Outcome of multivisceral echinococcosis: a case report

Zlata Hajric, Amela Pasic, Razija Spahic


Introduction: The pathogen of multivisceral echinococcosis is the same  agent as for single-organ echinococcosis: Echinococcus  granulosus.According to the consensus of experts under the aegis of the WHO-IWGE - WHO-Informal Working Group on Echinococcosis options of treatment should be: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and waitapproach or combinations thereof.

Case report: The presented case was a seven-year-old Caucasian boy, a permanent resident of rural region near Tuzla, Bosnia and Herzegovina, who had a history of asymptomatic giant liver and small lung hydatid cyst (multivisceral echinococcosis). We consider that the patient was in the phase of secondary hydatidosis even before undergoing the first treatment PAIR method of liver and continued with adjunctive chemotherapy. Two weeks after discharge, during the adjunctive chemotherapy he had one of possible complication where pre-existed smal lung hydatid cyst gotinflamed and performed an abscess massand potential septic risk, which required surgical and antibiotic treatment. Surgery and early postoperative course were normal and the patient was discharged with recommendation to continue with previously started adjunctive chemotherapy (Albendazol) according to treatment protocol.

Conclusion: Most infected persons are asymptomatic and clinical manifestations vary according to the anatomic location of the cyst, so we want to indicate the importance of routine ultrasound screening of preschool children, and eventually X ray chest scan.This case report highlights the necessity of caution with choosing appropriate treatment, even though size of cyst can be irrelevant to take surgical treatment in first line instead of  medical therapy.


echinococcosis, hydatid cyst, hydatidosis, diagnosis, treatment

Full Text:



Sherwani RK, Abrari A, Jairarpuri ZS, Srivastava VK. Intracranial hydatidosis. Report of a case diagnosed on cerebrospinal fluid cytology. Acta Cytol. 2003;47(3):506–8.

Jairajpuri ZS, Jetley S, Hassan MJ, Hussain M..Hydatid disease in childhood: revisited report of an interesting case. J Parasit Dis. 2012;36(2):265–8.

Grozavu C, Ilias M, Pantile D. Multivisceral echinococcosis: concept, diagnosis, management. Chirurgia (Bucur). 2014;109(6):758-68.

Sumer A, Caglayan K, Altinli E, Koksal N. Casereport: Spontaneous liver hydatid cyst rupture in a child. Israel J Emerg Med. 2009;9(1):13-6.

Çelik T, Akçora B, Tutanç M, Yetim TD, Karazincir S, Akın MM, et al. Ruptured pulmonary hydatid cyst: a case report.Turkiye Parazitol Derg. 2012;36(1):45-7.

Siracusano A, Teggi A, Ortona E. Human cystic echinococcosis: old problems and new perspectives. Interdiscip Perspect Infect Dis.2009;2009: 474368.

Moro P, Scantz PM.Echinococcosis: a review. Int J Infect Dis. 2009;13(2):125-33.

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

Arif SH, Shams-Ul-Bari, Wani NA, Zargar SA, Wani MA, Tabassum R,et al. Albendazole as an adjuvant to the standard surgical management of hydatid cyst liver. Int J Surg. 2008;6(6): 448–51.

Sumontra C, Philippe G, Adam M, Ahin B,Jay K. Images in Clinical Tropical Medicine About to Burst. Am. J. Trop. Med. Hyg. 2015; 92(3):474–5.

Djuricic SM, Grebeldinger S, Kafka DI, Djan I, Vukadin M, Vasiljevic ZV. Cystic echinococcosis in children - the seventeen-year experience of two large medical centers in Serbia.Parasitol Int. 2010;59(2):257-61.

Cobzaru RG, Dumitrescu AM, Ciobotaru M, Rîpă C, Leon M, Luca M et al. Epidemiological aspects of hydatidosis in children, in some areas of north-eastern Romania. Rev Med Chir Soc Med Nat Iasi. 2013;117(3):754-7.

Paredes S, Torres J, Muena P, Schnettler D. Hepatopulmonary hydatidosis: pediatric case report and literature review.Medwave. 2014;14(11):e6053.

Bobić B,Nikolić A, Radivojević SK, Klun I, Djurković-Djaković O.Echinococcosis in Serbia: an issue for the 21st century? Foodborne Pathog Dis. 2012;9(11):967-73.

Zargar-Shoshtari M, Shadpour P, Robat-Moradi N, Moslemi M. Hydatid cyst of urinary tract: 11 cases at a single center. Urol J. 2007;4(1):41–5.

Ammann RW, Eckert J.Cestodes: Echinococcus. Gastroenterol Clin N Am.1996;259(3):655–89.

Sumer A, Caglayan KMD, Altini E, Koksal N. Case report:spontaneous liver hydatid cyst rupture in a child. Isr J Emerg Med.2009;9(1):13–6.

Creţu C, Codreanu RR, Mastalier B, Popa LG, Cordoş I, Beuran M, et al.Albendazole associated to surgery or minimallyinvasive procedures for hydatid disease - how much and how long.Chirurgia (Bucur). 2012;107(1):15-21.

Horvat T, Grozavu C, Savu C, Cordoş I, Nicodin A, VoivulescuV. Indicaĺieabuzivă de tratament cu Albendazol în afecĺiunitoracice neparazitare. Jurnalul de Chirurgie Toracică. 1997;2(3-4):247-9.

Eckert J, Schantz P.M, Gasser R.P,et al. Geographic distributionand prevalence. In: Manual on Echinococcosis inhumans and animals: a public health problem ofglobal concern. WHO/OIE, Paris, France.2001;100-42.

World Health Organization (W.H.O) InformalWorking Group. International classification ofultrasound images in cystic echinococcosis forapplication in clinical and field epidemiologicalsettings. Acta Tropica. 2003;85: 253-61.

DOI: http://dx.doi.org/10.24125/sanamed.v12i2.188


  • There are currently no refbacks.

Copyright (c) 2017 Zlata Hajric

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.