Giant Hydatic Cyst in a 2-Year-Old Infant

Abstract

Background: Infantile cerebral hydatidosis is a serious infection and represents a major problem of public health that threatens the economy of countries in which it is endemic. It imposes a large-scale prophylaxis based on the interruption of the parasite cycle. Case description: We present a case of a 2-year-old girl with no medical history living in a rural region (Sidi Ifni), where contact with dogs, sheep, and cattle is not uncommon. One month before her admission, increased intracranial pressure (ICP) symptoms appeared made of headaches, vomiting, and visual disturbances. 15 days later, motor deficits and impaired consciousness were installed. The clinical examination found a sleepy infant with a Glascow Coma Scale at 14, left hemiparesis at 2/5 (Medical Research Council score), and bilateral 6th nerve palsy, A brain CT scan was performed, showing a round hypodense intraparenchymal lesion at the right frontal lobe. The intervention was performed to remove the gliant hydatic cyst according to the Dowling-Orlando technique. Postoperatively the patient had no motor deficit. The histopathological exam confirmed the diagnosis of an echinococcus granulosis cyst. Conclusion: Presentation of such a giant cyst in a 2-year-old infant is very rare. In such cases, genotype analysis of the parasite should be performed. The surveillance of dogs and periodic testing of their stools, with treatment if they are found to be infected, and preventing their access to raw offal at slaughterhouses and farms, will be effective in controlling the menace of hydatidosis.