Echinococcus multilocularis massive pericardial infection: Late and dramatic improvement under albendazole therapy

Lidove, Olivier; Chauveheid, Marie-Paule; Papo, Thomas; Vuitton, Dominique-Angèle; Piarroux, Renaud; Hernigou, A.; Charlotte, Frédéric; Piette, Jean‐Charles; Penaud, D.; Scheublé, C

doi:10.1016/j.amjmed.2004.08.024

Cited by 8 publications

(7 citation statements)

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“…Despite objective mass regression and encouraging immunological changes, the decision to withdraw albendazole remains difficult. Appropriate tools are still needed to measure the viability of the parasitic lesions in order to avoid an indefinite treatment in such patients [10].…”

Section: Discussionmentioning

confidence: 99%

“…Pre-operative echocardiographic assessment of the cyst may be helpful in guiding surgery. E. multilocularis heart involvement appears exceedingly rare, only a few studies reported isolated pericardial involvement due to E. multilocularis [10]. The Em2 plus ELISA test has a high sensitivity (97%) and specificity (99%) for the diagnosis of E. multilocularis infection [11].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of pericardial hydatid cysts by different echocardiographic imaging modalities

Nemes¹,

Geleijnse²,

Geuns³

et al. 2006

Int J Cardiovasc Imaging

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of pericardial hydatid cysts by different echocardiographic imaging modalities

Nemes¹,

Geleijnse²,

Geuns³

et al. 2006

Int J Cardiovasc Imaging

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“…More accurate methods of measuring the viability of the parasitic lesion are needed to more effectively treat patients. 7,8 Surgical cyst removal in patients with multiple small recurrent cysts should be considered because of the high risk of associated complications, including rupture, tamponade and anaphylactic shock. Furthermore, our findings emphasize the need for thorough and frequent reevaluation to detect new hydatid cysts in the heart and other target organs.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Echinococcosis Recurrent Intramyocardial-Extracardiac Hydatid Cysts With Pericardial Protrusion

Erkut

Ünlü

Özden

et al. 2008

Circ J

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chinococcosis is an infection with the canine tapeworm Echinococcus granulosus (E. granulosus) and is associated with various sheep-and cattleraising areas of the world. 1 Typically in humans, cysts form in the liver (60% of cases) and lung (20-30% of cases; more common in children). 2 Although most often found in the liver and lung, hydatid cysts can occur in any organ or tissue and if ruptured, there is dissemination of scolices (an immature stage) via the blood stream. Cardiac involvement of echinococcosis is rare, and occurs in approximately 2% of all patients, typically localized to the left or right ventricle. [2][3][4] Although cardiac echinococcosis is rare, localization to the myocardium may lead to life-threatening complications, including cyst rupture, anaphylactic shock, tamponade, pulmonary, intracerebral or peripheral arterial embolism, acute coronary syndrome, arrhythmias and infection, any of which require aggressive treatment. 4 We present a rare case of recurrent intramyocardialextracardiac hydatid cyst with pericardial protrusion that was surgically removed. Case ReportA 26-year-old man was admitted with chest pain and palpitations, which had started approximately 6 months before admission. He had undergone surgical resection 10 years earlier of an intramyocardial hydatid cyst without cardiopulmonary bypass. Physical examination did not reveal any abnormal findings: his lungs were normal on auscultation, no cardiac murmur or gallop rhythm was noted, and biochemical laboratory test results were within normal limits. Myocardial-specific enzyme values were within the normal range.The patient's chest X-ray was normal, except for the sternal suture, and the ECG showed normal sinus rhythm with T-wave inversion in leads V1-6, consistent with ischemia. Apical 2-chamber transthoracic echocardiography showed a multivesicular cystic mass on the left lateral ventricular wall in the pericardial sac. The cyst, measuring 6×4×5 cm, was localized to the inferoposterior wall of the left ventricle and protruded toward the pericardium ( Fig 1A); this finding was confirmed by transesophageal echocardiography (TEE). We did not detect any additional visceral localization of the cyst on abdominal ultrasonography. The patient was examined further by multislice computed tomography (CT) of the chest in order to determine the exact location, size and number of disseminated hydatid cysts; a 5.7×4.8 cm round cystic mass with well-defined contours was located next to the left ventricle (Fig 1B). The cyst had a germinative membrane that did not allow communication between the mass and the cardiac chambers or extrinsic structures. Additionally, in view of the clinical suspicion of coronary artery disease, coronary angiography was performed, and was determined to be normal.Because of the previous history of hydatidosis, serologic tests (indirect hemagglutination tests) were performed. The results were positive for E. granulosus, and there was an accompanying eosinophilia. Because the clinical, radiologic, and serologic finding...

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“…L'homme et la femme sont également atteints et l'âge moyen au diagnostic est de 55 ans en Europe ; la moyenne d'âge est plus basse et la femme plus touchée que l'homme dans le foyer asiatique [3,4,9]. [6,11,18,20,21]. D'authentiques métastases sont également possibles, en relation avec la migration de fragments parasitaires par voie hématogène.…”

Section: Une Maladie Hépatiqueunclassified

“…Il est important, dans ces régions, d'évoquer l'EA et d'envisager sans délai la réalisa-tion d'une sérologie spécifique, d'examens morphologiques hépatiques et/ou d'une biopsie qui permet d'éviter des retards diagnostiques [18,25]. Quand les lésions extrahépatiques constituent le mode de révélation de l'EA en dehors des zones connues d'endémie, la prise en charge peu s'avérer considéra-blement retardée [21].…”

Section: Une Maladie Hépatiqueunclassified

Échinococcose alvéolaire : d’une maladie rurale incurable à une infection urbaine sous contrôle ?

et al. 2010

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Echinococcus multilocularis massive pericardial infection: Late and dramatic improvement under albendazole therapy

Cited by 8 publications

References 6 publications

Evaluation of pericardial hydatid cysts by different echocardiographic imaging modalities

Evaluation of pericardial hydatid cysts by different echocardiographic imaging modalities

Cardiac Echinococcosis Recurrent Intramyocardial-Extracardiac Hydatid Cysts With Pericardial Protrusion

Échinococcose alvéolaire : d’une maladie rurale incurable à une infection urbaine sous contrôle ?

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