Echinococcosis in left ventricle: a case report

Abstract

Introduction: Echinococcosis, also called hydatid disease, is a common parasitic infection of the liver. However, echinococcus lesions rarely involve the heart, especially in children. Patient concerns: An 8-year-old child from grazing areas of northwest China was referred to our hospital for the complaint of inpersistent precordial chest pain and left upper quadrant pain for 3 years. Palpation showed hepatomegaly, abdominal palpable mass while inspection abdominal distension. Routine blood tests were within the normal ranges. Diagnosis: Combining the life history in pasture area, imaging features and serology results, it was consistent with the diagnosis of cardiac echinococcosis. Interventions: Surgery was performed to evacuate cyst liquid and remove the internal capsule of the cyst. Outcomes: There was no cystic lesion in heart on ultrasound and her physical condition improved significantly after the surgery. The patient died of hepatic hydatid cyst rupture due to refusing high-risk surgical treatment and other treatment. Lessons: We presented a rare case of cystic echinococcosis involving left ventricle in a child, and surgery is an alternative and effective therapy for this lesion due to the cyst rupture or leakage that can result in anaphylaxis. The typical imaging features of the cardiac echinococcosis on cardiac magnetic resonance are presented. Patient prognosis relies on proper treatment of all lesions.

Surgical Management of Cardiac Hydatid Cyst and the Residual Intramural Ectocyst

“…Cardiac HC is rare (0.5%-2%) compared to the liver (in 50%-70% of cases) [1,3]. And the involvement of the left ventricle and the interventricular septum is more common than other chambers of the heart [1,5,14]. There are no typical clinical signs and symptoms to draw attention to the possibility of the diagnosis, and many are asymptomatic and discovered accidentally [3].…”

“…HC is commonly located in the liver (>65% of cases) and the lungs (25%) [1]. However, even in countries where hydatid disease is endemic, only sporadic isolated cases of cardiac involvement (0.5%-2% of all cases) have been reported [2,[4][5][6]. Cardiac echinococcosis was first described in 1836 and the first successful operation for cardiac echinococcosis was performed by Long in 1932 [1].…”

A Unique Case of Cardiac Echinococcus multilocularis

“…The first reported case of cardiac alveolar echinococcosis in adults, has been recently published [6]. In another interesting recent case report, E. granulosus causing cystic echinococcosis (CE) in left ventricle has been described in an 8year-old child [2]. Yet another publication reports a giant hydatid cyst of the left ventricle in an 11-year-old child, also reviewing the 18 cases of cardiac echinococcosis reported thus far, all of which were due to cystic echinococcosis (CE) [7].…”

“…Alveolar echinococcosis, due to E. multilocularis is extremely unusual, accounting for < 5% of all cases of hydatid liver disease and, less frequently, lung disease. The mean age of presentation is 55 years [1,2], with children being rarely affected. Liver is the primary site of cyst development in almost all patients.…”

“…Lung manifestations always appear after the involvement of the liver [3]. Cardiac echinococcosis is very rare (0.03%-1% of all cases) [2], with the left ventricle being most frequently affected (55-60%).…”