Hydatid Disease Of Bone Research Articles

Kyste hydatique vertébral primitif à extension médiastinale postérieure compliquée d’une paraplégie

The vertebrae are the most common localization of hydatid disease of bone. This can lead to fatal consequences.We report the case of a 40-year-old-man, from a rural area, who had symptoms of medullary compression. The diagnosis of primary vertebral hydatid cyst, already suspected on the imaging data, was confirmed. A right posterolateral thoracotomy allowed drainage of the cyst and relief of the medullary compression. Medical treatment with albendazole was continued for 4 months. The postoperative course was uneventful and the symptoms of medullary compression resolved progressively. No recurrence was observed during a follow-up of 24 months.Vertebral localization of hydatid disease is the most common and serious skeletal complication. Thoracotomy allows drainage of the cyst and the pleural cavity, and relieves the medullary compression.

Hidatidosis osea primaria de tibia. presentación de un caso

Primary hydatid disease of the tibia. Hydatidosis is an endemic disease in different parts of the world. Its causal agent is the cestode from the genus Echinococcus. The most commonly affected organs in humans are liver and lung. Bone hydatid disease is a very rare entity, accounting for 0.5 to 4% of total cases. We report a case of a 58 year-old woman from La Rioja, Argentina, who consulted for left infapatellar pain and walking disability of eight months duration. Imaging studies showed a cystic lesion which involved metaphysis and diaphysis of left proximal tibia. Surgical resection was performed and histopathological study confirmed that it was a hydatid cyst. The patient did well and completed three cycles of treatment with albendazole. Currently, she has no evidence of disease and she recovered motility of her left leg. Primary hydatid bone disease, where there is no evidence of systemic disease, is even more unusual. Tibia involvement occurs in up to 15% of the cases. These lesions clinically manifest when they suffer any type of complications. Preoperative diagnosis is mainly made by imaging studies. Lesions are usually osteolytic and can involve cortical bone and extend to soft tissues. Differential diagnosis with inflammatory processes and bone tumors should is mandatory. Treatment is surgical and prognosis is poor due to its high morbi-mortality rate and recurrence risk from 70 to 80%.

Hydatid Disease of the Femur with an Extraosseous Extent due to a Former Biopsy Complicated by a Pathological Fracture

Hydatid disease of the bone represents about 1–2.5% of all human hydatid disease. Spine is the most affected part of the skeleton with 50% incidence of all bone hydatidosis. Extraspinal bone hydatidosis is much rare. Diagnosis is difficult in the bone hydatid disease. Bone tumors, tumor-like lesions, and specific and nonspecific infections should be considered in the differential diagnosis. Radiological, laboratory, and clinical findings combined with strong element of suspicion are the key for diagnosis. Bone biopsies should be avoided because of the danger of anaphylaxis, sensitization, and spread. This paper describes the management of a patient with primary hydatidosis of the femur, which had been complicated by an extraosseous involvement, cortical erosion, and a pathological fracture due to a former needle biopsy.

Literature review and clinical presentation of solitary hydatid cyst in the tibia presenting with pathologic fracture

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 solitary 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. Our 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.

A healed echinococcus pathological femoral shaft non-union—A case report and a literature review

Hydatid disease is prevalent throughout much of the world, mainly in the developing world and unprivileged areas. There are twelve subtypes of Echinococcus known today. However, in humans there are two main types of infection—Echinococcus multilocularis causing alveolar and Echinococcus granulosus which causes the cystic echinococcosis. The incidence of bone disease, caused by echinococcus is rare as only 0.5–4.5% of cases of echinococcosis have bony involvement. Primary hydatid disease of bone, is caused by E. granulosus, occurs when a bloodborne scolex settles in bone. In bone involvement, pericyst formation of the echinococcus does not occur, thereby allowing aggressive proliferation in an irregular branching fashion along the line of least resistance, especially the bone canals. When this proliferation causes damage severe enough to create a compromise in the solidity of the bone, a pathological fracture may occur. However, very few reports deal with the treatment of pathological long bone fractures, especially as the sole presentation of the echinococcus usually with a grim outcome. We present a case of a pathological femur fracture non-union caused as an isolated bony infection of echinococcus, treated successfully with serial debridements, antibiotics and fixation with a locked plate construct.

Pelvic bone hydatidosis

Bone hydatid disease is a rare pathology, characterized by its long clinical latency, the absence of radiological specificity as well as its challenging surgical treatment. We report an observation of pelvic bone hydatidosis in a 28-year-old patient, appearing with pain and stiffness of the hip as well as a degenerative aspect on the coxofemoral joint on X-ray. The treatment consisted of an extensive hemipelvectomy with femoro pelvic arthrodesis, completed by medical treatment. The functional result was excellent in spite of a break in the fixation material, which allowed a certain mobility at the proximal end of the femur. Hydatid disease of bone is infiltrating,diffuse, slow, and progressive, all characteristics explaining the often-delayed diagnosis. Medical imaging provides accurate analysis for planning a broad surgical resection. The quality of surgical resection is determined according to the risk of recurrence. Pelvic locations are particularly difficult to treat. After an enlarged and difficult surgical resection, reconstruction remains aleatory and poses many technical problems.

Bone Hydatid Disease Refractory to Nitazoxanide Treatment

We report a patient with bone hydatid disease that was refractory to both long-term daily treatment with albendazole, combined with cimetidine or administered as monotherapy ( approximately 15 years) and a relatively short course of nitazoxanide combined with albendazole (3 months). Despite continuous daily medical treatment, bone invasion and destruction proceeded. His pain and disability progressively increased.

Static intramedullary nailing as final treatment of pathological femoral fracture secondary to contaminated primary hydatid cyst: a case report and review of the literature

Echinococcosis (hydatid cyst disease) in humans is a rare parasitic disease that primarily involves the liver and the lungs. Skeletal manifestation of the disease is seldom and often presents as a clinical and radiological problem. The contamination of the primary hydatid cyst complicates the treatment which is also difficult because of the invasive nature of bone involvement and the spillage of fluid with subsequent contamination seeding. We present a case of pathological femoral fracture secondary to contaminated primary hydatid cyst that has been finally treated with static intramedullary nailing. We highlight the importance of including the hydatid bone disease in the differential diagnosis of destructive bone lesions, and we suggest the intramedullary nailing as the final treatment of specific type of pathological fractures.

Hydatid Bone Disease: A Case Report and Review of the Literature

Hydatid disease may develop in almost any part of the body and can be identified with a combination of clinical history, imaging findings, and serologic results; however, the diagnosis of bone hydatidosis is primarily based on radiographic findings. Bone hydatid disease is often asymptomatic, and its diagnosis is usually made at an advanced stage when lesions have become extensive. We present a case of a 45-year-old woman who was admitted to the University Hospital, Stara Zagora, Bulgaria complaining of pain in her left tibia. Radiographs revealed an oval cyst with a diameter of 3.5 cm, located in the diaphyseal part of the tibia. The cyst was excised, and no recurrence was observed on follow-up. Functional outcome was excellent.

Kyste hydatique de la diaphyse fémorale traité par l’association chirurgie, sérum hypertonique et albendazole: Hydatid disease of the femoral shaft treated with surgery and hypertonic solution wash-out combined with albendazole

We report a case of pathological fracture of the femoral shaft in a patient presenting a diaphyseal hydatid cyst. Surgical treatment consisted in wide resection followed by washout using a 20% hypertonic saline solution and nail plate fixation. Albendazole was given as adjuvant treatment. Postoperatively, the patient developed rhabdomyolysis with local superinfected necrosis which required early revision to remove the material. At twenty-two months, the local and general course was satisfactory. The pathological fracture healed and no secondary localization could be identified. Echinococcosis serology remained negative. The surgery-hypertonic solution-albendazole combination appears to be an attractive therapeutic solution for bone hydatid disease.

Hydatidose osseuse : étude de 11 cas

Introduction. – Osseous hydatid disease is defined as development within bone of multiple cysts that are the larval form of the tapeworm Echinococcus granulosus. Bone cysts account for only 0.5 to 2.5% of all hydatid cysts in humans. We report on our experience. Methods. – This retrospective study included patients managed between 1988 and 1998 for histologically documented hydatid disease of bone. Results. – Eleven patients were included, 6 men and 5 women, with a mean age of 40.7 ± 11.04 years (range, 27–60 years). Mean time to diagnosis was 22.7 ± 18.2 months (range, 5–36). The pelvis was involved in 6 patients and a long bone in 5 (the femur in 3, the tibia in 1 and the fibula in 1). Peripheral eosinophil counts were high in 4 patients and serological tests for hydatid disease were positive in 5 patients. Surgical treatment was used alone in ten patients and with albendazole in 1 patient. The main complications were fistulization ( n = 6) and suppuration ( n = 4). Five patients experienced recurrences. Conclusion. – Hydatid disease still occurs in Morocco. The liver and lungs are the most common targets. Bone cysts are uncommon but severe. the behavior of osseous hydatid cysts resembles that of locally malignant lesions. Although immunofluorescent assays are useful, the final diagnosis depends on histology. The treatment rests on surgical excision. Recurrence is common, particularly at sites that are difficult to access.

Hydatid disease of bone: Review of 11 cases

Osseous hydatid disease is defined as development within bone of multiple cysts that are the larval form of the tapeworm Echinococcus granulosus. Bone cysts account for only 0.5–2.5% of all hydatid cysts in humans. We report on our experience. Methods. – This retrospective study included patients managed between 1988 and 1998 for histologically documented hydatid disease of bone. Results. – Eleven patients were included, six men and five women, with a mean age of 40.7 ± 11.04 years (range, 27–60 years). Mean time to diagnosis was 22.7 ± 18.2 months (range, 5–36). The pelvis was involved in six patients and a long bone in five (the femur in three, the tibia in one, and the fibula in one). Peripheral eosinophil counts were high in four patients and serological tests for hydatid disease were positive in five patients. Surgical treatment was used alone in 10 patients and with albendazole in one patient. The main complications were fistulization ( n = 6) and suppuration ( n = 4). Five patients experienced recurrences. Conclusion. – Hydatid disease still occurs in Morocco. The liver and lungs are the most common targets. Bone cysts are uncommon but severe. The behavior of osseous hydatid cysts resembles that of locally malignant lesions. Although immunofluorescent assays are useful, the final diagnosis depends on histology. The treatment rests on surgical excision. Recurrence is common, particularly at sites that are difficult to access.

The use of polymethylmethacrylate in the management of hydatid disease of bone.

Hydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human hydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.

The use of polymethylmethacrylate in the management of hydatid disease of bone

Hydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human shydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.

Hydatid disease of bones and joints. 8 cases followed for 4-16 years.

Hydatid disease is a rare parasitic disease that seldom involves the skeleton. Treatment is difficult because of problems with the preoperative diagnosis, the invasive nature of the bony involvement and the variable anaphylactic reaction to the cyst fluid antigen. We present 8 cases with osseous hydatidosis who were treated over a period of 11 years. The spine was involved in 2 cases, the ilium in 2, the hip in 2, the tibia in 1 and the humerus in 1. We point out that diagnosis is difficult and the prognosis is often poor.

The value of plain film findings in hydatid disease of bone

The radiographic features of hydatid disease of bone have been reviewed in 16 Kuwaiti patients. The majority of the lesions were in the lower limb or pelvis, and the commonest presentation was with a pathological fracture. The radiological signs seen most often were lucent lesions in the bone, associated with expansion of the bone and thinning of the cortex. In patients with these signs soft tissue calcification appeared to be highly suggestive of hydatid disease. The disease was diagnosed before operation in only half the patients. In areas where the disease is endemic hydatid disease should be suspected when the lesions described are seen on plain films.

Hydatid Bone Disease of the Pelvis

Hydatid disease is caused by a parasitic tapeworm Echinococcus. This parasite in larval stage can thrive in many parts of the body, most frequently in the liver. Hydatid disease in bone is rare, but in areas where hydatid disease is endemic, it must always be considered in the differential diagnosis. Two cases of hydatid bone disease of the pelvis are reported. The treatment of choice is a combination of chemotherapy and surgery.

Radiographic and computed tomographic findings in hydatid disease of bone

Twenty-six patients with hydatid disease of bone were evaluated by means of radiography and conventional tomography. Fourteen patients underwent high resolution computed tomography (CT). In two patients with vertebral disease, magnetic resonance imaging (MRI) examination was also performed. Seventeen patients underwent surgery with histological examination in all. Based on the surgical data and gross examination of the specimen, the radiographic and CT findings have been reviewed to identify the most characteristic radiographic features and to assess the role of CT. Radiographic finding of hydatidosis are rarely typical in bone, and only in a few patients can CT contribute to the diagnosis. On the other hand, the local extension of the lesion both in bone and in soft tissues, which is essential in planning surgery, is always demonstrated well by CT.

Hydatid disease of bone

Twenty cases of hydatid disease of bone revealed by X-ray examination are presented. The vertebrae were involved in 12 of the cases, the pelvis in four, both the vertebrae and the pelvis in one, the ribs in two and the femur in one. These cases constituted 1.3% of all cases of hydatid disease observed in our hospital during the period 1957-80. The features of the disease are discussed in terms of plain radiographs, myelography and tomography. Tomographic studies have proved of value in differentiating the disorder from other diseases.

THE MANAGEMENT OF HYDATID DISEASE OF BONE AND JOINT

1. Twelve cases of hydatid disease of bone seen in Kuwait over the last ten years are reported. Ten of the twelve patients were Bedouins. 2. Seven cases were followed up and the results of treatment are discussed. 3. Curettage, formalin swabbing and bone grafts were used as the treatment of choice. 4. There may be a place for a conservative approach in some cases ; one such case reported here has been followed up for ten years. 5. The problem of prevention, especially in a Bedouin area, is briefly discussed.