Left Lower Limb Research Articles

Lemierre’s Syndrome – Case Report of a 20-Year-Old Male with Post-Anginal Sepsis

<b>Introduction:</b> Lemierre’s syndrome, first described by André Lemierre in 1936, is a rare but life-threatening condition. It is characterized by a triad of symptoms: pharyngeal infection, internal jugular vein thrombosis, and sepsis with distant abscesses, usually in the lungs. The primary pathogen is the anaerobic Gram-negative bacterium <i>Fusobacterium necrophorum</i> (<i>F. necrophorum</i>). In recent years, there has been an increase in the incidence of Lemierre’s syndrome.<b>Case report:</b> A 20-year-old male was admitted to the Emergency Department (ED) with jaundice, dyspnea, sore throat, fever up to 39C, neck pain, and left lower limb weakness. Examination revealed enlarged palatine tonsils with purulent exudates and a right-sided peritonsillar abscess. Laboratory tests showed elevated inflammatory markers, thrombocytopenia, and leukocytosis. Computed topography (CT) confirmed internal jugular vein thrombosis, abscesses in the right sternocleidomastoid muscle, and bilateral pleural effusions. The patient received oxygen therapy, antibiotics, anticoagulation, and pleural drainage. After 26 days of hospitalization, he was discharged with a recommendation to continue antibiotic therapy and low-molecular-weight heparin, as well as planned removal of the palatine tonsils (tonsillectomy).<b>Discussion:</b> Lemierre’s syndrome is a severe complication of upper respiratory tract infections, mainly affecting young individuals. Symptoms include pharyngeal infection, sepsis, and internal jugular vein thrombosis. Early diagnosis and appropriate treatment, including prolonged antibiotics and sometimes anticoagulation, are crucial. The rise in incidence may be linked to the irrational use of antibiotics. Educating clinicians is vital to improve outcomes and reduce complications.<b>Conclusions:</b> Initial symptoms of Lemierre’s syndrome are nonspecific, complicating early diagnosis. Neck imaging and/or positive blood cultures are key for diagnosis. The incidence is 1–2.5 cases per million annually, making it rare but potentially fatal. Mortality before antibiotics was around 90%; currently, it is 5–18%, but higher without proper diagnosis. Early imaging significantly improves prognosis.

Functional and Radiological Outcome of Simultaneous Bilateral Total Knee Replacement in a Tertiary Care Centre : A Quasi-prospective Study.

Osteoarthritis (OA) is the most frequent joint disease with a prevalence of 5313 per 100,000 persons in India. OA of the knee is a major contributor to mobility impairment, particularly among women. In these patients, total knee replacement (TKR) is widely accepted as the gold standard treatment for pain relief and restoration of function. Now, patients have the option of undergoing either a simultaneous bilateral TKR or a staged TKR. The former has shown significant advantages such as shorter rehabilitation, cost efficacy and shorter hospital stay. This study aimed to assess the functional and radiological outcome of simultaneous bilateral TKR in a tertiary care centre. 30 adult patients above the age of 55 years with severe OA knee who underwent simultaneous bilateral TKR between 2022-2023 were included in this prospective study. Preoperatively, they were assessed with radiographs including full length scannograms. Mean Anatomical Axis, Mean Mechanical Axis and Mechanical Axis Deviation (Varus) were calculated based on the scannograms by a single observer. The same observer administered the oxford knee score (OKS) preoperatively to all patients. Regular clinical and radiological follow up was done. After 1 year follow up, the same observer administered the Oxford Knee Score (OKS) to the operated knee. With a female preponderance among the study subjects (56.7%), the majority of the cases in our cohort were characterised as Grade IV Kellgren-Lawrence radiological grade of Osteoarthritis (76.66%) and were found to have tricompartmental involvement (70%). The mean anatomical axis for the right and left lower limb were 4.56±5.17 and 9.68±1.72 respectively. The mean mechanical axis deviation (Varus) for the right and left lower limb were 31.6±15.1 and 52.0±13.9 respectively. Preoperatively, mean mechanical axis for the right and left lower limb were 9.95±4.31 and 14.2 ±0.67 respectively. Postoperatively, mechanical axis was restored to near-normal values (3-5 degrees). Significant improvement in mean OKS from a preoperative value of 18.30 ± 3.46 to postoperative value of 33.50 ± 5.32 was noted at 1 year. Treatment of severe bilateral OA knee with simultaneous single staged bilateral TKR ensures good functional outcome , early mobility with minimal complications.

Ocular sequelae following snakebite envenomation

Abstract We report the case of a 33-year-old male patient who developed ophthalmoplegic symptoms following a viper snakebite. The patient presented with complaints of ptosis, blurred vision, and diplopia following a snakebite on his left lower limb. Clinical examinations revealed signs of envenomation, including local swelling and tenderness, alongside ocular manifestations such as limited extraocular movements and alternating exotropia. Blood investigations showed elevated white blood cell count and urinary abnormalities. The objective of this case report is to present the characteristic findings and management of this rare manifestation of a viper snakebite.

Epidemiological Profile and Awareness Regarding Animal Bite Management in an Urban Area.

The most common way for people to contract the deadly zoonotic disease rabies is through animal bites. This study was designed because there is a shortage of community-based data to determine the true extent of rabies infection and a lack of understanding regarding patient misconceptions in urban areas. The objective was to determine the scope of the issue and the epidemiological features of animal bite incidents. This was a facility-based cross-sectional study conducted at the field practice area (Urban Health Training Centre) under the Department of Community Medicine, Government Medical College. The study duration was one year (May 2023 to April 2024). Consecutive patients (accompanied by an attendant) attending the Urban Health Training Centre were included in the study. A purposive sampling technique was used, and around 400 animal bite cases were recorded in one year at the Urban Health Training Centre. Out of 1503 male cases at the Urban Health Training Centre, around 255 were dog bite cases (50.6%), whereas out of 1302 females visiting the Urban Health Training Centre, around 145 were dog bite cases (48%). The majority (35%) belonged to the age group of 11 to 20 years for both males and females. The mean age of the cases was 19.4 ± 3.4 years. The study found a male preponderance (64%), with females constituting 36%. The right lower limb (49.5%), left lower limb (39%), and upper limb were the most frequently bitten sites. Fifty-one percent of the cases fell into Category II. According to local data, the most popular home management practices were ghee oil and cold treatments. Although Category III is the most severe bite, only 35% had taken the anti-rabies vaccine (ARV), and 8.75% had received rabies immunoglobulin. The public and medical community need to be made aware of the importance of wound care and the prudent use of the anti-rabies vaccine.

Could exhaled methane be used as a possible indicator for hemodynamic changes in trauma induced hemorrhagic shock? Scientific basis supported by a case study

IntroductionIdentification of severe blood loss and hemorrhagic shock in polytrauma patients poses a key challenge for trauma teams across the world, as there are just a few objective parameters, on which clinicians can rely. We investigated the relationship between exhaled air methane (CH4) concentration and blood loss in a polytrauma patient. Decreased blood flow in the superior mesenteric artery (SMA) is one of the first compensatory responses to blood loss. Gases produced by the anaerobic flora of the intestinal segment supplied by the SMA are the primary source of exhaled CH4, which diffuses through the intestinal microvessels into the circulation and is finally eliminated through the lungs. We hypothesized that diminution of exhaled CH4 indicates blood loss and tested our theory in a severely injured patient. MethodsExhaled CH4 concentrations of a severely injured patient were measured using a photoacoustic spectroscope (PAS) attached to the exhalation side of the breathing circuit. The primary objective was to investigate the relationship between exhaled CH4 and conventional indicators of hemorrhage including hemoglobin (Hb) levels, base deficit (BD) values and vital parameters (heart rate and systolic blood pressure) in the early phase of in-hospital care (first 4 h). ResultsA severely injured patient was admitted with unstable hemodynamic parameters and incomplete left lower limb amputation, (Injury Severity Score: 38, 74/36 mmHg, 76 bpm). At the time of arrival, considerably lower CH4 levels were detected (22,800 PAU) in the exhaled air. During the first 4 h fluid and massive blood resuscitation, the exhaled CH4 levels were continuously rising in parallel with Htc and Hb values. Corresponding to these changes, BD values displayed a decreasing tendency. DiscussionOur study was conducted to characterize the changes in exhaled air CH4 concentration in response to hemorrhagic shock and to provide data on a viable clinical use of an experimental technique. According to our results, the real-time detection of exhaled air CH4 concentration is an applicable and promising technique for the early detection of bleeding and hemorrhagic shock in severely injured patients. Further research on large sample size and refinement of the PAS technique is required.

Multifocal linear morphea - a rare presentation with rapid progression and deformities in a young adult: a case report

Morphea or localized scleroderma, is an uncommon skin disorder characterized by skin thickening and hardening. This case report describes a late 20s married woman working at a spinning mill, who presented with a unique and rare manifestation of morphea. Over two years, she developed a linear black color thickening of the skin on her right upper limb, left lower limb, and abdomen, accompanied by deformities and functional impairments. The patient reported a rapid progression of hyperpigmented lesions and weakness, prompting medical consultation. Cutaneous examination revealed distinctive hyperpigmented, atrophic plaques with xerotic changes and flexion deformities. A biopsy from the chest confirmed localized scleroderma. Basic investigations were within normal limits. The patient was managed with weekly pulse therapy involving corticosteroids, resulting in some relaxation of skin tightness. This case highlights the importance of recognizing and promptly treating rare multifocal morphea presentations to prevent severe deformities and enhance the patient's quality of life. Long-term follow-up is essential to monitor treatment outcomes and disease progression.

Mycobacterium marseillense bloodstream infection combined with skin fungal infection: a case report and literature review

BackgroundNon-tuberculous mycobacteria (NTM) are present widely in the natural environment and can invade the human body through the respiratory tract, gastrointestinal tract, and skin. Immunocompromised patients are particularly prone to infection, which primarily affects multiple organs, including the lungs, lymph nodes, and skin. However, cases of NTM bloodstream infections are rare. Here, we report a rare case of Mycobacterium marseillense bloodstream infection with concurrent skin fungal infection in a patient after kidney transplantation. Related literature was reviewed to enhance the understanding of this rare condition.Case presentationA 58-year-old male with a history of long-term steroid and immunosuppressant use after kidney transplantation presented with limb swelling that worsened over the past two months. Physical examination revealed redness and swelling of the skin in all four limbs, with a non-healing wound on the lower left limb. Skin tissue analysis by metagenomic next-generation sequencing (mNGS) and fungal culture indicated infection with Trichophyton rubrum. Blood culture results suggested infection with Mycobacterium marseillense. After receiving anti-NTM treatment, the patient’s symptoms significantly improved, and he is currently undergoing treatment.ConclusionMycobacterium marseillense is a NTM. Gram staining suffered from misdetection, and the acid-fast staining result was positive. This bacterium was identified by mass spectrometry and mNGS analyses. Antimicrobial susceptibility tests for NTM were performed using the broth microdilution method. The results of the susceptibility test showed that Mycobacterium marseillense was sensitive to clarithromycin, an intermediary between moxifloxacin and linezolid. Bacterial clearance requires a combination of drugs and an adequate course of treatment. NTM bloodstream infections are relatively rare, and early identification and proactive intervention are key to their successful management.

Injury of the superficial femoral artery and posterior tibial artery associated with an atherectomy device.

Rotational atherectomy can offer a viable treatment for occlusive peripheral artery disease; maintaining the minimal invasiveness of an endovascular procedure, while allowing for a more complete lesion debridement compared with balloon angioplasty. This case report outlines a complication of guidewire entrapment associated with rotational atherectomy in the superficial femoral artery (SFA). A 57-year-old male underwent an atherectomy with Rotorex for left lower limb foot pain. During the procedure, the guidewire was suctioned into the atherectomy device, preventing any further advancement of the device and damaging the SFA and posterior tibial artery (PTA). The atherectomy device was withdrawn and a new vascular access site was gained in the left PTA. A covered stent was inserted to treat the original SFA lesion, and balloon angioplasty was used to repair the device-induced damaged to the PTA. While guidewire complications have been previously reported, this case report details the first reported case, to our knowledge, of guidewire entrapment while using a rotational atherectomy device. Knowledge of this possible complication of rotational atherectomy can aid in clinical decision making when choosing between treatments for peripheral vascular disease.

Draft genome sequence of Acinetobacter haemolyticus strain MUWRP1017 isolated from the pus of a female inpatient at Bwera General Hospital in Uganda.

The bacterium Acinetobacter haemolyticus, with a genome size of 3.4 Mb, was isolated from a pus swab of a wound on the left lower limb above the ankle joint of a female patient. This strain carries the antimicrobial resistance genes cephalosporinase blaADC-25, oxallinase blaOXA-264, floR, and sul2 and other resistance and virulence genes.

Covered stent combined with embolization treatment for complex congenital lower limb arteriovenous malformations: case report and literature review

BackgroundCurrently, the treatment outcomes for complex congenital arteriovenous malformations (AVMs) remain unsatisfactory. This article reports on the utilization of an abdominal aortic stent graft, in conjunction with embolization techniques, for managing acute heart failure triggered by complex congenital arteriovenous malformations in the lower limb.Case PresentationWe present a case involving a patient with congenital AVMs in the lower limb, who had suffered from prolonged swelling in the left lower limb and recently developed symptoms of heart failure. At the age of 67, the patient was definitively diagnosed with a complex congenital AVMs in the lower limb. This article delves into the practical experiences and limitations encountered in employing an abdominal aortic stent graft, coupled with embolization, to address acute heart failure caused by complex congenital AVMs in the lower limb.ConclusionsOur article presents the initial report on the challenges and limitations encountered in treating acute heart failure triggered by complex congenital AVMs in the lower limb, utilizing a combination of abdominal aortic stent graft placement and embolization techniques.

Enhancing Quality of Life in Venous Ulcer Patient with Irsal-e-Alaq (Hirudotherapy): A Case Report

Background: In general practice, venous ulcers (stasis ulcers) are the most common and recurrent leg ulcers. Ignorance of it can have a severe detrimental effect on one's quality of life, cause gangrene, and even the limb amputation. Venous ulcers are the most dangerous and disabling side effect of chronic venous insufficiency. Leech therapy seems to be effective for the treatment of varicose ulcers due to its salivary secretions which it injects during bloodsucking. The saliva of leeches contains certain biochemical with vaso-dilating, anticoagulant, anesthetic, thrombolytic, antibiotic, analgesic, and anti-inflammatory properties. As a result, Irsal-e-Alaq (Hirudotherapy), one of the Unani regimens, can effectively control it. Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) on venous ulcers. Intervention: A 60-year-old male has a complaint of ulceration in his left lower leg near the medial malleolus with swelling, pain, discharge, and darkening of the skin of the left lower limb. Four leeches were applied once every week for 2 months. Efficacy of leech therapy was assessed on every 15th day by pain /leg discomfort on 4 point scale ranging from 0-3, limb girth at calf, ankle & foot, pigmentation color on 4 point scale, pigmentation area, pain in ulcer on 4 point scale from 0-3, ulcer depth, PUSH Score. Hb% was assessed every 15th day to check anemia, colour flow Doppler was done to assess any change in vein anatomy. Result: In this case report, the ulcers were completely healed, and also showed remarkable improvement in other variables. Conclusion: Irsal-e-Alaq has been proven beneficial in treating venous ulcers and enhancing patient’s quality of life. Keywords: Venous ulcer, Hirudotherapy, Unani Medicine, Pain, Pigmentation.

Haemodynamic study of left nonthrombotic iliac vein lesions: a preliminary report

Nonthrombotic iliac vein lesions (NIVLs) are significant causes of chronic venous insufficiency (CVI) in the left lower limb and symptom recurrence following left lower limb varicose vein treatment. The goal of this study was to explore the haemodynamic and morphological characteristics of iliac veins in patients with NIVLs. Pressure at the caudal end of the stenotic left common iliac vein (LCIV) segment, local blood flow velocity, and time-averaged wall shear stress in the stenotic segment exhibited positive correlations with the clinical CVI classification (R = 0.92, p < 0.001; R = 0.94, p < 0.001; R = 0.87, p < 0.001), while the relative retention time showed a negative correlation (R = -0.94, p < 0.001). The pressure difference (∆P) between the two ends of the stenotic segment and the velocity difference (∆V) between the stenotic segment and the caudal end were positively correlated with the clinical classification (R = 0.92, p < 0.001; R = 0.9, p < 0.001). The cross-sectional area stenosis rate and length of the stenotic LCIV segment were positively correlated with the clinical classification (R = 0.93, p < 0.001; R = 0.63, p < 0.001). The results suggest that haemodynamic assessment of the iliac vein could effectively portray blood flow disturbances in stenotic segments of the LCIV, potentially reflecting the degree of iliac vein stenosis. Haemodynamic indicators are correlated with the severity of clinical CVI symptoms.

Management of Kampavata (Parkinson’s Disease) through Panchakarma: A Successful Case Study

Introduction Parkinson’s disease (PD) affects the central nervous system and is primarily characterized by the degeneration of dopamine-producing cells in the substantia nigra. Early signs include tremor, rigidity, bradykinesia, and postural instability, with later cognitive, sensory, sleep, and emotional issues. Ayurveda correlates these symptoms with Kampavata, primarily linked to Vata (bio-entities) imbalance. The prime aim of this paper is to study Panchakarma’s efficacy in managing Kampavata (PD). Case Presentation This is a case presentation of a 55-year-old male patient who has experienced tremors in the left upper and lower limbs, numbness in the left lower limb, loss of balance for 10 years, abnormal facial expression (masked face), difficulty in speech, and sleep disturbance for 5 years. The patient was treated with Panchakarma therapy for 30 days. Results Following treatment, the patient exhibited significant improvement in symptoms, assessed using the PD composite scale, with the total score decreasing from 68 to 19, along with evaluated by specific examination, bradykinesia test, reflexes, functional activities, and clinical features also notably improved. Discussion Panchakarma therapy, rooted in Ayurvedic principles, shows promise in managing Kampavata, associated with PD. Conservative management focuses on Vata balance, which offers substantial comfort and enhances patient quality of life. Conclusion Panchakarma therapy presents a potential avenue for treating Kampavata, addressing symptoms associated with PD, and improving patient satisfaction and well-being. Further research is warranted to validate these findings and explore the broader applicability of Ayurvedic approaches in neurodegenerative conditions.

Use of VAC System and Dermal Matrix as a Surgical Alternative for Lower Extremity Degloving Treatment

Introduction: Soft tissue degloving injuries are the result of high-energy forces that produce compression, twisting or friction of tissues causing soft tissue avulsion, in which a large portion of skin and subcutaneous tissue is detached from the underlying fascia and muscles with musculocutaneous damage and perforating fasciocutaneous vessels. Case Report: The case of a 67-year-old female patient was reported, who as a result of a traffic accident (run over) suffered cutaneous loss (degloving) of the left lower limb. The patient underwent surgical cleaning with debridement of dead tissue plus full-thickness skin autograft for partial coverage of the exposed area in the proximal region. At the same time the surgery was performed, the VAC system was placed. After multiple surgical cleanings, scarce granulation tissue was revealed in the middle and distal third of the left leg. Therefore, it was decided to cover the exposed area with dermal matrix for later definitive coverage. The patient is being followed up by outpatient service. It is revealed that the patient already performs assisted mobility, and the grafts are assimilated. Conclusions: Traffic accidents are a major problem worldwide, especially those of high-energy may require multidisciplinary treatment, prolonged surgical time until recovery and return to daily activities. The initial treatment for degloving has to be performed by trained professionals since the criterion for assessing flap vitality is indispensable. When complex skin grafts are not an option, advanced wound treatment should be used, as in this case, where VAC therapy and permanent synthetic substitute were used for the total coverage of a major defect with lost dermal tissue.

Giant Atypical Spindle Cell Lipomatous Tumor of Retroperitoneal Origin Presenting with Lung Metastasis and Extension to the Thigh: A Case Report with Literature Review

AbstractRetroperitoneal liposarcomas are rare, and their variants, atypical spindle cell lipomatous tumor (ASCLT), are rarer. Though ASCLTs are benign, they have high recurrence despite complete surgical excision. We present a rare case of a 22-year-old male presented with insidious-onset, and gradually progressive swelling over left inguinofemoral, and iliac fossa region. Also, the patients had a history of weight loss, pricking-type pain radiating to left lower limb, and breathlessness on exertion. Contrast-enhanced computed tomography (CECT) abdomen revealed a large well-defined heterogeneously enhancing soft mass located in pelvis, and involving left-sided iliopsoas muscle suggestive of retroperitoneal soft tissue sarcoma and CECT thorax showed metastasis. The CT-guided core biopsy led to the definitive diagnosis of low-grade ASCLT. Subsequently, the patient was initiated on concurrent neoadjuvant chemoradiotherapy followed by complete surgical excision. The findings in this report make it critical to enhance our understanding of this rare tumor, with surgery being the best treatment option.

Modified cervical laminoplasty in occipital-cervical junction meningiomas: case report and technical note

This article presents a case study of a 64-year-old female patient diagnosed with a meningioma located at the occipital-cervical junction (OCJ). The patient presented with neck pain and radiating pain in the left upper and lower limbs, and was diagnosed with meningioma through imaging studies. We utilized a modified minimally invasive surgical technique to successfully remove the tumor, along with performing a modified cervical laminoplasty (MCL). Postoperatively, the patient's neurological function improved, and there was no tumor recurrence during a 4-years follow-up. In this case, a modified minimally invasive surgical technique was employed, which differs from the traditional surgical approach for skull-base meningioma in several aspects. This technique may improve the postoperative quality of life for the patient and provide valuable reference for similar cases.

Outpatient regenerative therapy of a chronic diabetic foot ulcer with exposed bone surface

BACKGROUND: Treatment of deep chronic wounds with the bone tissue involvement against the background of lower limb atherosclerosis and diabetic foot syndrome does not fit any reasonable hospital stay duration and at the same time has no effective outpatient methods. Therapy with conditioned medium derived from human mesenchymal stem cells (CM-MSC) may be a solution for this problem. CLINICAL CASE DESCRIPTION: Patient F., 77-year-old, arrived for an outpatient treatment of local necrosis in the area of the 1st toe of the left foot in April, 2022. The main diagnosis: Peripheral arterial disease of the lower extremities. Multifocal atherosclerosis. Occlusion of the superficial femoral and popliteal arteries, diffuse lesions of the lower leg arteries on the left. Chronic arterial insufficiency of the 4th degree. Attempts of revascularisation of the left lower limb. Limited gangrene (Wagner IV) of the 1st toe of the left foot. Associated diseases: insulin-dependent type 2 diabetes mellitus (for more than 30 years). Diabetic polyneuropathy. Diabetic foot syndrome, neurotrophic form. Local treatment was performed by the microsurgical debridement of the affected surface in combination with the method of multilayered dressings, according to the previously patented technology. The microsurgical treatment of the bone surface in the wound area was carried out with the use of CM-MSC. Positive dynamics in the form of a partial closure of the bone fragment with soft tissue was observed on the sixth month of therapy. The complete closure of the open bone fragment was observed in 12 months from the beginning of the outpatient treatment. CONCLUSION: The developed method of treatment using CM-MSC can be effective for chronic wounds with open bone surfaces.

Biomechanical factors associated with patellofemoral pain in children and adolescents

To investigate the biomechanical factors associated with patellofemoral pain in children and adolescents. A cross-sectional, population-based study conducted in Brazil from 2019 to 2023, involving students from public schools. Adjusted prevalence ratios and their respective 95% confidence intervals for the outcome in relation to independent variables were calculated for association analysis, adopting a significance level of 5%. Out of the total of 283 students, 152 were female and 182 were aged between 16 and 18 years old. A positive association was observed between the presence of patellofemoral pain and a poor movement quality in both lower limbs (right side: p = 0.04 and left side: p = 0.04) as well as with dynamic valgus of the left lower limb (p < 0.01). Patellofemoral pain in children and adolescents is associated with poor movement quality in the lower limbs and dynamic valgus of the left lower limb. Actions targeting these biomechanical factors may be crucial for early diagnosis and clinical treatment of this disfunction.

Surgical treatment of localised pelvic lymphocyst infection after radiotherapy for endometrial cancer

Endometrial cancer is mainly treated clinically by surgery, supplemented by postoperative radiotherapy. Pelvic and abdominal lymph node dissection is usually an important part of surgery, and one of the most common postoperative complications is lymph node cysts. Infection of cysts is very rare in clinical practice and can be cured mainly by anti-infection and puncture drainage. However, in this case, the patient was found to have a pelvic abscess due to radiating pain in the left lower limb, and the infection of the local lymphocyst was found to have formed a pelvic abscess, and laparoscopic open drainage was performed after puncture drainage with no improvement in symptoms. The patient recovered after surgery.

Systemic Complications of an Exceptional Case of Ruptured Left Intra-Ventricular Hydatid Cyst in a Child

Cardiac involvement in hydatid disease is exceptional but has a formidable prognosis. Cardiac localization of hydatidosis exposes to the dissemination of vesicles in the systemic circulation, especially when it is located on the left side. Its treatment is essentially surgical, which helps to avoid complications and the spread of the disease. We report the case of a 13-year-old patient with no particular pathological history, hospitalized for an ischemic stroke and limb ischemia, who was found to have a mass at the apex of the left ventricle on transthoracic cardiac ultrasound. The diagnosis of hydatid cyst was strongly suggested by the discovery of hydatid cyst membranes during the anatomopathological examination of the operative samples from the surgical thrombectomy of the left lower limb. Cardiac magnetic resonance imaging showed a mycotic aneurysm, while serology for hydatid disease was negative. A medical treatment based on albendazole was initiated, but the patient died in a context of multi-visceral failure postoperatively after the cardiac mass excision performed under extracorporeal circulation.