Clinical Characteristics and Management of Patients with Cystic Echinococcosis in Salmaniya Medical Complex – A Retrospective Descriptive Study

Abstract

Introduction: Cystic Echinococcosis, commonly known as hydatid cyst disease, is a zoonotic disease caused by Echinococcus granulosus and commonly affects hepatic and pulmonary tissues. Although it is prevalent in some countries in the middle east, no epidemiological studies have been conducted to determine the epidemiology of cystic echinococcosis in the Kingdom of Bahrain. Methods: This is a retrospective descriptive study of all cystic echinococcosis cases diagnosed in Salmaniya medical complex between 2015 and 2020. Descriptive analysis of clinical, radiological, and histological data using frequencies and percentages was conducted. Results: A total of 11 patients were identified with cystic echinococcosis. Most of them (n=9; 81.82%) reported a travel history to endemic areas and had liver involvement. While most laboratory data were within normal ranges, radiological investigations of hepatic lesions revealed characteristic features of hydatid cysts, including well-defined margins (n=9, 100%), hypoechoic liver cysts (n=9, 100%) and floating lily sign (n=5, 55.56%). All pulmonary (n=6, 100%) and most hepatic cysts (n=7, 77.78%) required surgical interventions. Reoperation rates were 33.33% (n=3) and 16.67% (n=1) for hepatic and pulmonary cysts, respectively. Conclusion: Hydatid cyst is a rare disease in Bahrain and is seen mainly in patients who travel to endemic areas. Thus, extracting a detailed travel history is essential for the diagnosis of this disease. Clinical presentations are variable due to different tissues involved, natural history of the disease, and patients’ characteristics. Although prolonged medical treatment and minimally invasive procedures are of value, surgical interventions are required in most cases. Keywords: Bahrain, Cysts, Echinococcus granulosus, Humans, Zoonoses