A 15-year-old girl was admitted with a 2-month history of early satiety, abdominal pain, nausea, and progressive dyspnea. Abdominal examination revealed a markedly distended abdomen. The patient's family lived in a region endemic for hydatid disease and her brother had a hydatic cyst in the liver. Serum immunoglobulin G (IgG) against Echinococcus granulosus was positive (titer 1/1,280) using the immunofluorescence assay test, and eosinophilia was observed in a peripheral blood sample. Postero-anterior chest radiograph showed multiple irregular opacities in both lung fields (Figure A). Thoraco-abdominal computed tomography (CT) revealed multiple thin-walled cystic lesions in the lungs, liver, spleen, kidney, and right iliacus and gluteus maximus muscle (Figure B). Based on the clinical, laboratory, and radiological findings, disseminated hydatid disease was diagnosed. The patient received a prolonged course of albendazole 15mg/kg/day (4 weeks treatment, 2 weeks non-treatment periods) with good clinical evolution. She received only medical treatment because of the multiple organ involvement. Hydatid cyst disease is an endemic parasitic infection caused by Echinococcus granulosus, and is a major public health problem in Mediterranean countries11. Tekin R, Avcı A, Tekin RC, Gem M, Cevik R. Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation. Rev Soc Bras Med Trop 2015; 48:594-598.. Hydatid disease should be kept in mind in the differential diagnosis of multiple cysts in patients living in endemic areas11. Tekin R, Avcı A, Tekin RC, Gem M, Cevik R. Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation. Rev Soc Bras Med Trop 2015; 48:594-598.) (22. Turan Y, Yılmaz T, Göçmez C, Kamaşak K Kemaloğlu S, Tekin R, et al. Assessment of cases with intracranial hydatid cyst: a 23-year experience. J Neurol Sci Turk 2014; 31:90-98.. Early recognition of hydatid cysts cases is critical to prevent complications33. Tekin R, Kara AF, Tekin RC, Cimen D. Cardiac hydatid cyst case recovered with medical treatment. Anadolu Kardiyol Derg 2011; 11:650-651..
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1Tekin R, Avcı A, Tekin RC, Gem M, Cevik R. Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation. Rev Soc Bras Med Trop 2015; 48:594-598.
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2Turan Y, Yılmaz T, Göçmez C, Kamaşak K Kemaloğlu S, Tekin R, et al. Assessment of cases with intracranial hydatid cyst: a 23-year experience. J Neurol Sci Turk 2014; 31:90-98.
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3Tekin R, Kara AF, Tekin RC, Cimen D. Cardiac hydatid cyst case recovered with medical treatment. Anadolu Kardiyol Derg 2011; 11:650-651.
Publication Dates
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Publication in this collection
Jul-Aug 2016
History
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Received
09 Dec 2015 -
Accepted
29 Feb 2016
