Hydatid Disease Of Bone Research Articles

Recurrent Hydatid Disease of Temporal Bone and Skull Base: A Case Report and Literature Review.

Hydatid disease is a parasitic infestation caused by Echinococcus granulosus. The disease is rare in the head and neck region with varying presentations. We present a rare case of recurrent hydatid disease of the temporal bone with intracranial involvement; and the treatment thereof. Hydatid disease is endemic in few parts of the world, its occurrence in head and neck region is very rare. The commonest causative organism is E. granulosus giving rise to cystic hydatid disease. Most of the former are asymptomatic, but can give rise to symptoms because of their mass effects or rupture. Our case is a 38year male presenting to ENT department with recurrent left ear discharge, giddiness, headache and facial palsy having operated elsewhere twice in the past. The patient was investigated by Computed Tomography (CT) scanning and Magnetic Resonance Imaging (MRI) of temporal bones, head and neck regions. Which showed soft tissue attenuation of middle ear cleft and multiple cystic lesions in the middle and posterior cranial fossae indicating intracranial extension of disease. We operated for left subtotal petrosectomy with vestibular labyrinthectomy. During the perioperative period he was treated with Albendazole. Patient remains clinically and radiologically asymptomatic (post surgery 1year) till date of this manuscript submission. Hence, we report the recurrent hydatid cyst in the temporal bone and skull base, which was managed by combination of surgical and medical treatment.

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease.

Hydatid bone disease is a zoonotic parasitic infection that is caused primarily by the tapeworm Echinococcus granulosus, and it continues to be a major public health concern in pastoral regions. The reconstruction of limb function after limb salvage surgery remains a challenge for clinicians. The purpose of this study was to determine the clinical efficacy of palliative treatment of the management of advanced pelvic hydatid bone disease. From March 2005 to December 2018, medical records and images of patients with advanced pelvic hydatid bone disease treated with surgery combined with antiparasitic chemotherapy were evaluated retrospectively. The Enneking classification was applied to determine the location of the lesion, and the Musculoskeletal Tumor Society score system was used for outcome evaluation. Fifteen patients who met the criteria were included in this study, with a mean follow-up of 4.40 ± 1.76 years. All patients received treatment with surgery combined with antiparasitic chemotherapy. The mean number of surgical interventions per patient for pelvic cystic echinococcosis was 5.3 (range, 2-9 interventions per patient). Recurrence of pelvic hydatid bone disease occurred in 5 patients and was managed successfully through repeated debridement procedures. Palliative treatment with limb salvage surgery was an effective and practical approach to the management of advanced pelvic hydatid bone disease. Standard antiparasitic chemotherapy, which included albendazole at a dose of 10 mg/kg/day administered in two daily doses for 3 to 6 months, was also considered an essential part of the overall treatment strategy.

Complete excision of giant clavicular hydatid cyst: a case report

BackgroundEchinococcosis, also known as hydatid disease, is a zoonotic parasitic disease prevalent in pastoral areas, mainly involving the liver and lungs, and less frequently the bones and surrounding soft tissues. Diagnosis and treatment of bone hydatid disease is a challenge, and because of the insidious course of the disease, the lesions are often widely disseminated by the time patients seek medical attention.Case presentationA 29-year-old woman presented with a painless mass that was gradually increasing in size in the cervical thorax. Imaging revealed an enlarged clavicle with multiple bone cortical defects and the existence of cysts in the soft tissues surrounding the clavicle, for which complete excision of the clavicle and the attached cysts was performed. There was no recurrence of the cyst within one year after the operation, and the patient felt well and had normal shoulder joint movement.ConclusionsBone hydatid may appear in bones throughout the body, and cysts that leak from the bone into the surrounding soft tissues may spread at a relatively rapid rate. Prompt surgical removal of the affected bone and surrounding cysts is necessary for treatment.

Non-spinal Hydatid Disease of Bone: A Series of Nine Cases.

Extra-spinal osseous hydatid disease is reported in a small number of case series. In the present study, we report our experience with extra-spinal hydatid disease of the bone in a series of nine patients. In this retrospective study, the patients who were diagnosed with an extra-spinal osseous hydatid disease were included. All patients were treated surgically. Preoperative anthelmintic drugs were employed for the cysts that were diagnosed before the operation. Postoperative chemotherapy was performed for all patients. The study population included nine patients, including seven males and two females, with a mean age of 45.2±7.9 years and an average follow-up of 4.1±2.7 years. Non-specific pain was the most common symptom at presentation. Pelvic bones were the most frequent site of involvement. Serologic tests were false negative in seven patients. The disease was diagnosed preoperatively in five patients, and all of them were located in flat bones. The cysts were treated by radical excision in four patients, extended curettage in four patients, and amputation in one patient. The recurrence of the lesion was recorded in two patients who were treated by intralesional curettage. One case of suppuration was the only postoperative complication of this series. Osseous hydatid disease is a serious disease with challenging diagnosis, difficult treatment, and significant morbidity. Preoperative diagnosis is generally easier in flat bones. Radical resection is the optimal treatment of this disease, while non-radical resection is associated with a higher risk of recurrence.

Hydatid disease of bone

This review focuses on the incidence, clinical manifestations, and radiographic features of bone hydatidosis at various sites. The clinical presentations and imaging features of bone hydatidosis differ depending on the site of involvement. The first goal of this review is to distinguish the radiographic features of bone hydatidosis in various bones. The second goal is to help radiologists understand the incidence of hydatid bone disease at various sites and to recognize the clinical manifestations through imaging features. Consideration of both the clinical and radiologic characteristics can help radiologists to diagnose hydatid disease of bone.

Hydatid bone disease of the humerus: A case report from East Africa

Skeletal hydatidosis is extremely rare and involvement of the long bones of the appendicular skeleton is exceptional. We report on a case of a 68-year-old Ugandan woman who presented with a long standing history of a non-healing fracture of the mid-diaphysis of the right humerus. She had undergone multiple surgeries in peripheral health centres during the previous years. A shoulder disarticulation was carried out in our facility in agreement with the patient, who refused any other attempt of bone reconstruction. A diagnosis of hydatid bone disease was confirmed intra-operatively. There is no recurrence of the disease for a two-year follow-up period. To our knowledge this is the first case report of skeletal hydatosis in Uganda. It emphasises the diagnostic difficulties and delays, and how this led to inadequate management for the patient in this case.

Intraosseous Hydatid cyst of sacrum and pelvic bone. An Uncommon Occurrence

Skeletal hydatidosis results from deposition of the larval form of the Echinococcus, a genus of tapeworm. The incidence of bone disease is extremely low as most larvae are trapped by the liver and lung upon release of the embryo into the portal blood stream. Bone hydatid disease is often asymptomatic and its diagnosis is usually made at an advanced stage when lesions have become extensive. The interpretation of imaging studies can prove very confusing as there are no characteristic features and this often leads to misdiagnosis. We present a case of a 83 year-old man who was admitted to BPKIHS, Dharan complaining of pain and swelling in left hip.CT scan showed lytic lesion in sacral vertebra involving left sacroiliac joint and ilium and was falsely diagnosed as tuberculosis or neoplastic in nature. The result of FNAC concurred on an unexpected diagnosis of a hydatid cyst. This case illustrates that in the absence of high index of suspicion for echinococcal infection, imaging findings of hydatid disease in bone mimic to those of other skeletal pathologies and can lead to misinterpretation.

Masquelet’s induced membrane technique for the treatment of bone hydatid disease.

Bone Hydatid disease is a rare entity even in endemic areas. Insidious symptoms onset is due to progressive infiltration of the parasite into bony tissues. The frequent pseudo-tumoral presentation of bone parasitosis made its surgical treatment closer to carcinologic procedures. We report a case of hydatid disease of the femur managed in two-steps induced membrane surgical technique. Keywords: Hydatid cyst; femur; surgical technique.

Bone Hydatid Disease with Long Term Follow-Up: A Case Report

Introduction: Hydatid cysts of bones may develop in any part of the body, however, they are usually found in the liver and lungs. The primary localization of the cysts in bone is not common. Case Presentation: In this paper, we report the case of a 58-year-old man who was admitted complaining of leg pain. He had undergone hydatid cyst surgery several times over the past years. Conclusions: The patient had surgical removal of the hydatid cyst along with chemotherapy before and after surgery. The patient did not report any problem in a two-year follow-up after his last surgery.

Hydatid masquerade: A case of hydatid disease of the hip joint

Hydatid disease of the bone represents about 1–2.5% of all human hydatid disease. Hydatid disease of bone is uncommon. We present a rare case of echinococcal infection of pelvis which presented as painful limp in the left lower limb with selling in the inguinal region.

Hydatid disease: a 2 years retrospective study in a tertiary care center in South India

Background: Hydatid disease (HD) is a common parasitic zoonosis and its mortality, morbidity, and socioeconomic burden makes it a significant public health problem. Though a primary disease of liver (55-70%) followed by the lung (18-35%) it is now found to affect various other organs like spleen, kidney, peritoneal cavity, skin and muscles (2%) heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast, and bones (1%). This study is done to describe the spectrum of presentation of hydatid disease in India. Author also discuss the rare cases of soft tissue and bone hydatid disease and peritoneal hydatid disease in this study.Methods: It was a retrospective observational study done in a tertiary care center in India. Data was collected from patients admitted with diagnosis of hydatid disease from the patient data files and included patient profile, area of residence, occupation, history of exposure to farm animals or dogs, investigation findings and management given. Special emphasis was given to cases of extrahepatic hydatid disease and their management. The collected data was tabulated.Results: Author found 17 cases of documented hydatid disease in the two years period. This included 11 case of hepatic hydatid disease and 6 cases of extrahepatic disease with unusual locations of bone and soft tissue, lung and parietal peritoneum. The majority of patients were in the age group of 30-50 yrs with history of exposure to sheep and farm animals. All patients received 4-6 weeks of 15mg/kg/day albendazole preoperatively. Five patients showed regression in size of the cyst and were hence continued on medical management.Conclusions: The remaining patients underwent surgical drainage procedure. Albendazole was continued post operatively for next 6 months.

Treatment of Hydatid Disease of the Tibia by Using Poly-Methyl Methacrylate (PMMA) Bone Cements, Clinical Results of a Case Series

Introduction: Bone is an uncommon site of involvement in hydatid disease; with the prevalence of 0.5-2% among bone lesions. Case Presentation: In this study, we report the treatment of 5 cases of hydatid disease of tibia by curettage of the lesion; wash with Betadine lotion and hypertonic saline and filling the cavity with poly methyl metacrylate (PMMA) bone cement. After operation, we continued treatment with oral mebendazole for 6 months. Conclusions: With the average 89 months follow-up, no recurrence of the diseases was found in the patients. It seems that using of cement and oral anti-parasitic, after extensive resection of the lesion is a proper treatment of bone hydatid disease.

Surgery or radiotherapy for the treatment of bone hydatid disease: a retrospective case series

Currently, there is no accepted treatment for inoperable bone hydatid disease where medical treatment has proved ineffective. Alternative treatment strategies are therefore urgently needed. Radiotherapy may constitute a treatment option, but there is currently a lack of adequate evidence. This study sought to retrospectively assess the efficacy and safety of surgery or radiotherapy in the treatment of bone hydatid disease in patients attending a single hospital in China. This was a retrospective case series analyzing clinical data from consecutive patients treated between January 2000 and December 2011. Patients with an Echinococcus sp infection were counselled about their disease and the potential treatment options, and made an informed decision between surgery and radiotherapy. All patients were followed up. The treatment outcome was observed in the two treatment groups based on the frequencies of relapse and complications, and self-evaluated patient satisfaction. Of 40 patients (age range 25-57 years), 24 opted for surgery and 16 for radiotherapy. Relapse occurred in 14 patients (58%) post-surgery and in three patients (21%) post-radiotherapy. Bone defects, limb movement disorders, and pain were reported in seven patients (29%) post-surgery, while two patients (13%) reported hardening of the irradiated region or a limb after radiotherapy. Titres of parasite-specific antibodies decreased significantly after radiotherapy but not after surgical intervention. Patient satisfaction was significantly higher in the radiotherapy group. This retrospective case series describes, for the first time, the clinical outcomes in a series of patients treated with radiotherapy for bone hydatid disease. Although no direct comparison between the treatment groups could be made due to methodological limitations of the study design, this study indicates that well-designed prospective randomized controlled clinical trials assessing radiotherapy may be warranted in patients with inoperable hydatid disease of the bones.

Update on Human Bone Hydatid Disease

Hydatid disease is public health problem worldwide causing considerable health and economic loss. The disease may develop in almost any part of the human body. Bone involvement is often asymptomatic and diagnosis is primarily based on radiographic findings. Bone hydatidosis is less frequent than primary hydatidosis of the visceral organs. The localization of hydatid cysts in the bones has been little studied and so there is inadequate information in literature on the subsequent disease evolution from primary hydatidosis. We present a detailed review on hydatidosis of the bony skeleton particularly of patients who normally seek medical attention late. The review underlines the difficulties of diagnosis and treatment of bone hydatid disease and its variants that may be currently under-/mis-diagnosed in disease endemic areas. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider the disease(s) as a differential diagnosis in cases of multiple abnormal activities in bones especially among middle aged and elderly people in endemic areas. Bone hydatid disease treatment and management is delicate, expensive and risky and in most cases reccur at some point. We therefore advocate for improved active methods of disease prevention in endemic areas.

A Cystic lesion in Fibula: Hydatid Cyst

A 32-years-old man presented with right posterior calf pain for 4 months duration. He had not any important event in his history. Routine blood parameters were normal. Plain X-ray images of right culf showed advanced cystic, expansile and destructive lesion which was centered at distal fibula. Diagnosis of hydatid bone disease is difficult and depends primarily on clinical, radiologic, and serologic findings. Disease should be suspected in cystic lesions affecting the bone, especially in endemic areas, as it may easily be misdiagnosed

Hydatid disease of bones – Imaging spectrum

Hydatid cyst, caused by echinococcus granulosa, can produce tissue cyst everywhere in body. Skeletal cystic lesion is rare specially in long bones like femur and because of its unusual presentation, its diagnosis may easily be missed, unless be kept in mind. Hydatid disease is a parasitic infestation of the humans that can practically affect any part of the body. It commonly affects liver, lung and muscles. Bone hydatid is less common occurring in only 0.5–2% of cases and humans act as an intermediate host. In the patient evaluated by us, the plain x-ray showed multiple osteolytic lesions along the lower one third of the femur and the upper end of tibia. There was also cortical destruction of the joint surfaces that is seen with involvement of the joint. USG revealed a well-defined anechoic cystic lesion in the region of the calf in the substance of gastrocnemius muscle with fine septation and fine echogenic debris in the dependent part. MRI further provided data on the involvement of bone marrow and the extent of the disease. In the second patient, there was hydatid affection of the sacrum and spinal canal. The diagnosis was confirmed on tru-cut biopsy from the affected bone. Primary hydatid disease is a very rare entity and can be seen without evidence of any other visceral involvement. Cautious suspicion of the disease and early diagnosis is important for the management.

Radiation treatment of bone hydatid disease

Objective Explore the efficacy that radiation (6WV-X-ray) treat bone hydatid disease.Methods Establish seventy gerbils bone hydatid disease animal models which were randomly divided into four groups,one group was to be control group,the animal models in other three groups were given 40 Gy/5 times,50 Gy/5 times,60 Gy/5 times,6MV-X-ray positioning radiotherapy,3 months later(the end of radiotherapy),to observe the gerbils,general situation,to compare the mortality of scolex,protein and calcium concentration in capsule fluid,to observe the pathological changes of the horny layers and germinal layers,the varying of the bone cells in the irradiation areas and the ultrastructure of echinococcus granulosus cysts.Results Over the past 3 months,gerbils in each group has death cases,but the survival ones,general behaviors were normal.Among the groups,the difference of the mortality of scolex(such as Control group:22.6,40 Gy/5 times group:96.6,50 Gy/5 times group:131.5,60 Gy/5 times group:155.5) was statistically significant (P ＜ 0.01).Protein concentration (calcium ion concentration) in cyst fluid decrease (increase) with irradiation doses increase,The protein (calcium) concentrations are such as-the control group:1.0241 (2.8875),40 Gy/5 time group:0.7245 (3.0541),50 Gy/5 times group:0.6171 (3.5446) Gy to 60 Gy/5 times group:0.5058 (3.8241),which comgpared among each group there were significant differences(P ＜ 0.01).Histopathological results showed that echinococcus sac in the treatment groups showed different degrees of degeneration or necrosis,which compared with control group there were significant changing.Compared between 40 Gy and 50 Gy group,40 Gy and 60 Gy group,the pathological changes of echinoccus sac were significant difference (P ＜ 0.01),but between 50 Gy and 60 Gy group the pathological changes is not obvious (P ＞ 0.05).The bone cells of the irradiated groups have been varying degrees of degeneration or necrosis.By electron microscopy,with the irradiation doses increase,the horny layers and germinal layers have been varying degrees of damage.Conclusion Radiation therapy is effective for bone hydatid disease,but need to select the appropriate radiation dose according to the actual situation,to prevent the occurrence of irreversible osteonecrosis. Key words: Bone echinococcosis ; Model, animal; Radiotherapy

Recurrent primary hydatid disease of the tibia.

Hydatid disease is caused by a cestode, Echinococcus. Its intermediate hosts are herbivores but humans can be accidental hosts. Hydatid disease is endemic in some parts of America, Australia, the Mediterranean region, Central Asia, and Central and Eastern Europe. The organs most frequently affected by Echinococcus are the liver and the lungs. Primary involvement of the skeleton is rare. Cases have been reported in the vertebrae, pelvis, humerus and femur. The location of hydatid cysts in the tibia is rarely described in the medical literature. We, herein, report a case of primary hydatid cyst of the tibia presenting with a pathologic fracture simulating benign bone cystic lesion. The diagnosis of hydatid bone disease was not suspected preoperatively. This case emphasizes the importance of considering hydatid disease in the differential diagnosis of cystic bone lesions, especially in individuals coming from regions where the disease is endemic.

Composite Treatment for Primary Long-bone Hydatidosis

Hydatid disease is a parasitic tapeworm infection caused by the Echinococcus species. Involvement of the long tubular bones is rare in hydatid bone disease. Patients are initially asymptomatic and usually present at a later stage of the disease when the bony lesions are extensive. Diagnosing bone hydatid disease is challenging, even in endemic regions, and a high index of suspicion is required because the radiologic findings often mimic other bone pathologies. Recurrence following treatment can occur after a long period of quiescence.This article describes a case of hydatid disease in a 62-year-old woman with extensive diaphyseal tibial involvement. She was treated with initial chemotherapy followed by extended curettage, polymethylmethacrylate cementation, and intramedullary fixation. Functional outcome was excellent, with no recurrence at 60-month follow-up. She was fully weight bearing with no pain or discomfort and had full hip, knee, and ankle range of motion.This case was important due to its rarity, the diagnostic challenge it presented, and the composite nature of the treatment used to avoid recurrence. Diaphyseal bone hydatidosis can be initially treated like a low-grade malignant tumor with curettage and high-speed burring, followed by filling the defect with polymethylmethacrylate cement. The composite treatment of chemotherapy with the surgical protocol described offers a reasonable chance of long-term disease suppression. Recurrent disease can be treated with repeat curettage and cementation. Wide excision with reconstruction of the resulting defect should only be considered for recalcitrant diaphyseal hydatid disease.

Treatment of Chronic Osteomyelitis Secondary to Hydatid Disease of Bone Using Gentamycin Beads

Hydatid disease of bone is rare. It remains asymptomatic over a long period. It is usually detected after a pathological fracture or secondary infection or following the onset of compressive myelopathy in cases of vertebral lesions. Secondary infection of hydatid disease of bone could be difficult to treat. The authors present a case of chronic osteomyelitis of the proximal aspect of the left femur in a 37-year-old male patient secondary to hydatid disease of bone. It was treated by aggressive debridement, gentamycin beads, and bone graft to fill the defect. No recurrence of the hydatid lesion or infection was detected after 2 years. This case showed that in addition to aggressive debridement, gentamycin beads may be valuable in eradicating the infection in such a case.