Unusual presentation of hydatid disease with recurrence over five years in central India

Abstract

BACKGROUND: Human hydatid disease (HD) is a chronic parasitic infection caused by Echinococcus species. Classic human hydatid cystic disease is a neglected zoonotic disease caused by the larva of cestode Echinococcus granulosus, leading to serious life-threatening complications. This study examines the range of presentations, mainly uncommon sites and changes in hematological parameters in recurrence and before and after surgery. METHODS: Amongst a total of 109 cases of HD, 25 unusual sites of HD were retrospectively studied in central India tertiary care rural hospitals from January 2016 to December 2020. Demographic details, clinical details, treatment reports, hematological reports, histopathology reports, and ultrasonography (USG)/computed tomography (CT)/magnetic resonance imaging (MRI) reports were also retrieved. RESULTS: Histologically, scolices were found in 40.36% of the cases. Preoperative mean platelet volume (MPV) and platelet count (PLT) were significantly higher and lower, respectively, compared to the postoperative period. The recurrence rate of HD after surgery was 3.6%, while in the case of unusual presentation, recurrence was noted as 8%. All 4 cases of recurrence showed increased PLT (P < 0.0001). CONCLUSION: The study's findings highlight essential features of HD, which help early clinical suspicion, prompt diagnosis, and management to reduce morbidity and mortality related to HD. A possibility of HD should be considered in the differential diagnosis of cystic swellings present anywhere in the body, especially at rare and unusual sites. Platelet parameters and eosinophil count could be utilized to determine early suspicion and rule out the possibility of recurrence of HD.

Keywords

• hydatid cyst
• echinococcus
• recurrence