Cystic echinococcosis is the disease that occupies, together with trichinosis, the first place in the zoonoses in Romania. We present the case of a 75-year-old urban patient known for echinococcosis, firstly operated for bone cysts in the right coxofemoral joint at the age of 24, then in 2000 she was operated for a lung hydatid cyst and in 2011 she underwent a surgery for recurrent bone echinococcosis.After a 7-year lull, she returns due to the appearance of tumorous masses in the abdominal right flank, the right thigh, accompanied by pain in the right coxofemoral joint, functional impotence of the right lower limb, asthenia, anorexia. Based on clinical, immunological, imagistic examinations, the diagnosis of cystic echinococcosis localised in the liver, bone and muscle was established. Since the patient in association had ischaemic heart disease in NYHA III (New York Heart Association) congestive heart failure, surgical treatment was delayed and preoperative treatment with Albendazole 10-15mg/kg/day was started. Initially we will apply a conservative treatment, laparoscopic drainage and aspiration of the contents, saline instillation and aspiration.

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Background, objectives: Histological diagnosis of control biopsies in patients with heart transplant represents a significant step of monitoring, with a great influence on adjusting immunosuppressive treatment. Histological lesions are usually related to ischemia and reperfusion, with varying degrees of intensity. This study aimed to highlight the most important aspects of the histological diagnosis and differential diagnosis of postoperative myocardial lesions associated or unrelated to rejection in heart transplant. Materials and Methods: This retrospective study involved 53 patients who received cardiac transplant between 2000 and 2017. Patients were monitored by lesion quantification of endomyocardial biopsies, with diagnoses established based on biopsy material in the early, medium and late post-transplant periods. Hematoxylin eosin, Masson’s trichrome, and Van Gieson stains were used; immunohistochemical determinations used CD4, CD20, CD45, CD68, HLA-DR, VEGF and CD31. Results: Ischemia and reperfusion lesions were diagnosed on all biopsies in the first 6 weeks post-transplant. Nine cases of the Quilty effect were identified, and in 12 cases, the biopsies were performed on the same spot as previous biopsies. A significant number of transplanted patients presented cytomegalovirus that was difficult to diagnose on endomyocardial biopsies. Conclusions: The detailed study of ischemia and reperfusion lesions, as well as of changes un-related to rejection becomes a major objective in the short, medium and late post-transplant period. Overdiagnosis of rejection induces changes of the immunosuppressive therapeutic protocol, with alarming repercussions on cytomegalovirus reactivation, and risks of potentiating inflammation, myocyte destruction and the recurrence of disorders related to both inducing and aggravating heart failure.

This work is licensed under Creative Commons Attribution 4.0 License OJCR.MS.ID.000551. The histological monitoring protocol was applied in 63 patients with heart transplant performed at the Emergency Institute for Cardiovascular Diseases and Transplant of Tirgu Mures, between 1999 and the present time. Twenty-two of the 63 patients deceased during follow-up due to various complications, whereas 32 were diagnosed with cytomegalovirus infection [5,6], based on clinical

This work is licensed under Creative Commons Attribution 4.0 License OJCRR.MS.ID.000551. The histological monitoring protocol was applied in 63 patients with heart transplant performed at the Emergency Institute for Cardiovascular Diseases and Transplant of Tirgu Mures, between 1999 and the present time. Twenty-two of the 63 patients deceased during follow-up due to various complications, whereas 32 were diagnosed with cytomegalovirus infection [5,6], based on clinical