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Savu C, Melinte A, Grigorie V, Iliescu L, Diaconu C, Dimitriu M, Socea B, Stiru O, Varlas V, Savu C, Balescu I, Bacalbasa N. Primary Pleural Hydatidosis-A Rare Occurrence: A Case Report and Literature Review. ACTA ACUST UNITED AC 2020; 56:medicina56110567. [PMID: 33121083 PMCID: PMC7694107 DOI: 10.3390/medicina56110567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
Introduction: The larvae of Echinococcus, a parasitic tapeworm, cause hydatid disease. The most commonly involved organ after the liver is the lung but there are cases of hydatid cysts in all systems and organs, such as brain, muscle tissue, adrenal glands, mediastinum and pleural cavity. Extra-pulmonary intrathoracic hydatidosis can be a diagnostic challenge and a plain chest x-ray can be misleading. It can also lead to severe complications such as anaphylactic shock or tension pneumothorax. The purpose of this paper is to present a severe case of primary pleural hydatidosis, as well as discussing the difficulties that come with it during diagnosis and treatment. Case Report: We present the case of a 43-year-old male, working as a shepherd, presenting with moderate dyspnea, chest pain and weight loss. Chest x-ray revealed an uncharacteristic massive right pleural effusion and thoracic computed tomography (CT) confirmed it, as well as revealing multiple cystic formations of various sizes and liquid density within the pleural fluid. Blood work confirmed our suspicion of pleural hydatidosis with an elevated eosinophil count, typical in parasite diseases. Surgery was performed by right lateral thoracotomy and consisted of removal of the hydatid fluid and cysts found in the pleura. Patient was discharged 13 days postoperative with Albendazole treatment. Conclusion: Cases of primary pleural hydatidosis are very rare but must be taken into consideration in patients from endemic regions with jobs that may have exposure to this parasite. Proper treatment, both surgical and antiparasitic medication, can lead to a full recovery and a low chance of recurrent disease.
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Affiliation(s)
- Cornel Savu
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumophtisiology, 050152 Bucharest, Romania; (C.S.); (A.M.); (V.G.)
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
| | - Alexandru Melinte
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumophtisiology, 050152 Bucharest, Romania; (C.S.); (A.M.); (V.G.)
| | - Vasile Grigorie
- Department of Thoracic Surgery, “Marius Nasta” National Institute of Pneumophtisiology, 050152 Bucharest, Romania; (C.S.); (A.M.); (V.G.)
| | - Laura Iliescu
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Department of Internal Medicine, “Fundeni” Clinical Institute, 022328 Bucharest, Romania
| | - Camelia Diaconu
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Mihai Dimitriu
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Department of Obstetrics and Gynecology, “Sf. Pantelimon” Emergency Clinical Hospital, 021661 Bucharest, Romania
| | - Bogdan Socea
- Department of Surgery, “Sf. Pantelimon” Clinical Hospital, 021661 Bucharest, Romania;
| | - Ovidiu Stiru
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Department of Cardiovascular Surgery, “Prof. Dr. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Valentin Varlas
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Department of Obstetrics and Gynecology, “Filantropia” Hospital, 011171 Bucharest, Romania
| | - Carmen Savu
- Department of Anesthesiology, “Fundeni” Clinical Institute, 022328 Bucharest, Romania;
| | - Irina Balescu
- Department of Visceral Surgery, “Ponderas” Academic Hospital, Bucharest, 021188 Bucharest, Romania;
| | - Nicolae Bacalbasa
- Internal Medicine Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (L.I.); (C.D.); (M.D.); (O.S.); (V.V.)
- Center of Excellence in Translational Medicine, Department of Visceral Surgery, “Fundeni” Clinical Institute, 022328 Bucharest, Romania
- Correspondence: ; Tel.: +40-723-540-426
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