Abstract
Hydatid cysts are caused by a tapeworm Echinococcus granulosus. They usually occur in the liver. When occurring in spleen they present with vague symptoms which make it difficult for the physicians to diagnose. We present a case of a 10-year-old male who presented with fever, abdominal pain, and burning micturition along with vomiting. Abdominal exam revealed no visceromegaly. Abdominal ultrasound (US) and computed tomography (CT) scan showed multiple hypoechoic and hypo-dense areas, respectively. Splenic abscess, abdominal tuberculosis (TB), pyelonephritis and malignancy were ruled out with appropriate investigations. The patient was not responding to triple therapy of antibiotics (ceftriaxone, metronidazole, and cloxacillin). A final diagnosis of hydatid cyst of spleen was made when serum echinococcus immunoglobulin G (IgG) antibodies were found to be positive. The patient was treated with albendazole and was discharged on improvement. It is vital to be vigilant and consider echinococcal hydatid cyst as a differential in the lesions of spleen, especially if the patient has a rural background.
Highlights
Hydatid cysts are caused by a tapeworm Echinococcus granulosus
We present a case of a 10-year-old male who presented with fever, abdominal pain, and burning micturition along with vomiting
Echinococcosis or hydatid disease is caused by the parasitic tapeworm Echinococcus granulosus in its larval form
Summary
Echinococcosis or hydatid disease is caused by the parasitic tapeworm Echinococcus granulosus in its larval form. Fever was high-grade (102°F-103°F), continuous, gradual in onset, and associated with a non-productive mild cough. The child was previously admitted to another hospital where he developed urinary retention during his course of stay and was catheterized He was given intravenous (IV) augmentin and ciprofloxacin for four days and referred to CHK. The child was pale but his height (134 cm) and built was appropriate for his age His vitals were stable with a low-grade fever (100°F). Ultrasound (US) abdomen showed a spleen of 10.7 cm with multiple hypoechoic lesions over splenic parenchyma. An opinion was sought from pediatric surgery department They advised to continue triple regimen (ceftriaxone, metronidazole, and cloxacillin) and test for the presence of serum echinococcus antibodies.
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