Echinococcus granulosus hydatid cyst in rural Manitoba, Canada: Case report and review of the literature

Abstract

Echinococcal infections are a rare but important disease in Canada. The parasite’s traditional endemic area includes rural, northern communities with wild canines and ungulates. There is evidence that the endemic area is enlarging. Echinococcus can cause significant morbidity, and rarely death. An 18-year-old female presented with right upper quadrant abdominal pain. Computed Tomography (CT) of the abdomen showed a 5.4 × 4 cm cyst with the presence of “water lily sign”. She showed signs of cyst leak including eosinophilia and fever. Therefore, she underwent surgical resection of her cyst with Albendazole cover and was continued post-operatively for three months. CT head, chest, and pelvis failed to identify further sites of cyst formation. She has recovered well from surgery and is no longer followed by Infectious Diseases. The annual incidence and prevalence of Echinococcus disease are very low among the Canadian population. Therefore, there is a paucity of experience with new interventional techniques. Traditional management with surgery and anti-helminthic drugs is a reasonable alternative to percutaneous drainage. Screening communities has previously been determined not to be cost effective. Screening family members with similar risk factors has not been previously documented, and treatment has historically been reserved for symptomatic individuals with the disease. Keywords: Echinococcal granulosus, Echinococcal disease, Hydatid cyst, Parasitic infection, Hepatic cyst