing IHBD dilatation without PBD dilatation, cholecyst containing a 0.5 cm diameter stone and nonobstructive left kidney stone. In order to reduce the external biliary drainage, ERCP with endoscopic sphincterotomy was performed, and antibiotic treatment with Amikacin and Colistin was administered against the Enterobacter infection, according to the antibiogram. 3.RESULTS The first child, in whom the postoperative ultrasound detected residual cavity and residual hepatic hydatid cyst, received continuous treatment with Albendazole for 9 months, followed by discontinuous Albendazole 90-day cures with 2 week pauses between them. The mother, patient R.M., discharged from the Surgery Clinic 42 days after surgery, received 6 months of treatment with Albendazole postoperatively and was evaluated in September 2015, when no recurrence was found. 4.DISCUSSION The presence of several cases of hepatic echinococcosis within the same family is explained by the fact that all patients were exposed to the same risk factors: contact with possibly infected dogs, water consumption and potentially contaminated food with Echinococcus granulosus eggs, and lack of a proper hygiene.