Abstract
Hydatid cyst is an infectious disease characterized by cysts formed primarly within the gastrointestinal tract by echinococci. Hepatic hydatid disease, which is the most common form, remains asymptomatic until complications occur. In this report, we present an 80 years old patient who presented with a hepatic hydatid cyst which fistulized to the abdominal skin into the Emergency Department. Computed tomography of the abdomen showed inactive grade 5 cyst. Drainage without removal of the cyst failed to reveal active disease but the microbiological examination showed Klebsiella pneumonia that was sensitive to ampicillin–sulbactam as the causative agent. The treatment of the cyst with a combination of surgical and medical treatment was the successful treatment of Hepatic Hydatid Disease presenting with a cutaneous fistula.
Highlights
Cystic echinococcosis is a parasitic disease caused by the genus Echinococcus, affecting primarily the hepatobiliary, respiratory, and less frequently, the central nervous system
We report a rare clinical case of cystic echinococcosis presenting as a cutaneous fistula with a secondary bacterial infection
When liver is infected, increased pressure exerted by the cyst can produce symptoms of jaundice or abdominal pain, whereas lung involvement can present as hemoptysis, dyspnea or chronic cough
Summary
Cystic echinococcosis is a parasitic disease caused by the genus Echinococcus, affecting primarily the hepatobiliary, respiratory, and less frequently, the central nervous system. The cysts resulting from the parasitic infection remain asymptomatic for many years, and the initial presentation is usually due to the complications arising from fistula formation. The hepatobiliary system is the most common site of the fistulae, while cutaneous fistulae are rare (Sayek et al 2004). We report a rare clinical case of cystic echinococcosis presenting as a cutaneous fistula with a secondary bacterial infection. Case An 80-year-old man was admitted to the Emergency Department (ED) with right upper quadrant abdominal pain and a cutaneous lesion with white, purulent discharge that appeared a week ago in the same region. The abdominal wall was tender on palpation, and the examination of the lesion in
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