A rare case of coexisting tuberculosis with hydatid disease from North India with review of literature

Abstract

Coexisting tuberculosis (TB) and hydatid disease in an immunocompetent individual is an extremely rare occurrence. Given the similarities in the clinical manifestations and morbidities of both, specific diagnosis in individuals coinfected with these is difficult. We, hereby present a case of a 17-year-old adolescent man diagnosed to be a coinfection of pulmonary TB with pulmonary and cardiac hydatid disease, with the review of cases having a similar presentation. The coexistence of these infections should be considered in endemic areas. Management can only be done by a multidisciplinary approach including surgical, microbiological, histopathological and radiological facilities. Complete surgical excision of the cyst is the treatment of choice and medical therapy for both aetiologies should be appropriate to achieve cure.

Ruptured pulmonary hydatid cyst and lophomoniasis comorbidity in a young man: a rare case

“…Some microbial infections have been associated to pulmonary hydatidosis in the past [ 15 ]. However, there have been no reports of Lophomonas and CE co-infection.…”

Ruptured hydatid cyst presenting as recurrent pneumothorax with co-existing pulmonary tuberculosis and uniportal thoracoscopic management: first Indian report

“…Hydatid cyst is a common dsease in developing countries caused by Echinococcus granulosus, affecting mainly the liver and lungs with a prevalence rate of 5-10% in endemic parts of Asia [1]. According to the global tuberculosis report 2020, tuberculosis is one of the top ten causes of death worldwide, accounting for 10 million cases, with India bearing a 26% global burden [2].…”

“…The immune response in PTB controlled by CD4+Th1 cells is mediated by the cytokines interleukin 12, tumor necrosis factor-α and interferon-g, while in hydatid disease, the immune response controlled by CD4+Th2 cells is mediated by the cytokines interleukin 4, 5 and 13. As a result, immune responses are antagonistic [1]. Thus, hydatid disease's predominant Th2 response downregulates the Th1 response, creating an anti-inflammatory environment intensifying PTB and masking clinically early manifestations of hydatid disease in patients with respiratory infections [1].…”

“…As a result, immune responses are antagonistic [1]. Thus, hydatid disease's predominant Th2 response downregulates the Th1 response, creating an anti-inflammatory environment intensifying PTB and masking clinically early manifestations of hydatid disease in patients with respiratory infections [1].…”