Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle

Nell, Manuel; Burgkart, Rainer; Gradl, Guntmar; Eisenhart-Rothe, Rüdiger von; Schaeffeler, Christoph; Trappe, Dennis; Costa, Clarissa Prazeres da; Gradinger, R.; Kirchhoff, Chlodwig

doi:10.1186/1476-0711-10-13

Cited by 24 publications

(16 citation statements)

References 27 publications

(55 reference statements)

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“…CT or MRI is used for imaging. Muscle invasion can present as masses with cystic cavities mimicking bacterial abscesses (27). The involvement is usually by invasion from the primary lesion or metastatic dissemination.…”

Section: Computed Tomographymentioning

confidence: 99%

Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update

Bulakçı

Kartal²,

Yılmaz³

et al. 2016

Diagn Interv Radiol

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Section: Computed Tomographymentioning

confidence: 99%

Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update

Bulakçı

Kartal²,

Yılmaz³

et al. 2016

Diagn Interv Radiol

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“…Moreover, primary extrahepatic infections are extremely rare with E. multilocularis. Indeed, only a few cases of AE with no evidence of liver involvement have been reported in the literature (12)(13)(14). In the present case, imaging could not confirm the presence of any hepatic involvement and no biopsy was ever performed.…”

mentioning

confidence: 56%

“…Bone abnormalities at CT consist of heterogeneous and active destructive osteolysis (18). MRI may show a diffuse infiltration and tubelike cavities/cystic lesions with a multivesicular morphology if soft tissues are involved (13,18).…”

mentioning

confidence: 99%

Fatal Alveolar Echinococcosis of the Lumbar Spine

et al. 2013

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For the last 10 years, the southern part of Belgium has been recognized as a low-risk area of endemicity for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a severe liver condition and can sometimes spread to other organs. However, alveolar echinococcosis involving bones has been described only very rarely. Here, a fatal case of spondylodiscitis due to E. multilocularis contracted in southern Belgium is reported. CASE REPORTA 75-year-old man, a former legionnaire living in the southern part of Belgium, was referred to our institution because of deterioration in his condition despite several treatment attempts. His medical history included alcoholic liver cirrhosis, diabetes mellitus type II, and the presence of numerous nonevolutionary lung nodules, thought to be aftereffects of tuberculosis.The patient initially came for a hospital consultation because he had been suffering from a severe pain in the lower back for a few weeks. Laboratory investigations revealed pathological values for hemoglobin (12.4 g/dl; normal values [NV], 13.3 to 17.2 g/dl), platelet count (102 ϫ 10 9 /liter; NV, 150 ϫ 10 9 /liter to 450 ϫ 10 9 /liter), C-reactive protein (40 mg/liter; NV, Յ6 mg/liter), alkaline phosphatase (137 IU/liter; NV, 40 to 124 IU/liter), gammaglutamyl transferase (66 IU/liter; NV, 5 to 50 IU/liter), gamma globulins (34%; NV, 11.1 to 18.8%), and total IgE (2,005 IU/ml; NV, 0 to 105 IU/ml). The patient's eosinophil count was within the normal range. A radiological examination confirmed the presence of an osteitis and a paravertebral abscess in the L5 region. A transbronchial biopsy of the pulmonary nodules was performed using a thin needle, and a histological examination revealed numerous necrotic granulomatous lesions, suggestive of tubercles. Thin-needle biopsies of the lumbar lesions also demonstrated the presence of several necrotic granulomas on histological examination. Bacteriological cultures including a specific medium for the growth of mycobacteria (MB/BacT system; bioMérieux, France) were performed on the pulmonary and lumbar biopsy specimens but proved negative, as did direct examination for acid-fast bacilli (AFB). A PCR specific for Mycobacterium tuberculosis (RealAccurate M. tuberculosis kit; Pathofinder, The Netherlands) was also performed on the lumbar biopsy specimens but was noninterpretable because of the presence of amplification inhibitors. In an attempt to confirm the suspected tuberculosis, chirurgical biopsies were performed on the L5 vertebrae and the paravertebral abscess. Histological examination again revealed the presence of granulomas, and all bacteriological cultures and microscopic examinations, including the detection of mycobacteria, remained negative. M. tuberculosis PCR performed on the biopsy specimens was negative (using the same method as used in the thin-needle biopsies).However, despite the lack of laboratory evidence, an antituberculosis treatment combining isoniazid, rifampin, ethambutol, pyrazinamide, and moxifloxacin was i...

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“…Humans are most commonly affected by the larva of tapeworm Echinococcus Granulosus followed by Echinococcus Multilocularis, and Echinococcus Vogeli [6,7]. The pathogenesis of Hydatid cyst in muscles is not clearly known.…”

Section: Discussionmentioning

confidence: 99%

Hydatid Cystic Disease of Lumbar Paraspinal Muscles

Shah¹

2017

BJSTR

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Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle

Cited by 24 publications

References 27 publications

Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update

Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update

Fatal Alveolar Echinococcosis of the Lumbar Spine

Hydatid Cystic Disease of Lumbar Paraspinal Muscles

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