Diagnosis Of Pulmonary Hydatid Disease Research Articles

Cytological Diagnosis of Pulmonary Hydatid disease by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Cyst Fluid.

*Pathology Department, ABVIMS and Dr RML Hospital, New Delhi †Respiratory Medicine Department ABVIMS and Dr RML Hospital, New Delhi Disclosure: There is no conflict of interest orother disclosures

Computed tomography diagnosis of pulmonary hydatid disease

Pulmonary hydatid disease is a helminthic zoonotic disease caused by Echinococcus infection. The symptoms may appear several years after infection. Chest computed tomography (CT) is the preferred examination method and plays an important role in early diagnosis, treatment, and prognosis evaluation. CT can be used to diagnose simple cystic lesions. However, when the cysts are infected or ruptured, atypical imaging findings such as increased cyst density, blurring of the cyst wall, and surrounding exudation may lead to misdiagnosis of lung infection or lung abscess, hindering the therapeutic effect. We analyzed and compared the atypical imaging manifestations of pulmonary simple hydatid disease and hydatid cyst rupture. The aims of this report are to improve clinicians' understanding of these diseases, promote early diagnosis and treatment, and reduce the occurrence of complications.

PULMONARY HYDATIDOSIS- STILL UNRECOGNIZED IN ENDEMIC REGIONS: A 10 YEAR REVIEW.

Background. Echinococcus disease in still endemic in many low-middle-income countries, with 1 million people infected at any one time. Surgery, the mainstay of its treatment, is costly. Objectives. To describe the presentation, clinical features and outcomes of children referred with pulmonary hydatid disease at Inkosi Albert Luthuli Central Hospital in Durban, South Africa. Methods. A 10-year review of children with pulmonary hydatid disease at Inkosi Albert Luthuli Hospital was carried out. The data collected were demographic, clinical, laboratory and radiological. Cases were mapped geographically to analyse for clustering of cases. Spearman’s correlation was used to assess for correlations between laboratory markers. Results . A total of 24 subjects, 75% of whom were male, were included. The mean (standard deviation) age at diagnosis was 8.9 (3.4) years. The mean delay in diagnosis was 5.8 (5.7) months. Of the subjects, 15 (71.4%) were from the Eastern Cape and 9 from KwaZulu-Natal provinces. Seventy-nine percent of the patients had been exposed to dogs, while 8% reported exposure to either sheep or cattle. There was right-sided preponderance, with 11 right- and 7 left-sided cysts; 6 patients had bilateral cysts, and 4 associated extrapulmonary cysts. Indirect haemagglutination assay was positive in 70%, and blood eosinophilia was present in 45% of the subjects, with no correlation between the two markers ( p =0.22). Surgery was the only modality of treatment in 18 (75%) subjects, while 5 had had prior medical therapy for disseminated disease. The mean intensive care stay postoperatively was 2 (2) days with no mortality. Conclusion. Despite exposure to known risk factors and living in endemic regions, there is often a significant delay in diagnosis of pulmonary hydatid disease at Inkosi Albert Luthuli Hospital.

Water lily sign and serpent sign in pulmonary hydatid cystic disease

The teaching image depicts sections of CT chest showing water lily sign and serpent sign. In the diagnosis of pulmonary hydatid disease, these signs are pathognomonic, these must be corroborated clinically, and early interventions should be done to avoid rupture of cysts leading to complications.

OUTCOME OF CAPITONNAGE IN MANAGEMENT OF PULMONARY HYDATIDOSIS

Background Pulmonary hydatidosis is an endemic disease in Iraq. The treatment of choice for pulmonary hydatid disease (PHD) is surgical. The the aims of surgery are evacuation of cyst contents, closure of bronchial openings, and prevention of intra-operative soiling. The management of residual cyst cavity is controversial and the majority of surgeon recommend leaving the cavity open. However, others prefer to close it by capitonnage. Objectives The objective of this study was to assess the outcome and safety of capitonnage in surgery of pulmonary hydatid cyst and comparing our results with the relevant literature. Patients and Methods Seventy two patients with diagnosis of PHD (simple or complicated) admitted to our institution from November, 1 st 2010 to July, 1 st 2013. The demographic and clinical features were recorded. Diagnostic work-up was clinical, plain chest X-rays aided by CT scan of the chest and bronchoscopy in doubtful cases. Serological tests were not done routinely. In all patients the residual cavity of the cyst was closed by capitonnage using a series of purse-string Vicryl sutures from the bottom outwards. Results The cysts were intact in 38 patients (52.17%) and ruptured in the remaining 34 (47.83%). lung parenchyma preserving techniques were used in all patients except one (1.4%) who had lobectomy. All patients run a smooth postoperative course except five (6.9%) who developed prolonged air leak (n=1), empyema (n=2), empyema and pneumothorax (n=1) and one case of recurrence (1.4%). There was no mortality. Conclusions The results of capitonnage procedure in this series were superior to studies in which the cyst cavity was left open with lower complication and reoperation rates.

Pulmonary hydatid disease is difficult recognized in children.

Pulmonary hydatid disease is a significant health problem for children in endemic areas. Pulmonary hydatid disease is more frequent than hepatic hydatid disease in children. The aim of this study was to evaluate the characteristics of pulmonary hydatid disease for children in our province which is endemic for echinococcosis. This study was performed retrospectively between 2007 and 2012 by reviewing the medical records of patients (≤17 years) who were diagnosed with pulmonary hydatid disease. The medical records of these patients were evaluated with respect to the demographic characteristics of patients, management strategies, length of hospital stay, and outcomes. A total of 120 (52.9% boys and 46.3% girls) patients with the diagnosis of pulmonary hydatid disease were enrolled in this study. The mean age was 10.15 ± 3.93 years. The significant numbers of patients were admitted with a ruptured hydatid disease and managed with lung preservation. The mean follow-up was 11.3 ± 3.8 (3-24) months. Recurrence was detected in three patients during follow-up. Pulmonary hydatid disease is usually symptomatic. Hydatid disease must be considered in differential diagnosis while evaluating thoracic lesions in endemic areas.

Invasive aspergillosis associated with pulmonary hydatid disease

A patient presented with a cavitating lung lesion. Serology and sputum microscopy led to the diagnosis of pulmonary hydatid disease. However, histology of the operative samples revealed aspergillosis in the cavity and surrounding lung tissue. This is the first report of invasive aspergillosis occurring as a consequence of spontaneous hydatid cyst rupture.

Pulmonary Echinococcosis with Chest Wall Involvement in a Patient with no Apparent Risk Factors

Pulmonary hydatid disease is rare in the U.K., and chest wall involvement has to our knowledge not previously been described in this country. We report the case of a 72-year-old man who was found to have a left upper lobe opacity on his chest radiograph. He declined further investigation at the time, but 2 years later developed a palpable mass over his left lateral chest wall. Fine-needle aspiration-biopsy of this mass revealed the diagnosis of pulmonary hydatid disease. Despite thorough questioning, no risk factor could be identified for the development of the disease. Hydatid disease should be remembered as a rare cause of mass lesions identified on chest radiographs even in non-endemic regions. Spread to the chest wall may mimic malignancy.

Pulmonary hydatidosis in children.

In the years 1963-1991 inclusive, 88 patients were operated on with a diagnosis of pulmonary hydatid disease. The cysts were intact in 69 and infected in 19 cases. It was possible to use a surgical technique that preserved the pulmonary parenchyma in 67 patients. In this technique, the cavity after removal of the mother membrane is left open and only the air leaks are sutured. Continuous postoperative drainage of the residual cavity and the ipsilateral hemithorax always resulted in complete inflation of the affected lung. Enucleation of the endocyst and extended resection of the sclerotic pulmonary parenchyma were performed in 15, enucleation and obliteration in three, lobectomy in two and Barrett's method was applicable in one patient. A bronchopleural fistula developed in 11 patients postoperatively and in four of these cases a second thoracotomy was necessary. Postoperative empyema developed in four cases. There were two postoperative deaths in the series. Eighty-six patients were symptom-free in the long-term postoperative follow-up. We conclude that in the surgical management of the disease it should not be necessary to obliterate the residual cavity with extensive suturing which always leads to extra fibrosis with loss of viable pulmonary parenchyma.